Diagnosing Dickinson: Epilepsy or Migraine? (How headaches inspire artists and writers)

I wrote this paper a few years ago and plan to publish it, but since it’s just sitting on my computer, I thought I’d share. I’m a frequent migraine sufferer and early episodes (including symptoms I interpreted as paranormal, like hearing voices and seeing flashing lights) were formative of my creative identity. Understanding these relatively common symptoms of migraine (which affect around 10% of the human race) will give you a greater understanding of “creative madness.” PS – this is unique and potentially ground-breaking research: please share, and please credit me.

migraineThe poetry of Emily Dickinson can seem so otherworldly and obtuse that readers often assume creative metaphor, and try to guess what Emily really meant. This practice has dominated critical approaches as well. Recent efforts, however, have been made to diagnose what chronic illness, if any, the American poet suffered from during her lifetime. This post will investigate the modern claims raised in two popular non-fiction titles published in 2010.

It is clear from Dickinson’s poetry that she was describing her own actual experience of suffering and pain – and there is more than enough biographical evidence to suggest that she had some kind of mysterious and hidden illness, which may have been a major cause of her social reclusion. In the 2010 biography, Lives Like Loaded Guns, Lyndall Gordon presents the case that Dickinson suffered from Epilepsy – using mostly historical and biographical facts to bolster her claim. What is missing in Gordon’s analysis, however, is a close reading of Emily’s poetry. Gordon conjures the image of a poet living in constant fear of having a spell or fit that will release a violent, volcanic explosion:

“Allowing for the poet’s resolve to ‘tell it slant’, through metaphor, are we not looking at epilepsy? The word, from the Greek, means seizure, and the onset, which the poems describe, is what doctors call the aura. Dickinson’s word is a ‘Presentiment’: a Shadow indicates ‘that Suns go down—’: . . . The notice to the startled Grass That Darkness—is about to pass— In Greek, aura means ‘breeze’. In Dickinson this intensifies, as ‘Winds take Forests in their Paws—’. A ‘Thunderbolt’ blacks out consciousness (‘The Universe—is still—’), and then an ‘electric gale’ wafts the body beyond ‘its dull—control’.” (Gordon 116-117)

This “explosive” aspect of epilepsy is played up by Gordon conscientiously, as it serves as a parallel to Emily’s sometimes stormy personal and familial relationships (hence the “violent” title, Lives like Loaded Guns):

“In Emily’s youth the sickness (epilepsy) was described in violent terms. The victim falls ‘as if hit by gunshot’, followed by ‘spasmodic throes’. These appear as if a creature, recently dead, were subjected to ‘the shocks of a galvanic battery’. A spark as to a ‘barrel of gunpowder’ will ‘induce the explosion’. Fingers are clenched and eyes, ‘suffused’ with moisture, swivel.” (Gordon 119)

This frenzied excitement, though traces of it may be read in Dickinson’s more stirring poems, does not reveal itself as fully as one might expect. As I aim to show in this paper, the erratic symptoms of epilepsy (twitching, shaking, falling) are not the symptoms we meet most often in Emily’s work. This may be why Gordon’s diagnosis has met a cool reception by Dickinson scholars. Connie Ann Kirk, author of Emily Dickinson: A Biography, describes the academic misgivings surrounding the 2010 academic conference of the Emily Dickinson International Society in Oxford:

“Ms. Gordon sets out her epilepsy claim early on in her study and then embraces it as fact in such a way that it colors her reading of the poetry and other facets of the poet’s life. Some scholars at the conference were concerned that the general reading public would accept the claim of epilepsy as fact as well, when the matter is still under scrutiny in the scholarship.”

