Review of New Cluster Headache Book: Psychedelic Outlaws

Dr. Joanna Kempner shares her knowledge freely and without condescension, throwing in witty quips as she talks. It’s clear she’s a college professor. But the cool one you want to share a beer with after class. 

She has a way of making connections that most people would miss, especially regarding racial and gender bias in the healthcare system. That was the focus of her first book, “Not Tonight: Migraine and the Politics of Gender and Health.” After that, she focused her unique lens on Bob Wold, Clusterbusters, and the plight of legitimizing psilocybin mushrooms as a medical treatment.

I don’t remember our first encounter. It feels like Dr. Kempner has always been there, somewhere in the crowd or standing at the podium at every headache event. She may not have cluster headaches, but she is very much one of us – an honoree “Clusterhead.”

I was fortunate to get an advanced copy of her latest book, “Psychedelic Outlaws: The Movement Revolutionizing Modern Medicine,” now available wherever books are sold. I cried on page one.

What stood out to me in Psychedelic Outlaws?

Dr. Kempner points out that getting a cluster headache diagnosis is difficult for anyone who is not a white, middle-aged man. Of course, as she notes, this is due to the empirical bias of medical research. Many women and people of color struggle to get a diagnosis because one doctor in the 1970s decided cluster patients all look the same because his patients did. (That is why it took me – a young woman – seven years for doctors to believe me.)

Diagnosis is only the first hurdle. Dr. Kempner explains cluster headache treatments are problematic, with severe side effects like the “Imitrex death cycle.” Yet, high-flow oxygen is notoriously difficult to get prescribed, covered by insurance, and filled correctly. She chronicles how Bob and other patients like him tried dozens of medications. Some patients went as far as brain surgery, but found nothing worked long-term. That makes the accidental discovery of psilocybin mushrooms to prevent cluster headaches all the more fantastic. 

How do psychedelics come into play?

Dr. Kempner poignantly shows how the cluster headache community mirrors the habits of fungi. On the surface, Clusterheads struggle with one of the most painful conditions known to humankind. They feel isolated and alone. Yet, in that darkness, they find one another and provide support like the mycelium underground transporting nutrients to struggling plant life. From Yahoo forums to Clusterbusters patient conferences, they share tips for pain relief and DIY their treatments to save one another’s lives. Though, they’ve lost a few to suicide along the way. 

While the roots of her book focus on Bob and cluster headaches, Dr. Kempner branches out to show the maddening history of psychedelics. Her research details how Westerners coopted psychedelic mushrooms for modern uses while dismissing (or destroying) the indigenous communities who discovered and used them first. She illustrates how tighter FDA restrictions halted psychedelic research for decades and outlines its resurgence through the “shroom boom” in the 2010s.

What does Dr. Kempner's book do for people with cluster headache?

Psychedelic Outlaws: The Movement Revolutionizing Modern Medicine highlights the resilience and desperation of patients when the medical community fails them. Dr. Kempner sprinkles her conversations with Clusterheads in each chapter like a call to arms for doctors and researchers to see them as partners. The magical part of her book does not come from a mushroom; it stems from a group of patients who refuse to give up.