The English cartoonist James Gillray drew a famous panel titled “The Gout.” The wordless image showed a naked human foot, bitten by a tiny demon. How would he illustrate “Headache”? Years ago, my wife and I saw a modern dance piece called “The Garden of Earthly Delights,” based on paintings by Hieronymus Bosch. At one point a man engaged in a pointless, maniacal struggle with another jammed his opponent’s head up against one side of a bass drum, and pounded the other side. That might do.
My wife suffers from migraines. I don’t, but I have seen enough of hers to bless all sufferers. The head itself seems to be infected from the inside. You don’t want to sleep, because when you wake there is no change. You are compelled to toss and turn, but tossing and turning give no relief. Pain is compounded by hopelessness. Since no one ever has just one migraine, each new one holds out the prospect of endless repetition. A migraine thrusts life into an old world and a police state, where the gates of heaven are shut against you.
This being the city, there are headache specialists to consult (until HMOs and Obamacare drive them out of business). My wife’s is a tall, serious man, originally a Soviet Jew, with an office on the Upper East Side. His waiting room is the Lourdes of migraine sufferers. Never have I seen a collection of patients so silent, so downcast. Most of them are women, proving yet again that men relieve their tensions with alcohol, violence, and meaningless sex. The wall art aims to soothe — one painting shows a grape arbor, with a red apple hanging miraculously among its fellow fruits. It is the fruit of the Tree of Relief — eat it, and you will have knowledge of Good and No More Evil. No one in the waiting room can stir herself to look at it.
This doctor’s technique is to inject the forehead, temples, and shoulders with Botox. Botox is best known as the weapon of vanity against time. If you don’t go in for nips and tucks and Chinese eyes, Botox is the other way to hold facial wrinkles at bay. After 40 we are all supposed to have the faces we deserve. And so it is of those who get themselves injected with Botox — their faces are bland, puffed, and wiped like a crashed hard drive of all the information of experience. And yet Botox can also fight migraines by paralyzing muscles that go into spasm. My wife’s doctor’s way with a needle is disconcertingly freehand — he pricks there, there, and there, like a conductor cuing pizzicato. Normally these cures last for three months; my wife’s headaches, tough customers, start creeping back after ten weeks.
No self-respecting city-dweller has only one specialist on call — that would be like knowing only one restaurant — and another doctor my wife turns to from time to time uses another technique: injecting mild anesthetic into knots of muscles called trigger points. This causes them to relax, and my wife to relax. This doctor is a merry badger, happy to discuss Bernie Madoff or other figures of the moment as he plies his healing arts. His office is near the U.N., and his waiting room, like his colleague’s, is a Pool of Bethesda, crowded with glum sufferers, despairing of either Jesus or the angel.
A third way of fighting headaches is the universal solution to all problems: Change your life. In the case of migraines, it involves changing how you walk, stand, and carry yourself. The Alexander technique is a posture program developed by an actor at the turn of the last century who found his voice going; he decided to tinker with his instrument, got his voice back, and spawned a movement. Actors and singers remain disciples to this day; my wife has found an instructor on Union Square. This is a remedy for the long haul, like fighting the jihad by promoting democracy, though it may work best in the end.
An aching head makes a new map of the city, with highlights at all the addresses where relief is to be found. It joins the sheaf of maps that show the ways to fresh vegetables, leg presses, socks, work, art, drinks, 24-hour pharmacies, and ATMs. If you copied them all together into one map it would be as dense as the Talmud.
Different circumstances appear to set migraines off, or to exacerbate them. One is the approach of rain. My wife’s barometer is her head. She can predict the weather as well as a field full of cows (standing, clear; sitting, rain); better than human meteorologists. When we see, out our apartment window, or down a vista of side street, a black cloud dragging its heavy udder along, she says, “You see that cloud? It’s inside my head.” This month, an anthology of unseasonable showers, drizzles, and downpours, has been a particular trial.
One other factor surely is the bustle of city life. The very density that supplies an array of cures creates the need for them. What the city gives with the right hand, it filches with the left. Take the background of jackhammers, ambulances, garbage trucks, barflies, cell-phone yakkers, subways taking the curve into Union Square, and barking news readers on the driver’s-seat screens in taxi cabs, and add, in the supposed refuge of your apartment, someone drilling — a molly bolt? an oil well? — in the apartment upstairs, and the clenched muscles and swollen veins of the neck and head exchange glances and say, “Time to party!”
And yet Thomas Jefferson, bard of the soil and president in a capital that, if it was better than a pigsty, was still not a real city, had headaches too. “Fits,” he called them, and they kept him in a dark room from nine to five for three weeks at a time. If he suffered what I have seen, I say let him have Sally.