At the same conference, Norbert Hirschhorn, MD, challenged the central piece of evidence used to support Gordon’s diagnosis – a remedy of glycerine that was prescribed to Emily by Dr. James Jackson:

“The hypothesis for epilepsy is based principally on finding the medication glycerine, which ED took with some frequency between 1851 and 1854 (prescribed by the eminent Harvard professor and co-founder of the Massachusetts General Hospital, Dr. James Jackson) in a list contained in a folder on Health and Medicine in the Jones Library, Amherst. The list is titled ‘Medicinal Uses of Glycerine in the 19th Century’, and was derived from a popular self-help text, Health at Home or Hall’s Family Doctor (2). Among dozens of uses was a formula for epilepsy that called for ‘half an oz. of hydrate of chloral and twenty five drops of essence of peppermint in four oz. of pure glycerine.’ Gordon comments: “Glycerine has many uses, but one of the medical uses in those days was for epilepsy…. This use of glycerine in the treatment of epilepsy (as distinct from its use for TB) has gone unnoticed.” (3) This claim for glycerine is unsupported by the evidence. Glycerine, a sweet syrup obtained from fats or oils, was never identified as an active principle against epilepsy in any official pharmacopoeia, dispensatory or textbook on epilepsy written in the 19th Century that I could locate.” (Hirschhorn)

And yet if not completely fitting, some of the issues raised by Gordon do seem applicable to Emily’s poetry – especially the “presentiment” and dread of a coming storm, which ravages everything in its path (Dickinson writes frequently of violent storms ripping up trees or flowers; or overwhelming a small boat out at sea). The “aura” that Gordon identifies, however, is not unique to epilepsy. It is also present (arguably with more distinction) in a related chronic neurological disorder: migraine.

And as Andrew Levy’s poetic but ultimately speculative A Brain Wider than the Sky (2010) points out, many migraine sufferers have noticed parallels between their experiences and Dickinson’s poetry. Levy’s book, which appropriates its title from Emily, so firmly establishes the link between Emily and migraines that in popular culture Dickinson has become openly referred to as a “migraineur” along with Thomas Jefferson, Lewis Carroll, Rudyard Kipling, Charles Darwin and Elvis Presley (Grossman).

According to Levy, Dickinson “described so many different kinds of pounding inside the human head—a funeral inside the brain, the breaking of floors, the buzzing of flies, the driving of coffin nails—that a modern migraining reader sees a whole different level to her slant rhymes, and wants nothing more than to travel back in time and bring her a cup of hot darjeeling.” (Levy 91)

Given the possibilities (and limitations) of these two diagnoses, what is missing, in my estimation, is a rigorous examination of the relationship and difference between epilepsy and migraine, and a closer reading of Dickinson’s poetry with an eye towards the specific symptoms of each. This undertaking – which serves as the base of this article – will be illuminated further with the accounts of modern migraine sufferers, who use language and metaphors very similar to the “The Belle of Amherst.” The purpose and conclusion of this attempt will be to establish Levy’s migraine hypothesis on firmer ground, by demonstrating that many of Dickinson’s poems (and especially her most renowned) accurately describe migraine symptoms.

Let me begin by pointing out that the diagnoses of Gordon and Levy (epilepsy and migraine, respectively) are highly related – individuals with one disorder are at least twice as likely to have the other. Comorbid disease presents challenges in both differential diagnosis and concomitant diagnosis:

“Because of its greater prevalence, migraine is common in people with epilepsy, whereas epilepsy is rare in migraineurs. The diagnosis and treatment of each disorder must take into account the potential presence of the other.” (Silberstein and Lipton)

So we are not necessarily looking for an “either/or” scenario. It is possible that Dickinson suffered from both epilepsy and migraine; in fact if we agree with Gordon’s claim of epilepsy, migraine symptoms are to be expected. And yet there are differences in the symptoms by which they can be distinguished.

Symptoms of Epilepsy vs. Migraine

According to a 2005 article published in Advanced Studies in Medicine titled “Differentiating Migraine from Epilepsy,” both epilepsy and migraine are characterized by “positive neurologic signs and symptoms, as well as similarities in ictal progression. Shared symptoms may include visual symptoms, altered consciousness, and headache. Ictal progression for both epilepsy and migraine with aura develops from a preaura prodrome (or premonitory phase), followed by the aura, the ictus, and finally postdrome” (Haut S658).

These stages will briefly be explored below, focusing on the differences between both afflictions.

Prodrome

The preaura prodrome is reported by 60% of migraine patients, but less commonly in epilepsy patients. In migraine, it may be characterized by “behavioral irritability, talkativeness, appetite changes, water retention, and sleep disturbances” (Haut S659). These changes, when recognized, allow frequent migraine sufferers to know when a migraine is coming and take precaution.

