Throughout my life I’ve had occasional debilitating headaches. I worried when I was younger that it was something more serious than migraines, because every so often I’d hear a colleague say something like, I’ve got a migraine today. No fun! and I’d think, well, whatever I’ve got going on isn’t migraines because there’s no way I’d be continuing to work or posting on social media if I had a migraine. My thing must be something else.
But it was not something else. For me it starts as a normal headache, which feels like I’ve got on a ski cap that’s a size too small. The most common cause is caffeine disruption: I’ve had more caffeine than usual over the past week, and then a day comes on which there’s a sudden drop in caffeine intake. There can be other causes: altitude, lack of sleep, smoke-filled environments. All the things that would give a normal person a headache.
If I notice early on, I can “head it off” by taking Excedrin (which contains caffeine), or by taking a brief nap, or by putting a cold pack on my forehead. But if I don’t catch it in time, or even sometimes if I do, it will turn into something worse.
Nausea appears. This isn’t I-ate-something-spoiled nausea, which originates in the stomach; it’s a spinning feeling that radiates from the head. It starts small, like there’s a spinning top in there sending out signals that my internal gyroscope is just a degree or two off from the direction of gravity. This feeling is the last available exit ramp; if I can’t stop it now, then it can’t be stopped, and it goes on to feel like I’m on one of those wild fairground rides, like the earth is spinning off its axis.
Then I start to vomit. This is the most miserable point of the ride, because the nausea is in full force. I am hunched over a toilet, and the vomiting isn’t just a polite tilt-and-spill into a bucket, like pouring out the overfill from a cup of coffee at Starbucks, but rather is a kind of violent shouting, and it continues long after there’s nothing left to give. It’s like my body is trying to expel my organs, like whatever this thing is that has taken hold of me won’t be satisfied until my lower intestine has been pushed out of my mouth. This part lasts about half an hour. I’m not able to talk while this is happening; I can only lie on the bathroom floor, moaning.
A few times in my life I have been unlucky enough to experience this in shared spaces. Once on a bus in New Jersey, where I used my coat as a makeshift bucket to vomit into. Once while trying to summit Mount Rainier, where altitude sickness sent me vomiting and moaning all the way down Disappointment Cleaver while the guide probably thought I had lost my mind. Once at a job in a warehouse that was attached to a building with long, labyrinthine hallways and rooms that stored a lot of unused furniture (why, I don’t know) and where I curled up on the floor in the dark behind a fancy wardrobe-type thing covered in a tarp, leaving the rest of the staff to wonder where I had gone (“Where the hell have you been?”). And once on my first day of a temp job where I shout-vomited into a toilet in the office bathroom – they must have heard me – and then stumbled out of the office onto the streets of Boston afterward. On the questionnaire sent over by the temp agency, where it asked how I had performed on my first day at the job, they had simply entered a question mark.
When I left the temp-job office, I went to the emergency room. Doctors there didn’t seem worried and sent me home (not before the attending doctor instructed an intern to perform a digital rectal exam, for what reason I cannot remember). It was the same result from any doctor I saw about this: doesn’t seem like anything serious, but they also didn’t name it.
When my body has finished trying to turn itself inside out, I generally collapse into sleep: a dark, intense, and deep sleep that lasts about an hour. And when I wake up, it’s as if I have been rebooted. Not with newfound energy or vitality, but as if I have been reborn as a rock, or a tree, existing without movement or thought, and the next few minutes almost, almost make it worth it. It’s a legitimately wonderful feeling. The closest I ever come to simply being.
None of us can know what it’s like to be in someone else’s head, but I’m confident I’ve got the best case migraine scenario: rare attacks that end within a few hours and which leave me feeling strangely peaceful afterward. Lots of people go through this several times per month, and for some the migraines linger rather than being a short cycle, and that must be terrible.
When I started experiencing migraines as a teenager there was no Reddit, and there was nobody to explain what was happening. These days a person only needs to take a walk through r/migraine to read the detailed experiences of thousands of people trading survival tips with each other. Even there, however, I have yet to meet anyone who has migraines like mine: an hour or two of intense, soul-crushing nausea followed by a total brain reboot and an odd sense of peace. But maybe you have found your way here because this is your experience, too. And you know what? We’re fine. We’re fine!