So Much More Than a Headache: Understanding Migraine through Literature

Book Review by Laura Grace Simpkins

Kathleen J. O’Shea. The Kent State University Press, 2020. ISBN 978-1-60635-403-2

Can language ever fully represent pain? Much writing about illness returns us to that question, including two books published this year: Pain: The Science of the Feeling Brain and Ouch!: Why Pain Hurts, and Why It Doesn’t Have To (both 2021). The arguments for or against are usually circular, and predictably inconclusive. In So Much More Than a Headache: Understanding Migraine through Literature, an anthology of writing about migraine, editor Kathleen J. O’Shea declares that ‘literature can capture the authentic voice and language in ways objective texts cannot’ (xiii). Although I’m relieved O’Shea picks a side, I’m more interested in whether So Much More Than a Headache can move us away from asking whether language can represent pain altogether.

So Much More Than a Headache is a collection of poems, essays, and fiction by writers—some famous, some not—across five centuries, most of whom are or were migraineurs. For O’Shea, a literary professor whose life with migraine ‘began when I was 14, moved from episodic migraine to chronic migraine in my 30’s’ (106) let down by the lack of pharmaceutical solution and frustrated with how self-help guides exaggerate the control migraineurs have over their disease, this book is personal, and a passion project. The anthology is separated into five themes: 1. ‘What it feels like’, 2. ‘What people don’t see: the invisibility of migraine’, 3. ‘It’s just a headache?’, 4. ‘It’s a lifelong, full-time job’, and 5. ‘When it’s gone’, and is bookended by two essays that speak to all five: Joan Didion’s ‘In Bed’ (1984) and Anna Leahy’s ‘Half-Skull Days’ (2012). In her introductions to each section, O’Shea points out what might be useful to readers who are migraineurs themselves, or are family members and friends, or are medical practitioners.

‘The truth is’, O’Shea writes in the preface, ‘most of the general public still see migraine as “only a headache,” rather than the complex brain disease we now know it is’ (xii). Her intention, in So Much More Than a Headache, is to offer insight on a disease that many of us are ignorant about and which is often difficult to describe—‘at least in ways that aren’t clinical and objective’ (xii). After taking us through the stages of migraine, from Prodrome Phase to Migraine Attack to Postdrome Phase, O’Shea leaves it up to her selection of writers—many of them illness writing heavyweights like Oliver Sacks, Irvin D. Yalom, and Virginia Woolf—to describe migraine in ways that are personal and subjective. I most enjoyed the poetry by writers I didn’t already know, especially Linda Pastan and Kevin Crossley-Holland’s joint imagery of the skull during migraine as a fragile eggshell:


the eggshell skull
won’t hold,
will crack,
Linda Pastan, ‘Migraine’ (1995) (8).


My skull cracks open.
Look at the birds,
looks at the birds release, a spray,
a fantail flowering.
Kevin Crossley-Holland, ‘Deliverance’ (1983) (182).


O’Shea’s anthology will be empowering for migraineurs, comforting to those close to them, and essential for medical professionals. Her own contributions are clear, straight-forward, and accessible. I was reminded, however, of Theodor Adorno when he writes, ‘The bad essay chats about people instead of opening up the matter at hand’;[1] while I do not think there are any ‘bad essays’ in this book, it strikes me that O’Shea could have been more radical in her framing of the collection, could have gone further than her opinion that language can represent pain, further than her declaration that ‘literature can capture the authentic voice’. Adorno is right, unfortunately: sometimes other people’s suffering, even that of Sacks, Yalom, and Woolf, isn’t always that interesting to read about (and I say that as someone who writes extensively about my mental health!) unless it opens something up beyond sharing and comparing experience. For me, Crossley-Holland’s migraine poetics does just that. His ‘birds release’, his ‘fantail flowering’ imaginatively evokes the pain of migraine whilst elegantly reminding us of its aesthetic potential, potential that I believe O’Shea somewhat overlooks.

So Much More Than a Headache could have been an opportunity to explicitly challenge the reliance upon medicalised language that has marginalised and misunderstood migraineurs for centuries. The book itself could have expanded the definition of what migraine actually is; demonstrated how symptoms were and are identified using creative description long before clinical description; and could have made a case for considering creative writing as an epistemology in its own right within the medical humanities. O’Shea is indeed persuasive when she uses the collection to evidence how literature can represent, illustrate, and encapsulate pain, propelling us beyond the usual circularity of such arguments, to a certain extent. Where there is more work to be done is on speculating how migraine poetics and aesthetics can intervene in and contribute to ‘clinical and objective’ research on migraine aetiology, symptomatology, diagnostics, and management.


Laura Grace Simpkins’ writing has been published by The Polyphony, is forthcoming in It’s Freezing in LA, and has been broadcast on BBC Radio. She is currently working with the Wellcome Collection on an essay series on the medication lithium carbonate. Her website is at

[1] Adorno T W. The Essay as Form. New German Critique 1984:32—154.

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