Nursing Book Club
The Headache by Tom Zeller Jr.
The Science of a Most Confounding Affliction — and a Search for Relief
An in-depth look at the common but poorly understood problem of headache disorders.
The World Health Organization estimates that about 40 percent of all people suffer from headache disorders. These can include migraines (about 15 percent of the population), chronic headaches (about 5 percent), and cluster headaches (about 1 percent).
Author Tom Zeller Jr., a veteran science journalist, writes from personal experience: He suffers from cluster headaches, which are sometimes called “suicide headaches” because they may be one of the worst pain disorders known.
Zeller calls this book “a story about pain.” His goal is to make headache disorders understandable to the general public. There are lots of descriptions of different types of headaches and different types of pain. (For example, cluster headaches affect only one side of the head.)
Severe, frequent headaches can seriously interfere with personal life, work, and school. The lost productivity has a big economic cost too. So, why do we still have so few answers about what really causes headaches, or how best to treat them? Zeller searches for answers.
Not Enough Research
Considering that they are so common, headache disorders are surprisingly under-researched. Zeller had to travel to the Danish Headache Center, near Copenhagen, Denmark, to participate in clinical trials.
The newest class of medications to treat migraines — triptans — came out 35 years ago. They remain an imperfect solution: Some users rate their efficacy as low as 30 percent, and their effectiveness seems to diminish the longer they’re taken.
Another promising drug — a calcitonin gene-related peptide — was first described in the 1980s, but it wasn’t approved by the FDA until 2018. Its efficacy also seems to wane with repeated use.
I suffered from migraines myself, as did everyone in my family. It was not uncommon for me to be summoned to the school nurse’s office to pick up a child lying on a cot with the lights off and ice on their head. Never did I dream that headache disorders and their remedies would still be so mysterious decades later.
The amount of science in this book may be too much for anyone but a serious sufferer trying desperately to understand their own malady. However, reading The Headache makes a strong case for taking the problem a lot more seriously.
CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.