The Aura

The most interesting symptoms, especially in light of Dickinson’s poetry, are the visual and auditory effects that may manifest during the aura stage.

According to Haut, “Seizures with visual manifestations may be confused with migraine aura, while altered consciousness during a migraine may be difficult to distinguish from complex partial seizure” (S659). It is unfortunate, Haut continues, that the term “aura” is used in both migraine and epilepsy, because they represent different entities:

“An aura occurs in about 20% to 30% of migraineurs, and it is not necessarily present during each episode. The aura of epilepsy represents a simple partial seizure, it precedes 80% of temporal lobe seizures, and it is absent in idiopathic generalized epilepsy. Interestingly, aura in epilepsy (especially prior to a generalized tonic-clonic seizure) is often accompanied by retrograde amnesia for the event. . . . Patients are fully interactive during the epilepsy aura but may have no memory of it after the seizure. The duration of aura in migraine versus epilepsy is quite different. The aura of migraine is prolonged (15-60 minutes), whereas in epilepsy, the aura is typically less than 1 minute. . . . The most common aura symptoms in migraine are visual, whereas in epilepsy, they are usually limbic (ie, rising abdominal sensation, deja vu, fear).” (Haut S660).

Although headache and visual symptoms are common to both, these symptoms may also be distinguished. Migraneurs most commonly report bright, shimmering, jagged lines that are known as fortification spectra. An area of lost or depressed vision within the visual field is also common in migraine, along with loss of sight or blindness. In epilepsy, “visual symptoms are often colored, appearing as circular and spherical shapes in a hemifield” (Haut S662).

For migraines, these visual effects build and expand, following an indistinct opacity or loss of illumination:

“The classic scintillating scotoma, with march of fortification figures and expansion over time, is characteristic of migraine. Typically, some alteration of perception initially occurs either as an indistinct opacity or as a loss of illumination. This sensation is followed, in seconds to minutes, by the appearance of a small central scotoma of only a few degrees that is lined on one side with a luminous, zigzag line, termed the fortification spectrum. The spectral lines usually form an acute angle and are nonconfluent. These lines may be colored or gray, and they appear to oscillate in brightness, suggesting a boiling or rolling effect. The fortification spectrum expands in the shape of a horseshoe and is often lined on the inner edge by an absent area of vision termed the negative scotoma. The term buildup is used to describe the gradual expansion of the fortification spectrum, and occurs in 75% of cases. As the scotoma expands, it typically drifts or “marches” toward the periphery, this process generally lasts from 20 to 30 minutes. There are estimates that the cortical disturbance responsible for the scotoma proceeds at a rate of 3 mm per minute through the visual cortex. During the scotoma, mental efficiency may be impaired, and reasoning, reading, writing, or speaking may be affected” (Digre et al.).

Unlike epilepsy, which would be quick and sudden, migraine disorder is a process that sufferers can witness unfolding, developing and building. Rather than a fall followed by temporary memory loss, migraineurs are completely and acutely conscious of their own brain, witnessing these strange effects and the unraveling/diminished mental ability.

Auditory effects

Another symptom of particular interest is unusually altered hearing ability, which can manifest in hearing voices calling your name, music that isn’t there, white noise or humming. Most commonly people hear bells or ringing. C. W. Lippman, who was also the first to describe what became known as the “Alice in Wonderland Syndrome” of visual distortion, records the following:

All migrainoids occasionally hear sounds which don’t exist. The most common occurrence is the ringing of a doorbell or a telephone bell. In a migrainoid’s home the following scene is a familiar one:

You are having dinner. Your wife suddenly gets up from the table. You hear her go to the telephone, take down the receiver, and say, ‘Hello?’ She repeats the words several times, hangs up, and returns to the table with a puzzled face. She murmurs something about having been sure that she heard the telephone ring.

Dinner is resumed. Presently she says, ‘Do you hear the telephone ringing?’
You frown and say, ‘No.’ You continue eating.

