Migraine*, Oliver Sacks

*Migraine (Revised and expanded), Oliver Sacks, 1992

This is the 18th volume in the “Essays Project.” While the Essays Project has focused mainly on essays, we became intrigued with Oliver Sacks and are taking something of a detour to read his complete work, essays or not.

[[More to come…]]

Front Matter

There are prefaces to the original edition, and, to this, the 1992 edition. There is also a forward by William Gooddy, a migraine specialist whom Sacks praises in his prefaces. There is also a historical introduction, which summarizes over 2,000 years of medical writing on migraine; I will pass on summarizing this.

The following, from the ’92 Preface, is Sacks’ comment on the aims of the book; I think his thoughts on why humans may need to be ill, for a brief time, will be very interesting.

Migraine, of course, is not just a description, but a meditation on the nature of health and illness, and how, occasionally, human beings may need, for a brief time, to be ill; a meditation on the unity of mind and body, on migraine as an exemplar of our psychophysical transparency; and a meditation, finally, on migraine as a biological reaction, analogous to that which many animals show.

–Oliver Sacks, Migraine, xv

I. The Experience of Migraine

C1. The Common Migraine

As I read through this chapter, the vast range of symptoms and manifestations attributed to Migraine would seem to defy any sort of classification. However, Sacks grapples with this by describing constellations of symptoms, and also sequences of symptoms/constellations, and leaves me with the sense that Migraine really is a distinct and identifiable entity.

One thing which I think, perhaps, he does not emphasize enough is that migraine recurs over the course of months and years, and I think that it is this pattern of recurrence (even though the symptoms may change completely) that I find most convincing.

Sacks’ high level description is that there is a prodomal phase (when the first hints of what is coming occur), the attack proper, resolution, and finally rebound. I’m particularly struck by the fact that both prodomal and rebound phases may often (but not invariably) include feelings of great well-being.

II. The Occurrence of Migraine

This section examines when migraines occur, and divides them into periodic (occurring a particular times and with particular rhythms of occurrence), circumstantial (appearing in response to particular circumstances), and situational (as a reaction to intolerable situations such as stress).

III. The Basis of Migraine

We skimmed this section, except for focusing on the psychological causes of migraine.

IV: Therapeutic Approaches to Migraine

We only skimmed this section. As the title suggests, it has to do with approaches to avoiding, ameliorating or otherwise treating migraines.

V: Migraine as a Universal

This section is really just one chapter which is on Migraine Aura and Hallucinatory Constants. It discusses, and tries to systematize the types of hallucinations seen during the migraine aura phase. There are three types: phosphenes (stars and scintillating points of light); spectra: the classical expanding scotoma with its ‘fortification edges’; dynamic geometric patterns (grids, mosaics, spirals, etc.)

The interesting thing about these hallucinatory phenomena is the possibility that they are a direct reflection of activity and function of cortical cells. For example, the ‘fortifications’ around the edge of a scotoma may (perhaps) be produced by groups of edge/orientation detecting cells. Similarly, Alan Turing described how waves of chemical reactions can give rise to regular geometric patterns in “The Chemical Basis of Morphogenesis.”

Another thing this brought to mind was John Conway’s Game of Life, in which 2D cellular automata with simple rules can produced spreading and repeating patterns of activity. See the wikipedia article. One wonders if the cortex, when undergoing a migraine, can generate such spreading and repeating patterns.

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The Catalyst: RNA…*, Thomas Cech

*The Catalyst: RNA and the Quest to Unlock Life’s Deepest Secrets, Thomas R. Cech, 2024. Cech won the Nobel Prize in Chemistry in 1989 (with Sidney Altman) for the discovery of the catalytic properties of RNA, which means that RNA could both carry RNA and replicate itself.

Reading this with the inaccurately-named “26-minute book club” in the Spring of 2025.

The Disordered Mind…, Eric R. Kandel

The Disordered Mind: What Unusual Brains Tell us about Ourselves, Eric R. Kandel, 2018.

Kandel is an eminent neuroscientist, known for his work on the low-level mechanisms of learning and memory as demonstrated in Aplysia. He’s won a host of prizes, including the Nobel for this work. Interestingly, as an undergraduate he majored in humanities, and afterwards became a psychiatrist, before migrating into neuroscience. Now in his 90’s, he is writing about larger themes, and addressing himself to more general audiences.

Writing after having read four chapters: The book is interesting, but I wish it went into more detail. Though it is also possible that the detail is not available — i.e. we still not shockingly little about mental disorders.

