Reviewed by Agnieszka Tennant | posted 03/15/2005 09:00 a.m.
Well-mannered bosses and human resource heads don't talk about it. Young women like me who miss work because of migraines maybe shouldn't draw attention to it. But it's obvious if you take inventory at most workplaces: the trouble with hiring young women is the number of days they call in sick.
Estimates vary, but all sources, including the U.S. Department of Labor, agree that reproductive-age women have up to two times higher rates of absenteeism than men. Yes, it's partly because more women than men stay home when their children get sick. And more women than men get morning sickness. But I wonder if the work absences aren't also due to the fact that it's mostly women who suffer from the ailments that still mystify doctors.
Is it that time of the month? They get hormonal headaches. Too much stress? Had nuts? A pickle? Brie? Chocolate? Migraine. No stress? Then, too, they might get a headache—especially if they slept too little, or too much. Too much caffeine? Or not enough? All cause headache. It's raining? Their fibromyalgia flares up. A business trip? They return weighed down by chronic fatigue syndrome. Oh, and have we mentioned depression yet?
The genetic tendency to oppress women in particular is just one common denominator of these ailments. The misfiring of the same neurotransmitters as well as changes in estrogen levels have been implicated in all the above. They're literally all in our heads—in the sense that there's increasing evidence that they originate and take place in the brain—writes Chicago journalist Paula Kamen in All In My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable, and Only Slightly Enlightening Headache. As many doctors are still learning and Kamen knows all too well, headaches, chronic pain, fatigue, and depression are comorbidities. They often go together.
If anyone has the right to use the headache excuse or the clichéd "I'm tired of being sick and tired" complaint, it's Kamen. The Chicago writer has had a headache since that fateful time she tried to put in her contact lenses at 24. She felt a stab behind her left eye, as if someone stuck a fork in her eye socket. That was about 15 years ago. Since then, the pain has only spread and intensified after a septoplasty—a surgery to correct a deviated wall between the nostrils—that was supposed to bring relief. Which is why she calls her pain the Headache.
Kamen's memoir details a plethora of exasperating attempts to find lasting relief from her only partially explicable headache. Except for "colonic irrigation and Jews for Jesus," she has tried everything. Narcotics made her too tired and too dumb to work. Yoga bored her. Other remedies that brought no lasting relief include visits to famous headache centers; treatment by respected neurologists; a myofascial therapist; the triptan drugs (which 95 percent of the time abort my migraines); a Russian reflexotherapist who "beat the living crap" out of her during 20 sessions; biofeedback; a friend who doused her with Lithuanian "holy water"; and immersion in lavender oil. She went on Prozac to get off of Xanax, which worked—but only if she kept raising the dosage, and that gave her hellish withdrawal side effects. Let's see … what else is left? Oh, she tried Botox, too. Her velvety smooth forehead felt nice to touch but did nothing for her headache.
More than just an admirably light-hearted and amusing—if occasionally inundated with data—headache journal, Kamen's memoir is also a grown-up feminist's reckoning with a female Achilles' heel. She gently takes to task the first-wave feminists, who, in their concern to usher women into the workplace on an equal footing with men, diverted their eyes from typically female illnesses such as fibromyalgia (which counts among its victims 90 percent women), chronic fatigue syndrome (which afflicts two to four times more women than men), and migraine (75 percent of its sufferers are women).
Denial, of course, never helps. Ironically, Kamen writes, "in their efforts to counter enemies portraying women as essentially 'hysterical,' feminist thinkers have gone too far to the opposite extreme in denying chronic pain's reality, portraying it as mainly a tool of propaganda against us, a social construct." Those who care about women's rights cannot turn a blind eye to weaknesses that science says afflict their gender more than men. Only the honest exploration of these frailties will enable them to debunk persuasively the myths that some doctors and employers hold: for instance, that women bring their chronic pain on themselves; that they're faking it; that they're lazy; that they are a tad too emotional about their pain in general (does the word hysteria ring any bells?); that women who visit doctors too often are just drug seekers (they may well be, but for a good reason).
Kamen's book will also open the eyes of those, usually in the alternative medicine field, who see illness as the language the body uses to tell us something, as in "Take a week off," or "You're always in a hurry." As Kamen's experience clearly shows, pain is often the body's way of communicating nothing but a miserable and only partially explainable chemical disorder. Here she builds on the late Susan Sontag's Illness as Metaphor, which argues that "the most truthful way of regarding illness—and the healthiest way of being ill—is one most purified of, most resistant to, metaphoric thinking." Sontag reminded her readers of tuberculosis, which in the 19th century was considered a disease of passionate, sensible individuals who needed it to purify them of the drudgery of everydayness.
Apart from fellow sufferers, All In My Head will help those who are married to, work with, or socialize with one of the 90 million people in the United States who struggle with chronic pain. Kamen—who since the onset of her pain has completed two books but missed many deadlines along the way—compares the daily dose of energy that chronic pain sufferers have to marbles. Her reservoir of energy is between three and five marbles per day, depending in part on the weather and her sleep patterns. Going to a party takes four marbles; returning a call one marble; grocery shopping two or three marbles. If she gets less than eight hours of sleep on a given night, her Headache will be particularly cruel the next day. "I don't know what my brain secreted as I slept, but I wouldn't have been surprised if it were opium," she writes.
At the end of the book, Kamen does something a tad affected. She switches her format from memoir to memo and gives advice to all groups of people who have ever misunderstood her (they include "neurologists," "government," "journalists," and "society"). It's helpful advice, but she rubs it in unnecessarily, repeating the complaints she'd already made implicitly. Still, while she is far more winsome as a memoirist than a pontificator, Kamen, of all people, has the right to get her discontentment off her chest.
The resulting awareness, of course, won't cure the suffering of many people who, like her, are afflicted by chronic, invisible pain. But it might just alleviate their social headaches.
Agnieszka Tennant is associate editor of Christianity Today.
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All In My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable, and Only Slightly Enlightening Headache is available from Amazon.com and other book retailers.
More information is available from the publisher.
More about author Paula Kamen, including her other books and plays and contact information, is available on her website.
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