I call Abbott Northwestern Hospital. I want a CT scan. I want to see my brain on paper. I want analysis, diagnosis, reassurance that it's all there, all in working order. I will remain motionless in a large steel cylinder for as long as it takes. The words I want to hear? Your brain is healthy. Everything is in working order. You go, girl.
I am transferred to the proper desk, and I explain myself. The woman doesn't get it. Do you have a referral? she asks. I say no. Were you in an accident? Have you experienced bleeding? No, no bleeding, I tell her. But I do have an intense migraine every six or seven weeks. It always lasts three days. She is silent for a moment. She isn't sure what to say and explains that the CT scan policy requires a patient referral from a licensed doctor.
Okay, I say. How about an electro-encephalogram?
She seems annoyed. Are you epileptic? she asks. No, I say. I have never had a seizure, but I do have these fits now and then when I feel like my head is coming apart.
She is silent again. Then, What is your name?
I tell her. Listen, I say. What difference does it make whether I have a referral? If I am able to pay for it, why can't I have it done?
She is confused. I'm going to give you two names, she says. One is a headache specialist; the other is a psychiatrist. Perhaps they can help you.
Are you my referral? I ask.
She hangs up.
I don't need a shrink. If I have unresolved issues, I want to keep them. Imagine having nothing to work though. I'm curious, is all, about what's inside my head. Maybe I'm bored. Maybe, at 34, I want to learn something new about myself. My hands are restless. And, every month or two, a school of small silver fish swim from the periphery across my retina. In the flash and shimmer of scales, I see a warning both frightening and familiar.
The fish in my head skitter and swarm, all together now, like neon tetras: magnetized, of one mind. They spring from the deep into the aqueous humor of my eyes, a fleeting school of grunion, a run of smelt. And when the lights appear, flashing and blue against the purple sky lining my forehead, I brace myself. These are lights of distress.
Within an hour, the fish have gone. I want them back. In their wake is a sudden darkness, a burst of black ink. The left side of my face has gone numb, except for the fault line, the thin stream of pain flowing from its gnarled source in my left shoulder, up my neck, arcing over my ear into the watery blue pool of my left eye. Its ending, where cornea meets air, is metallic and sharp. I am nauseated. My sinuses click with static pressure, and I believe a creature gilled and green may find birth in my face.
I hear my blood in my ear: wish, wish, wish. My skin feels rubbery and damp; my nerves have turned their attention upward. I think about what is cool: a washcloth; a bag of frozen mixed vegetables; the head of an ax; wet sand. Then I think about the hot: steam; boiled cabbage; lava; branding irons; wax. I want it all-cool, then hot, then cool-against the softness called a temple. Not gently; this pain is beyond gentleness. It demands a worthy opponent. Pain negates pain. Let me rest my head in coals, then a bowl of frost. Call the Marquis.
No one knows why migraines happen. I have to eat. I can't do much about my hormones or my sex or my age, and I don't take drugs. I won't blame my serotonin levels or genetics, though the woman who gave birth to my mother, and my mother, both experience migraines regularly. So I'm thinking, give me the scan. Show me the breeding ground for my shimmering fish, and perhaps I'll find the answer for why, every six weeks or so, I am forced to curl up in a corner with my eyes closed and fingers clenched, treading the waters of nausea and pain.
According to the medical establishment, the following "measures" may soften or eliminate the ache in my head: eat less meat and more fish; eat tofu; eat onions and garlic (they reduce clumping of platelets). Ingest magnesium, riboflavin, and fish oil. Cut down on wheat, chocolate, and aged cheese (and most of the foods I crave). Meditate. See a chiropractor. Apply finger pressure to the following places: the back of the hand where the bones of the thumb and index finger meet; the bridge of the nose; the hollow at the base of the skull; the base of the cheekbone; the top of the webbed area between the big and second toes. Get acupunctured. Take caffeine and/or aspirin in regular, moderate amounts. Heat your body and cool your head (take a hot bath -- add some dry mustard -- with your head in a bucket of ice). Dip your finger in sesame oil, then salt and pepper, and shove it up your nose. I'm serious. And this is my favorite: Avoid such lifestyle and environmental triggers as stress, sun, hunger, fatigue, sex, lights, loud noises, weather changes, and strong smells. (Or simply commit penacide, the suicide of the senses.)
