Sunday, September 20, 2009

`We All Have Something'

We were seated at the kitchen table, eating the vegetable-barley soup my wife had just made, when she complained of difficulty focusing her eyes. Calmly, she described seeing “floaters,” phantom images she knew to be illusory but disturbingly real. They appeared angular and spiky, in the middle of her field of vision, and I remembered the pictures drawn by Dr. Oliver Sacks’ patients and included in his first book, Migraine. And I thought of the exchange between Hamlet and his mother when the prince sees the ghost:

Hamlet: “Do you see nothing there?”

Gertrude: “Nothing at all; yet all that is I see.”

My wife called her eye doctor’s office and the receptionist, obviously wanting to leave promptly at noon on a Saturday, tried to talk her out of it. “Are you a doctor?” my wife asked. The doctor called back and told her to report to the office immediately. I drove, dropped her off and took the boys to the library. We feared a detached retina but after a brief exam the doctor made a more benign diagnosis: ocular or ophthalmic migraine, without headache. Something to do with blood flow in the brain. Symptoms disappeared in 30 minutes and may never reappear, or she may have the same experience periodically. Not the worst prognosis in the world, particularly after one has already contemplated certain blindness.

According to this recent interview, Oliver Sacks is at work on a new book tentatively titled The Mind’s Eye, about vision and hallucinations. The project gains poignancy with the neurologist’s loss of vision in his right eye as the result of a tumor. Sacks says:

“…I worked in a migraine clinic, I saw more than a thousand people with migraine. I’ve had migraine myself since I was three or four. (I had visual migraine, which is another reason I’m interested in all things visual.) A lot of understanding develops when one first sees a patient. They stumble, they don’t know what’s relevant, they tell a story, you fill in other stories and between you, you begin to arrive at something. At that time I began to read a whole lot of technical pieces about migraine, and I read something that inspired me. It was a late 19th century book called Megrim which was the old word from the 1860s, and that book had every sort of dimension -- sociological, physiological, human. And I thought, it’s a century later, but we still need a book like this. And I thought, it’s the 1960s, but we still need a book like this. I’m very attracted to the full, almost novelistic descriptions we had in the 19th century. I think doctors and scientists naturally work well with this sort of format.”

“So I wrote my first book, Migraine, in this sort of vein. And when it was published, it got equally noticed by scientific readers and by popular readers. I think migraine turns out to be unexpectedly interesting--but then I think everything turns out to be very interesting, relevant to the human condition. You may not actually have migraine, but we all have something, and it’s perhaps about having something, living with something and dealing with something.”

Sacks’ friend W.H. Auden dedicated a poem to him in 1971, two years before the poet’s death. In “Talking to Myself,” the speaker addresses his body as “You”:

“Seldom have You been a bother. For many years
You were, I admit, a martyr to horn-colic
(it did no good to tell You – But I’m not in love!):
How stoutly, though, You’ve repelled all germ invasions,
But never chastised my tantrums with a megrim.”


fran manushkin said...

About six months ago, I had the same experience as your wife. I was terrified until i found out what it was. Had I known that my bizarre "light show" was harmless and temporary, i would have found it found it a pleasure--a kind of personal aurora borealis.

Heather said...

Hi there,

According to the IHS (ICHD II, there is no such thing as an "ocular migraine." Migraines are, still unfortunately, largely misunderstood by the great majority of doctors.

Retinal migraine, however, is a descriptive term relative to the phenomena of migraine itself, i.e., visual disturbances/aura without head pain. Simply put, it's just a plain old "classic" migraine, featuring aura.

Unfortunately, migraine is not a benign occurrence and aura with or without head pain may indicate a higher risk for stroke or heart disease.

What's nice, though, is that some people only experience this a few times in their life. Those of us that suffer chronically, however, are living in the midst of life interrupted and we are the population most prone to suffering a migrainous stroke that may or may not kill. Yes, migraines kill. It's very rare, but it does happen.

I encourage your wife to seek treatment if she continues to have these episodes. I have had migraine all of my life but the didn't change until I hit my late 20s. Now I experience permanent aura and other debilitating symptoms along with the discovery of a hole in my heart which may be contributing.

I hope your wife continues to have good health, and that you don't mind my post, I am all about advocating awareness about migraines and dispelling the myths surrounding them.

Best wishes to you and your family!

Fran Manushkin said...

Heather, thank you for this information. If my aura returns I'll call my doctor.

Nige said...

I had exactly this too, a year or two back - had it two or three times in the course of a week or so, always, oddly, at exactly the same time of day. Then it stopped. As will yours, I hope. In my experience, the surest medical diagnosis is usually 'one of those things'.