| Homework 2 |
| 1 | Migraines Joan Dtdion For people who have never experienced one, it is difficult to understand what a migraine headache is. In the following essay, taken from The White Album, Joan Didion defines migraines, explains their causes and cures, and tells how she has learned to live with them. Words to Know aphasia inability to speak cerebral of or related to the brain contraindications indications that something is inadvisable contretemps embarrassing incident convalescent healing debility weakness euphoria a feeling of well-being histamine a substance used to dilate, or enlarge, the blood vessels incapacitating disabling lobotomy surgery to cut nerves in the brain predisposition a tendency or inclination vascular of the blood vessels yoga a Hindu discipline X hree, four, sometimes five times a month, I spend the day in bed with a migraine headache, insensible to the world around me. |
| 2 | 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. |
| 3 | 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. "Do you have headaches sometimes? frequently? never?" the application forms would demand. "Check one." Wary of the trap, wanting whatever it was that the successful circumnavigation of that particular form could bring (a job, a scholarship, the respect of mankind and the grace of God), I would check one. |
| 4 | "Sometimes," I would lie. That in fact I spent one or two days a week almost unconscious with pain seemed a shameful secret, evidence, not 326 Chapter 9 Definition merely of some chemical inferiority but of all my bad attitudes, unpleasant tempers, wrongthink. For I had no brain Junior, no eyestrain, no high blood pressure, 2 nothing wrong with me at all: I simply had migraine headaches, and migraine headaches were, as everyone who did not have them knew, imaginary. |
| 5 | I fought migraine then, ignored the warnings it sent, went id 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. |
| 6 | It was a long time before I began thinking mechanistically enough 3 to accept migraine for what it was: something with which I would be living, the way some people live with diabetes. Migraine is something more than the fancy of a neurotic imagination. It is an essentially her reditary complex of symptoms, the most frequently noted but by no means the most unpleasant of which is a vascular headache of blinding severity, suffered by a surprising number of women, a fair number of men (Thomas Jefferson had migraine, and so did Ulysses S. Grant, the day he accepted Lee's surrender), and by some unfortunate children as young as two years old. |
| 7 | (I had my first when I was eight. It came on during a fire drill at the Columbia School in Colorado Springs, Colorado. I was taken first home and then to the infirmary, at Peterson Field, where my father was stationed. The Air Corps doctor prescribed an enema.) Almost anything can trigger a specific attack of migraine: stress, allergy, fatigue, an abrupt change in barometric pressure, a contretemps over a parking ticket. |
| 8 | A flashing light. A fire drill. One inherits, of course, only the predisposition. In other words I spent yesterday in bed with a headache not merely because of my bad attitudes, unpleasant tempers and wrongthink, but because both my grandmothers had migraine, my father has migraine and my mother has migraine. No one knows precisely what it is that is inherited. The chemistry 4 of migraine, however, seems to have some connection with the nerve hormone named serotonin, which is naturally present in the brain. |
| 9 | The amount of serotonin in the blood falls sharply at the onset of migraine, and one migraine drug, methysergide, or Sansert, seems to have some effect on serotonin. Methysergide is a derivative of lysergic acid (in fact Sandoz Pharmaceuticals first synthesized LSD-25 while looking for a migraine cure), and its use is hemmed about with so many contraindications and side effects that most doctors prescribe it only in the most incapacitating cases. |
| 10 | Methysergide, when it is prescribed, is Migraines Joan Didion 327 taken daily, as a preventive; another preventive which works for some people is old-fashioned ergotamine tartrate, which helps to constrict the swelling blood vessels during the "aura," the period which in most cases precedes the actual headache. Once an attack is under way, however, no drug touches it. Migraine 5 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. |
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