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Book Review: A Brain Wider Than the Sky by Andrew Levy

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A non-sufferer’s sympathy and empathy both fail to provide access to the pain of a migraine, much like a migraineur's (migraine sufferer's) use of metaphor fails to adequately describe these “nerve storms in the brain” to a non-sufferer. Andrew Levy, author of A Brain Wider Than the Sky, will immediately identify this article as written by a non-sufferer, a perceptive quality that has also allowed him to recognize the onset of migraine attacks in other sufferers. This is no magic trick. For over 40 years Levy has suffered from what Lewis Carroll, author of Alice In Wonderland, called his “bilious headache”, and it is within this diary that Levy juxtaposes personal records with a solid history of the migraine.

The International Headache Society (IHS) classifies migraines into various subsets, ranging from migraine without aura (code G43) to migraine induced seizure (code G43.3). A sufferer can experience all variances within a lifetime due to the shifting nature of what is coldly defined as a neurological syndrome. The triggers or migraine generators can be anything from the smell of detergent to a long haul flight, and the attack can last minutes, hours and months. Levy documents the mind-boggling 'cures' and remedies that have been tested over the centuries, including the Bahamian treatment of wearing two live frogs until they are dead and the horrific medical intervention known as Trepanation.

Trepanation or trepanning is one of the oldest surviving medical procedures still practised today. Examination of prehistoric skulls date the procedure as far back as the 7th Millennium BC. Trepanning commonly involved drilling or scraping holes into the skull to expose the dura mater, a thick membrane that carries and drains blood from the head towards the heart. Aretaeus of Cappadocia (1st Century CE), as Levy points out, “instructed fellow physicians to 'scarify unsparingly' — cut and cut and cut — then 'excise a portion of the arteries,' the ones 'discovered by their pulsations.'” Surgeons still use the procedure, albeit modified, to treat hematomas and also to gain access to the brain. Thankfully, it is no longer considered a viable treatment for migraineurs.

Our modern perception of migraine treatment is dominated by prescriptive medication, but drugs have always been a primary alleviant. Opiates, quinine and arsenic during Victorian times, and later tricyclic anti-depressants, Vicodin, Topamax, Imitrex and Frova would become available to the modern migraineur. Herbal remedies also gained in popularity, such as henbane and belladonna, and less worrying infusions of “coriander, opium, wormwood, juniper and honey.” Levy prescribes himself a humdrum course of steam, tea and ice pack, yet there seems to be a logic in this application of hot and cold extremes, maybe because the mind has to focus on something else other than the migraine. Applying pressure to the pain also has easing qualities, as Levy's son demonstrates on the numerous occasions he wraps himself around his Father's head.

Throughout the diary Levy is careful not to fall into the trap of romanticizing the 'syndrome', but this is difficult when you have a star-studded cast of literary, scientific and musical figures who have promulgated hemicrania, as it was once called. Virginia Woolf, Sigmund Freud, Karl Marx, Friedrich Nietzsche and Elvis Presley all suffered from migraines and experienced the aura that precedes the pain phase. The aura or visual phase is linked with creativity, the development of Migraine art, and can consist of blackouts, hallucinations and field of view distortions. In fact, the migraine is linked with creativity full stop, somehow the altered state of conciousness allowing new perspectives to be known. But let us not be fooled, for an attack will debilitate a migraineur with little advance warning and any painting or poem becomes irrelevant when you can barely see.

The personal aspects of the migraine diary uncover the possibility that the condition is inherited, and Levy provides accounts to establish this. Levy “got migraines from his mother, who got migraines from her mother,” and his brother is also a migraineur. Levy also communicates how intrinsic the migraine becomes over time as the sufferer jostles, rails against, is subdued by and ultimately accepts the 'nerve storms' as part of life. So much a part of Levy's life that he names his son Aedan, after Saint Aed, curer of headaches.

There is a well established network of support for migraine sufferers, and this comes as no surprise considering it is more prevalent than diabetes, asthma and epilepsy combined. It is of no help that the condition is stigmatised by the language of classification and the inability of a non sufferer to truly comprehend the painful experience of an attack, which is why A Brain Wider Than the Sky is required reading for both migraine sufferer and non sufferer.

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  • Brian

    This touches on a subject (migraines) that is of a topical importance to me. I enjoyed the review, and have added this book to my future reading list.

  • As a migraineur, I spend an amazing amount of time trying to find the trigger to each attack. The term “nerve storms” really captures the event and these storms range from mild summer showers to hurricane force winds. This is one book I will buy – perhaps to gain some insight about my condition and also – to find some solace in knowing others feel the need to record their symptoms in a pain diary like I do. Migraines control life and turn the strong and vibrant into pitiful lumps.