Scintillations

When I was twelve, I gave my mom the scare of her life with my first migraine. It struck while I was in gym class, out on a field with a sky populated by puffy, brightly edged clouds. The barometric pressure was diving as a storm started to come in. I remember watching the clouds bloom and shuffle, neglecting my role as left fielder (I was terrible at softball), and their bright edges left my vision full of flashing afterimages. It was exactly the conditions that now, eighteen years later, I've learned to call triggering. Bright lights and a fluctuating barometer set off my migraines every time.

Coming back inside after class, I suddenly found I couldn't see my teacher's face. The place where his face should be was...a void? Or a discontinuous chunk of the classroom? I couldn't decide. And when I switched my focus from him to the chalkboard, I couldn't focus on the words. Chunks of the classroom seemed to disappear. Baffled and a little scared, I hunkered down into my desk for a few minutes, until I had the abrupt realization that I was about to throw up. I remember stumbling out of the classroom, and making it halfway to the nurse's office before I threw up into a trashcan. At twelve, this was about the most embarrassing thing I could have ever done, but it didn't even occur to me to be embarrassed until days afterward. I somehow found the nurse's office, and with crystal clarity I can remember the terror of losing feeling in my hands, my vision swimming with blindspots and fractured images, the overwhelming nausea, and the slowly dominating headache. My headaches always begin on the right side behind the eye, then spread to the temple and behind my ear, and the pain is more continuously vicelike than throbbing.

By the time my mom had been called and came in, my vision had returned, though I was still nauseated, and writhing in pain from the headache. Thankfully, I don't remember the drive to the hospital, where they ran the standard touch-your-nose-now close-your-eyes-and-touch-your-ear neurological exam before running a CAT scan. I remember the doctor (about 60 years old and male) congratulating me on my neuro exam, and the tightness of my mom's hand around my shoulder. That was when she first learned I wasn't likely to have a tumor or other life-threatening illness.

The migraine diagnosis was easy, and we were both relieved. Through high school, I learned to expect a migraine about every month or two. I also learned my triggers: a trifecta of stress, low barometric pressure, and afterimages. When I found myself unable to read a sign, or focus on someone's face, I would drop what I was doing and race for a dark quiet place. I started carrying a small bottle of Advil with me at all times, and still do. In my twenties the incidence of migraines dropped to about once every three months, in part at least because I learned not to look at the brightly edged clouds or strobing concert lights that would set a migraine off. I'm grateful for their infrequency.

As my career in biology has matured, I've taken a more academic interest in my auras, which are not the C-shaped fortification structures I often see depicted in aura artwork. For me, the blindspots scatter across my whole vision, populating different regions, digesting their content, and dissolving it into scintillating nothingness. It's fascinating and terrifying - every time there's a moment of worry that this time I'll never come out of it; that I'll never get my vision back. But in the meantime I manage the headaches with routine and rigor, and am grateful that the diagnosis on that day in 1993 was something so mundane, if not truly benign.