Now watch her for the next five minutes, You’ll notice every now and then she appears to be listening intently. She probably continues to hear the phone at intervals all through the rest of the meal. But she won’t mention it again. She has learned from experience to rely one someone else’s testimony about the telephone bell. (qtd. in Rose 227)

Ictus

The ictus is the main event; in migraine, the typical ictus is “a prolonged unilateral throbbing headache with associated features, whereas in epilepsy the ictus is brief and self-limited” (Haut S659).

The “associated features” of migraine include extreme sensitivity to light and noise:

About three quarters of migraine suffers complain of sound sensitivity. It is the third most common migraine symptom behind throbbing pain and sensitivity to light. About 77 percent of females and 70 percent of males experience sound sensitivity with migraine attacks. (migraine.com)

The more severe symptoms of epilepsy may include loss of consciousness, violent muscle contractions or stiffening and collapsing to the ground, drooling, teeth gnashing, thrashing of head and legs, vocalizations, and loss of bladder and bowel control.
However, while an epileptic seizure or fit typically lasts 1 or 2 minutes, a migraine can last from 4 to 72 hours (Haut S659).

Postdrome

In epilepsy, the altered state of consciousness that a person enters after experiencing a seizure is called the postictal state, which is characterized “poor attention and concentration, poor short term memory, decreased verbal and interactive skills, and a variety of cognitive defects specific to individuals” (Fisher and Schachter). It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures.

In migraine, “postdrome features include impaired concentration, malaise, or euphoria” (Haut S659).

Already with these differences, we can begin to examine Emily’s poetry with an eye towards diagnosis: Does she experience symptoms of aura – and if so, does she experience black outs or loss of vision? What about fortification spectra? Does she hear phantom noises, voices that aren’t there, music or ringing? Does she display an aversion to light and noise?

In particular, is she dealing with something quick, sudden and fleeting, that comes as a shock and departs just as suddenly leaving mental fog? Or is it something that grows slowly, builds, lasts a long time, and finally fades away – leaving her weak, confused, but also with a sense of euphoria or malaise? And most importantly, does she describe twitching, thrashing and falling; or intense, throbbing headache? With these questions in mind, we are in a better position to re-examine her poetry.

Migraine Experiences

Before we begin, however, it will be useful to familiarize ourselves with a few testimonials from modern migraine sufferers. It is difficult to comprehend, for those without the symptoms, how jarring and disturbing migraine symptoms can be collectively – especially when they manifest for the first time. Sufferers often think they are losing their mind or having a spiritual (or demonic) encounter. Obviously Dickinson would not have used medical terms to describe her experiences – she would have done the best she could with the language at hand. Hence it will be worthwhile to examine the accounts of contemporary migraine sufferers, to witness the kind of language they use.

The following are a selection of comments posted on various online message boards (primarily the “Live Journal for Support Group for Migraine Sufferers”) which were collected by the Migraine Aura Foundation.

“For me, it’s accompanied by a faint, far-away, whistling sound, and all the noise around me sounds ‘muffled’. This has only happened to me very rarely, thankfully! It’s very upsetting!”

“I see blotches of black or dark grey. My sense of smell and hearing are heightened. I also have audial hallucinations. I hear humming or ringing noises or sometimes a high-pitched tone. Then I feel a weird sensation that’s hard to explain. Sort of like being on an airplane as it’s pressurizing. Noises sound louder, and light seems brighter. I can also feel the headache in the background. It’s not actually pain yet, but it’s there.”

“I had many headaches as a child and at eight, I remember my shock when a friend told me she had never one… Around the age of eleven, I suffered from commanding inner voices and rhythms that terrified me with their insistence. They always came when I was alone and they seemed to want to impose their will on me, to press my body into their marching orders. The danger of madness seemed very real to me then, and I’m lucky they vanished. It’s hard for me to know if those numinous moments in childhood are connected to auras. I can’t help but think there is some neurological fragility underlying those experiences, but whether they were followed by headaches, I honestly don’t know.”

“To best describe my lead up symptoms, first my hearing is affected. To give an idea, if you imagine a radio in the adjacent room to you that you can hear it is on but can’t make out the speech clearly; that is how I hear… I also get like hearing hallucinations – this can be like if I run my hand over a quilt, the sound of my nails against the material sounds like lots of little voices. These symptoms last from about 5 minutes to a max of about 20 minutes and I need to sleep in a quiet room while they are happening. I can tell you they are most scary to go through because they make you paranoid and so powerless to do anything – you just have to ride out the storm and then there are 2 – 5 hours of severe head pain afterwards.”

