Gravity's Rainbow

botany, shoes, books, and justice

July 16, 2016

Headache medicine’s problems with legitimacy persist despite the “discovery” of a neurobiological mechanism underlying migraine. For while the emphasis on the brain does somewhat mitigate migraine’s association with psychosomatic, feminized personalities, locating migraine in the brain also managed to inscribe gendered cultural assumptions about the personalities of headache patients into the physical structure of their bodies. The newly biomedicalized migraine has not eliminated characterizations of a migraine patient as a particular kind of person, but instead has transformed the moral character of the migraine patient into a new, still highly gendered biomedical configuration.

Joanna Kempner in Not Tonight

July 13, 2016

[I]n 1973, Seymour Diamond and Donald Dalessio, then codirectors of the famous Diamond Headache Clinic in Chicago, wrote that the inability of people with migraine to adapt represents the repressed hostility of the migraine patient.

Joanna Kempner in Not Tonight

I am actually pretty angry about having a painful and debilitating disease that most people like to treat as an attitude problem so they can tell me to go to therapy and do yoga and meditate and otherwise remove myself from the world where I inconveniently highlight the failures of medicine, our bodies, and our economy.

July 10, 2016
by sarcozona

How did psychological theories come this far in migraine medicine? Judy Segal has argued that the explanatory power and popularity of the migraine personality could be attributed to its expansiveness — the migraine personality could describe almost anyone. The migraine personality became what Ian Hacking refers to as an “interactive kind.” Interactive kinds are categories that not only define but also constitute people. That is, some classifications organize individuals’ experiences in such a way that they adapt or respond to their classification. Such was the case with the migraine personality. People with migraine began to adapt to Wolff’s concept of the “migraine personality”: the category altered how they thought, behaved, and classified themselves.

Joanna Kempner in Not Tonight

How has migraine changed me? How has your idea of migraine changed me?

June 27, 2016

Migraine complicates the relationship between specific disease and
legitimation. Migraine has a well-established diagnosis, a subspecialty in medicine that is devoted to its treatment, brain imaging that illustrates a migraine in process, pharmacological interventions, research that links certain forms of migraine to genetic mutations, insurance companies and policy makers that recognize its existence (albeit to a limited degree), and a pharmaceutical industry that already markets some drugs to treat it and which is trying to develop more. And while researchers have not yet articulated a specific cause of migraine, they have developed a neurobiological model to explain much of the migraine process. Moreover, migraine differs from most of the contested illnesses that have been studied in that it has been defined as a medical diagnosis for hundreds, if not thousands, of years. Yet these advances have so far not been sufficient to validate the experiences of those with migraine, nor to bring resources to
the study and treatment of migraine.

Legitimation, therefore, must depend on something more than the discovery of biomedical pathology. Legitimation also has a moral dimension. In other words, for a disease to be fully legitimated, the people who have it must be viewed as deserving of care and resources.

Joanna Kempner in Not Tonight

Migraine’s legitimacy deficit makes it much harder to live with because the people around you see it as some combination of

  1. your fault
  2. not hard
  3. not real

And so I am not deserving of care and support.

Not Tonight

My library finally got Not Tonight for me yesterday. 15 pages in and have 5 post-its sticking out of the pages already! I’ve been making notes in pencil since it’s a library book – I think I’m going to have to do a lot of erasing before I turn it back in!!!

What’s this book about?

How do our entrenched ideas about mind, body, gender, and legitimacy shape what we believe about migraine?

[I]f biomedicine has discovered that migraine is “real,” why does it remain so easy to ignore, dismiss, and delegitimate? Has the “discovery” of the brain in migraine really erased the idea of the hysterical patient that is so deeply embedded in doctor-patient interactions about pain? In this book, I argue that the recent biomedicalization of migraine is not powerful enough to erase centuries of sexism in culture and in medicine. If anything, the transformation of migraine from a disorder of the mind to a disease of the brain has reified some of the same stultified ideas about gender that always made life difficult for both men and women in pain. The result has important implications for how we understand whose pain and suffering is taken seriously and whose is ignored on an individ­ual level, at the clinic, in the annals of medical journals, and by policy makers.