The New Yorker:

More than 1.2 billion people worldwide suffer from migraine and other debilitating conditions that are under-studied and often not taken seriously.

By Jerome Groopman

Two decades ago, I was leaving my morning clinic at the hospital where I work when I suddenly felt an excruciating pain in my head. It was as if my skull were exploding while simultaneously being gripped in a vise that was getting tighter and tighter. I became nauseated and dizzy, and made my way unsteadily to the emergency room. I was in my early fifties, and my first thought was that this could be a burst aneurysm, known to some physicians as “the worst headache of your life.” To my relief, a cat scan showed no sign of bleeding in the brain; then came the bad news. A neurologist arrived, examined me, and said he thought that I was suffering from a migraine. I had never had one before, but his diagnosis turned out to be correct, and, since that time, migraines have been an indelible feature of my life. Their frequency and severity have varied over the years, but once you become a migraineur, as doctors sometimes call us, you are always wondering when your next attack will be, planning how you might strategize around it, scrutinizing your life for possible triggers, and looking for some new treatment that might curb the agony.

As Tom Zeller, Jr., writes in “The Headache” (Mariner), the unpredictability of chronic headache conditions is particularly unnerving for those who suffer from them: “You may be delivering a speech before a large crowd, cooking dinner for a friend, or simply lazing alone on a hammock staring at the sky. You may even be sound asleep when it happens. At any moment it can appear, creeping in like a shadow in some cases, ambushing like a predator in others.”

Zeller, a science journalist, does not get migraines. He suffers from something generally acknowledged to be even worse: cluster headaches. Often featuring in lists of the most painful conditions in medicine—along with trigeminal neuralgia, sciatica, and gout—cluster headaches are named for the way that they descend in clusters, several times a day. The intensity of the pain is reflected in another name for the condition: suicide headache. Zeller describes the pain as “white-hot, blinding but invisible, frantic but elephantine” and writes of “writhing on the bathroom floor; of spittle and drool; of fingertips ground furiously into the scalp in a futile attempt to soothe whatever shrieking complex of anatomy is tearing at the right side of my head.”

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