Summary:
“All pain is simple” reads the opening sentence of
this unusual and striking book. The next sentence reads, “And all pain is
complex.” These two sentences foreshadow many puzzles to come: how do we live
between chaos and control? Why can’t doctors figure migraines out? Why don’t
they agree on a treatment for a particular
patient? Olstein is a poet and long-term migraine sufferer. Her book offers
many observations about pain, and her attempts to define it, describe it, and
plumb its nature through language. There is no linear narrative or argument,
rather 38 very brief chapters—usually three to five pages—and many of these
could be read in a different order.
Olstein uses the terms “studies” and “research” for her efforts to capture
pain, to explain it, and to understand the cause(s) of her disease. Her mother
had migraines; women have three times the rate of men; she had a childhood head
injury. Do any of these factors explain her disease? No. And what treatments
work? She lists some 50 drugs/supplements/activities she has tried to deal with
her illness. None of these have worked in a definitive way. Further, she lists
some 30 side-effects she has experienced from these various treatments (pp.
74-75). She has had multiple migraines, one lasting three months, but she also
says drugs keep pain at bay: “mostly the medication does work” (p 90).
Some disparate figures help her focus her inquiry: Joan of Arc (possibly a migraine
sufferer), the TV character Dr. Gregory House (racked with chronic pain, he is
an opioid addict), Virginia Woolf, and Hildegard of Bingen (possibly a migraine
sufferer). Also ancient writers such as Lucretius, Pliny the Elder, and
Antiphon the Sophist, and contemporaries from different fields, such as
mathematics and neurology. Also she refers to poems by Emily Dickinson,
Elizabeth Bishop, and C. D. Wright, as well as to an article on gendered literature
by Siri Hustvedt.
Largely written
during a writing residency, these are incisive notes plus associations as she
plumbs not only her illness but also her responses—as poet, as thinker, as
searcher for healing—to the bizarre, long, difficult path of her migraines. (We
have only brief mentions of her personal and family life.) While she refers to
some scientific literature, it is more often that her insights come from
artistic fields such a literature, sculpture, drama, and popular music. She
writes that her work with a therapist over a dozen years has been helpful to
her.
There is no conclusion…nor can there be. Her illness,
treatment, and writing are all works in progress. Patients are different;
doctors are different; science evolves. In their many forms and presentations,
migraines are mysterious and complex, as this book creatively and powerfully
shows. Olstein writes, “The beauty, the love, is in what we perceive” (p. 144).
We may take this observation as the guiding principle for the
book.
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