“I do get the feeling that I am larger than I logically know my body to be, and closing my eyes doesn’t change anything. But then sometimes closing my eyes does make me feel normal again, especially when it seems like my feet are on the other side of the room. I don’t remember if I always saw any change in depth perception, but it always seemed to at least feel like a change in depth perception. I just don’t remember if objects seemed farther away, but my body parts most certainly did. It seems like a lot of different things are happening here and I don’t know if I can separate them out as discrete experiences.”

“The ‘voices’ usually came from behind me, usually over my left shoulder. It sounded like somebody I knew, but I could never figure out who. Usually it was a pretty short sensation, just a few seconds. There wasn’t exactly murmuring, it was more like my name was riding on a wave and was cresting when I heard it.”

“I never used to get auras… then a few years ago I started getting visual auras [spotty vision, temporary blindness in my left eye, flashing blue lights, etc] Then last year I started smelling things… like cotton candy, bacon, cough syrup, etc… and a few months ago, I was sitting in my room reading, when I heard my name… just plain as day, like someone was trying to get my attention… it sounded like someone I know but… I don’t know who… I jumped, and immediately freaked out… the experience left me quite shaken… an hour or so later I went to bed, and woke up during the middle of the night with the worst migraine ever. It’s happened a few times since then… I’ve heard my name, heard some sort of music, and heard what sounds like running water/dishes from the kitchen. It doesn’t last very long at all, and is almost always followed by a migraine.”

“I’m used to hearing weird things when I’m falling asleep or just waking up/still sort of dreaming, and this isn’t like that. It happens when I’m fully awake and alert, even when other people have been in the room. It’s good to know I’m not going crazy.”

“It’s getting more and more prominent, hearing almost whispering and like I can hear music [i.e. musical hallucinations] but can’t quite make it out, as if a radio is on somewhere far away. Strange white noise [i.e. tinnitus] as well sometimes.”

“Sometimes I hear quiet music playing that isn’t really there. It drives me crazy looking for the source and then I realize it is quite literally all in my head. Thank goodness it doesn’t happen frequently. More often, I have olfactory hallucinations where I smell chocolate, bacon, maple syrup, etc. My husband never smells these things when I do, so I can only assume they are not really there. So bizarre!”

“I often hear what sounds like someone walking around in our house. They aren’t sounds of the house ‘settling’ either. It will sound quite distinctly like someone’s shoes hitting our kitchen floor — that’s the one room on the main floor of our house that isn’t carpeted. If I’m on the lower level of our house, I’ll be sure I’m hearing someone walk from one end of the house to the other. There are also times when I’ll think I’m hearing music, but the stereo, radio, and television are turned off.”

Revisiting Emily Dickinson’s Poetry

It may be difficult, especially for those already familiar with the interpretation of Emily Dickinson’s literature (which often extends to lofty heights and universal experiences of suffering, love and death) to re-read her poems looking for symptoms of neurological disorder; nevertheless it is worth the effort. What I’ve attempted below – and I believe the attempt to be unique – is to arrange a selection of Dickinson’s poems within the typical stages of a migraine episode. If some of the poems defy such classification, it is usually because they are about the entire migraine event, rather than simply partial symptoms. Let me point out again that, although I believe Emily to have suffered from some migraine episodes and recorded her experiences, I will not claim that Emily only suffered from migraines; a few of her poems do seem to describe something like epilepsy – others seem to point to night tremors or sleep paralysis. Nor am I claiming that Emily’s poetry is only about migraine (although the condition may have prompted her to speculate on life, death and suffering).

The Prodrome/Aura
Sensitivity to sound, auditory effects
Emily describes a state of waiting for an inevitable occurrence of dismay and despair:

The inevitable-
While I was fearing it, it came,
But came with less of fear,
Because that fearing it so long
Had almost made it dear.
There is a fitting a dismay,
A fitting a despair.
‘Tis harder knowing it is due,
Than knowing it is here.
The trying on the utmost,
The morning it is new,
Is terribler than wearing it
A whole existence through.