According to me, the following measures will effect, in some way, relief -- if only momentary -- from the pain of migraine: Masturbate until your arm tingles and you think you feel a shark born of your head going after those blessed little fish. Chew, late at night, bark from the trees in your neighborhood, preferably oaks (easy to grip between your teeth) or willows (willow bark tea has been recommended for use in place of aspirin). But don't swallow; spit. Curse, loudly, as you spit. Sit in the middle of your living room in the lotus position and take deep, deep breaths. Blow out evenly, continuing until you pass out and tip over. The pain in your legs will, momentarily, ease the one in your head. Have your children, one at a time, as you lie curled in the fetal position, sit on your head and bounce, gently, humming "The Barney Song." If you have no children, ask a friend; or slide your head into a doorway, close the door as far as it goes, and prop it shut with bricks. Lie there until morning or until someone knocks and says, "Oh, my God. Are you okay?" Don't speak; simply moan. Cover your face with a down pillow, and scream. Scream things that make no sense to anyone but you. Scream in other languages, in tongues, in rhyme. Scream Psalm 23 until your voice is hoarse and you're either laughing or weeping hot, salted tears. Find someone who loves you and beg him, plead with her, to do the very thing that needs to be done; find an ax, a machete, a drill. Use it. Peel back layers: hair, skin, bone. Dig until the fins appear, and cut the wild, writhing thing away.
As a child, in a Texas restaurant with my grandmother and two aunts, I ordered flounder from a large menu of items I didn't recognize. I knew flounder was fish, and I liked fish. The flounder came, eye and skin and tail, on a bed of rice. It stared back at me, and its gills were still as I nudged it with a fork. Was I to eat it all, or leave the fins or the skin out of some gesture of respect? Where was the filet I had envisioned, pieces of which I'd dip lightly in butter? My selection was prescient: The next day, in the backseat of my grandmother's car, cruising up toward Arkansas, a small school of fish swam before my eyes, glinting and flicking in a light whose source lay buried deep in the fissures of my brain. By the time we found a hotel that evening, the light had found my nerves, and my head throbbed like surf, pulsing with the coming in of a dark blue tide. Kill me now, I thought. I need water, I said. For three days, I drank only water, ate nothing at all, and prayed to Poseidon for forgiveness.
I am older now. I possess rabid hormones, menstruate, and do not have a steady relationship with my serotonin levels. I ingest caffeine, cheese, and cheap white wine on a regular basis, and am prone to the stress of being a "yes" person, a mother, and one of the self-appointed general managers of the universe; my ass is a trailer hitch for people in need. I take One-a-Day Plus Iron vitamins. I don't sleep enough. I straddle barbed-wire fence between the fields of random abstraction and concrete sequence. I am a practical, levelheaded woman. But still, in swells of pain, I creep outside at night and, spread-eagled on the lawn, call out to the sea god to quell, with his trident, the roiling within my head.
There is a dock on Lake Tahkodah in northern Wisconsin where, if you lie still on your belly, hang your head over the edge, and immerse your hands in the clear water, the fish -- sunfish, bluegill, perch, bass -- will swim to you and kiss the tips of your fingers. If you reach for them, they deliquesce. You must be languid and still, and those fish, by the dozens, will love your forearms and the palms of your hands with the swish of tailfins and the fragile rippling of gills.
My next migraine is due, according to patterns of my own currents and riptides, in 11 days. I'm thinking, this time, of joining them -- the fish -- of slipping into the water, head first, through surface light, down through weeds and over muck, where things are cool and green. I have no gills. There are neither fins nor scales on my body. But I am streamlined; I have purpose. With my eyes wide open, my skin wetted and slick, I'll swim toward the deep where everything is remote and still. I'll become phosphorescent and grow a tail, and the fish in my head will swim out and along with me, a reasonable woman for whom the salt water of the open sea is the obvious cure for the ache of land legs and the stress of being human.
Holly Harden has published nonfiction and poetry in various literary journals, including Water~Stone, The Journal of Graduate Liberal Studies, and three candles, and was nominated for the 2002 Pushcart Prize for her essay "Marking Time." A former secondary-school English teacher, she lives in Scandia, Minnesota, with her husband (a Lutheran pastor) and their three children, and is currently working on a collection of essays, The Pastor's Wife, and a series of Barbie poems.
From Fourth Genre (Fall 2002). Subscriptions: $25/yr. from Michigan State University Press, Journals Division, 1405 S. Harrison Rd., Manly Miles Building, East Lansing, MI 48823. A consistently engaging journal of nonfiction essays, commentary, and book reviews, Fourth Genre has been nominated for an Utne Independent Press Award for writing excellence.