Snow Crystals, Kenneth Libbrecht

Snow Crystals: A Case Study of Spontaneous Structure Formation, Kenneth Libbrecht, 2022

This is Libbrecht’s magnum opus, at least on snow; this goes deep into the science. …and I love that he has ordered the references by date, so you can see the history of the science leading up to Libbrecht’s work.

Notes still in progress…

Four Billion Years and Counting…

Four Billion Years and Counting: Canada’s Geological Heritage. Produced by the Canadian Federation of Earth Sciences, by seven editors and dozens of authors. 2014.

November-December, 2024.

I am reading this with CJS. It is a nice overview of regional geology, and it is nice that all the examples come from Canada, and at least some of the discussion is relevant to Minnesota Geology. The book is notable for its beautifully done pictures and diagrams.

A Room of One’s Own, Virginia Woolf

Reading on my own, circa Fall 2024.

This book or extended essay is based on a lecture on Women and Literature that Woolf gave, or at least that is the framing of it in the book. She approaches the topic by explaining how she came to develop her thoughts about it:

“At any rate, when a subject is highly controversial–and any question about sex is that–one cannot hope to tell the truth. One can only show how one came to hold whatever opinion one does hold. One can only give one’s audience the chance of drawing their own conclusions as they observe the limitations, the prejudices, the idiosyncrasies of the speaker. Fiction here is likely to contain more truth than fact.”

She begins with an account of going to Oxbridge, and walking about the colleges. She notes that, being a woman, she is barred from walking on the grass, and is not welcome in the library. She has lovely descriptions of the landscape and colleges:

To the right and left, bushes of some sort, golden and crimson, glowed with the colour, even it seemed burnt with the heat, of fire. On the further bank the willows wept in perpetual lamentation, their hair about their shoulders. The river reflected whatever it chose of sky and bridge and burning tree, and when the undergraduate had oared his boat through the reflections they closed again, completely, as if he had never been.

And as we accompany her, she recounts her thought process. I love her metaphor (more extensive than the excerpt I quote) of thinking as fishing…

Thought — to call it by a prouder name than it deserved — had let its line down into the stream. It swayed, minute after minute, hither and thither among the reflections and the weeds, letting the water lift it and sink it, until–you know the little tug–the sudden conglomeration of an idea at the end of one’s line: and then the cautious hauling of it in, and the careful laying of it out?

Pausing in my account here, but passages that I like for various reasons follow:

“Lamb is one of the most congenial; one to whom one would have liked to say, ‘Tell me then how you wrote your essays?’ For his essays are superior even to Max Beerbohm’s, I thought, with all their perfection, because of that wild flash of imagination, that lightning crack of genius in the middle of them which leaves them flawed and imperfect, but starred with poetry.“

“Many were in cap and gown; some had tufts of fur on their shoulders; others were wheeled in bath-chairs; others, old though not past middle age, seemed creased and crushed into shapes so singular that one was reminded of those giant crabs and crayfish who heave with difficulty across the sand of an aquarium. “

“Fiction must stick to facts, and the truer the facts, the better the fiction — so we are told. “

“It was the time between the lights when colours undergo their intensification and purples and golds burn in window-panes like the beat of an excitable heart; when for some reason the beauty of the world revealed and yet soon to perish (here I pushed into the garden, for, unwisely, the door was left open and no beadles seemed about), the beauty of the world which is so soon to perish, has two edges, one of laughter, one of anguish, cutting the heart asunder. The gardens of Fernham lay before me.”

“I thought at last that it was time to roll up the crumpled skin of the day, with its arguments and its impressions and its anger and its laughter, and cast it into the hedge. A thousand stars were flashing across the blue wastes of the sky. One seemed alone with an inscrutable society.”

TBD –The first chapter is brilliant, and I have high hopes for the rest of the book, but have gotten distracted! But I shall return.

LS: Land Above the Trees: A Guide to American Alpine Tundra, Ann Zwinger & Beatrice E. Willard

February 2024…

This book was recommended in Kim Stanley Robinson’s The High Sierra: A Love Story, as a good guide to the ecology and botany of the Sierra Nevada (and the upper portions of other North American ranges). And, indeed, it is beautifully written with a narrative style in which the reader moves through landscapes with the authors, looking at this and that, in contrast to what I had expected would be more of a catalog or encyclopedic approach. The book is divided into two principle parts: part 1 examines elements of ‘above the trees’ ecosystems, like fellfields or krumholtz; part 2 looks at particular North American tundra ecosystems, with one chapter being on the Sierra Nevada.