June 29th, 2022


Serena Williams' pain (and mine)

Jeff Jacoby

By Jeff Jacoby

Published May 4, 2021

I'm not normally a reader of People magazine, but I consumed every word of the story it ran last month on Serena Williams , America's mighty tennis champion.

The 23-time Grand Slam winner, I learned, had been suffering from unusually intense migraine attacks ever since the outbreak of COVID-19 forced her to spend most of her time indoors at home. Williams has struggled with migraine headaches since her twenties, but they had usually been infrequent enough, and the pain manageable enough, that they didn't disrupt her life.

But last March, the migraines grew far worse; the reason, People's story suggested, was heightened stress from the pandemic and spending too much time staring at a computer.

The story had a happy ending: Williams's doctor prescribed Ubrelvy, a migraine medication newly approved by the Food and Drug Administration, and her headaches diminished in severity.

I don't have much in common with Williams — I have yet to win my first Grand Slam, for example — but anyone who is afflicted with migraine is my sister or brother in misery and stories about their plight are apt to catch my attention.

I have been getting migraine attacks since I was 8 or 9 years old. Such attacks terrified me when I was young; I have a vivid memory of sitting in my 5th grade class, wondering if I was dying of brain cancer. I had no idea why I was suddenly struggling to see through blind spots that grew larger and larger, or why there were jagged rings of light curving around my field of vision, or why, as those weird visual phenomena gradually faded, I was experiencing such agonizing pain behind one eye.

It wasn't until I was in college that I learned I wasn't the only one to experience those tortures, and that in fact there was a name for them. Beginning in my teens, migraine attacks could persist for 12 to 15 hours, and often left me prostrated with extreme nausea.

Not infrequently, they caused me to have a kind of aphasia: I couldn't remember basic words, couldn't understand the meaning of anything I tried to read, and was incapable of stringing together even the simplest sentence. As you might imagine, that was particularly frightening for someone who makes his living with words.

Needless to say, I have tremendous compassion for fellow migraineurs. The late George Keverian, who was speaker of the Massachusetts House of Representatives from 1985 to 1991, was a migraine sufferer whose attacks were often so painful that he had to closet himself in a dark, quiet room until they subsided.

In 1989, he and fellow Democrat Richard Kraus, a state senator from Arlington, were rivals in the race for Massachusetts treasurer, and Kraus decided to make political hay of Keverian's migraine condition.

"The speaker is a man who doesn't like to say no to people," Kraus said snidely. "Someone who, at the prospect of having to say no to someone, has to run into his office with a migraine headache is not someone who can run the treasury."

I was outraged on Keverian's behalf, and rode to his defense in an editorial for the Boston Herald, where I then worked. Castigating Kraus for his "cruel and nasty ad hominem insults," the Herald condemned his "sorry performance," and said it gave the public "a good look at the bad taste of which he is capable." Take that, you insensitive ignoramus.

Over the years I've tried any number of medications to prevent migraine headaches from coming on, or to keep attacks that can't be prevented from growing too unbearable. As far as I could tell, the drugs never worked. It was age that eventually helped: Once I reached my forties, the severity of my migraines diminished. I continue to get them, and they continue to hurt like hell and wreak havoc with my vision, but very rarely now do they last more than a few hours.

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One of more renowned migraineurs in American history was Thomas Jefferson, who would sometimes suffer what he described as a "paroxysm of the most excruciating pain," which "came on every day at sunrise and never left me till sunset." Ulysses Grant was another migraine sufferer. He recalled in his memoirs that he was in the throes of an attack on the day he received Robert E. Lee's offer to surrender. It turned out to be the best treatment possible:

On the 8th [of April 1865] I had followed the Army of the Potomac in rear of Lee. I was suffering very severely with a sick headache, and stopped at a farmhouse on the road some distance in rear of the main body of the army. I spent the night in bathing my feet in hot water and mustard, and putting mustard plasters on my wrists and the back part of my neck, hoping to be cured by morning. During the night I received Lee's answer to my letter of the 8th, inviting an interview between the lines on the following morning. . . . When the officer reached me, I was still suffering with the sick headache; but the instant I saw the contents of the note I was cured.

Women are more likely to be stricken with migraine than men. Among American celebrities, Elle McPherson, Lisa Kudrow, Cindy McCain, Khloe Kardashian, and Carly ("I haven't got time for the pain") Simon are members of the migraine club. So is Joan Didion , the legendary novelist and New Journalism icon, who in 1979 published what is probably the most famous essay about migraine ever penned. It appears in her collection The White Album; here is an excerpt:

Three, four, sometimes five times a month, I spend the day in bed with a migraine headache, insensible to the world around me. Almost every day of every month, between these attacks, I feel the sudden irrational irritation and the flush of blood into the cerebral arteries which tell me that migraine is on its way, and I take certain drugs to avert its arrival. If I did not take the drugs, I would be able to function perhaps one day in four. The physiological error called migraine is, in brief, central to the given of my life. When I was 15, 16, even 25, I used to think that I could rid myself of this error by simply denying it, character over chemistry. . . . For I had no brain tumor, no eyestrain, no high blood pressure, nothing wrong with me at all: I simply had migraine headaches, and migraine headaches were, as everyone who did not have them knew, imaginary.

I fought migraine then, ignored the warnings it sent, went to school and later to work in spite of it, sat through lectures in Middle English and presentations to advertisers with involuntary tears running down the right side of my face, threw up in washrooms, stumbled home by instinct, emptied ice trays onto my bed and tried to freeze the pain in my right temple, wished only for a neurosurgeon who would do a lobotomy on house call, and cursed my imagination. . . .

Migraine gives some people mild hallucinations, temporarily blinds others, shows up not only as a headache but as a gastrointestinal disturbance, a painful sensitivity to all sensory stimuli, an abrupt overpowering fatigue, a strokelike aphasia, and a crippling inability to make even the most routine connections.

When I am in a migraine aura (for some people the aura lasts fifteen minutes, for others several hours), I will drive through red lights, lose the house keys, spill whatever I am holding, lose the ability to focus my eyes or frame coherent sentences, and generally give the appearance of being on drugs, or drunk.

The actual headache, when it comes, brings with it chills, sweating, nausea, a debility that seems to stretch the very limits of endurance. That no one dies of migraine seems, to someone deep into an attack, an ambiguous blessing. My husband also has migraine, which is unfortunate for him but fortunate for me: perhaps nothing so tends to prolong an attack as the accusing eye of someone who has never had a headache.

"Why not take a couple of aspirin," the unafflicted will say from the doorway, or "I'd have a headache, too, spending a beautiful day like this inside with all the shades drawn." All of us who have migraine suffer not only from the attacks themselves but from this common conviction that we are perversely refusing to cure ourselves by taking a couple of aspirin, that we are making ourselves sick, that we "bring it on ourselves." . . .

There certainly is what doctors call a "migraine personality," and that personality tends to be ambitious, inward, intolerant of error, rather rigidly organized, perfectionist. "You don't look like a migraine personality," a doctor once said to me. "Your hair's messy. But I suppose you're a compulsive housekeeper."

Actually my house is kept even more negligently than my hair, but the doctor was right nonetheless: perfectionism can also take the form of spending most of a week writing and rewriting and not writing a single paragraph. . . .

[W]hen the pain recedes, ten or twelve hours later, everything goes with it, all the hidden resentments, all the vain anxieties. The migraine has acted as a circuit breaker, and the fuses have emerged intact. There is a pleasant convalescent euphoria. I open the windows and feel the air, eat gratefully, sleep well. I notice the particular nature of a flower in a glass on the stair landing. I count my blessings.

If you're not prone to migraine attacks, count your blessings and be grateful not to know what they are like. And if you do get migraines, I can only say that you have my deepest sympathy. I truly feel your pain. Several times a month, and for hours at a time.