Rather than “suffering”, she is referring to something recurring, something that “is due” – most likely a fit or episode (which could classify either epilepsy or migraine). She often refers to this experience as “death” figuratively, but makes clear that it “was not death” but something like it.

It was not death, for I stood up,
And all the dead lie down;
It was not night, for all the bells
Put out their tongues, for noon.
It was not frost, for on my flesh
I felt siroccos crawl,
Nor fire, for just my marble feet
Could keep a chancel cool.
And yet it tasted like them all;
The figures I have seen
Set orderly, for burial,
Reminded me of mine,
As if my life were shaven
And fitted to a frame,
And could not breathe without a key;
And I was like midnight, some,
When everything that ticked has stopped,
And space stares, all around,
Or grisly frosts, first autumn morns,
Repeal the beating ground.
But most like chaos,–stopless, cool,
Without a chance or spar,–
Or even a report of land
To justify despair.

Rather than the language we would except of an epileptic thrashing about or moving uncontrollably, she describes herself as frozen, like a corpse, locked up and immobile. The poet notices the sounds of bells ringing, her cold feet, and crawling skin. As I’ve pointed out, “ringing noises” are a common feature of migraines – along with, as it happens, cold extremities and crawling skin. According to user “Jenny R.” on an online thread under the topic “Anyone have skin hypersensitivity that have migraines?”:

“Sometimes I can’t stand to wear a tight fitting top because it feels like there are hundreds of ants crawling under it, drives me insane. I do know that a lot of time when I get these feeling I end up with a migraine at least within the next few days.”

In The Migraine Brain, the authors ask “Do you often have cold hands? Do your fingers or toes turn blue, red, or pale after you drink a cold drink? The tendency toward cold hands is often a symptom of migraine. And a condition called Raynaud’s syndrome, a vascular disorder that causes decreased circulation in the fingers and toes, is also connected in some people to migraines” (Bernstein and McArdle).

Interestingly, the poems concludes with a sailing reference, “report of land” – which will allow us to identify this “not death” experience with Emily’s ship/storm poems.

Besides bells, Dickinson also categorizes this “death” with a buzzing sound and the loss of eyesight. She again repeats the storm imagery:

I heard a fly buzz when I died;
The stillness round my form
Was like the stillness in the air
Between the heaves of storm.
The eyes beside had wrung them dry,
And breaths were gathering sure
For that last onset, when the king
Be witnessed in his power.
I willed my keepsakes, signed away
What portion of me I
Could make assignable,-and then
There interposed a fly,
With blue, uncertain, stumbling buzz,
Between the light and me;
And then the windows failed, and then
I could not see to see.

It is telling that Dickinson describes the buzz as “blue” – mixing seeing sounds and hearing lights is another common migraine feature; blue light in particular seems to be the color most often experienced by migraineurs, although I can’t find any medical study confirming this. Dickinson also hears music that has no earthly source, and describes it as “silver”:

Musicians wrestle everywhere:
All day, among the crowded air,
I hear the silver strife;
And — waking long before the dawn —
Such transport breaks upon the town
I think it that “new life!”
It is not bird, it has no nest;
Nor band, in brass and scarlet dressed,
Nor tambourine, nor man;
It is not hymn from pulpit read, —
The morning stars the treble led
On time’s first afternoon!
Some say it is the spheres at play!
Some say that bright majority
Of vanished dames and men!
Some think it service in the place
Where we, with late, celestial face,
Please God, shall ascertain!
She also hears whistling, or a bugle:

Heart, not so heavy as mine
Wending late home —
As it passed my window
Whistled itself a tune —
A careless snatch — a ballad — A ditty of the street —
Yet to my irritated Ear
An Anodyne so sweet —
It was as if a Bobolink
Sauntering this way
Carolled, and paused, and carolled —
Then bubbled slow away!
It was as if a chirping brook
Upon a dusty way —
Set bleeding feet to minuets
Without the knowing why!
Tomorrow, night will come again —
Perhaps, weary and sore –Ah Bugle! By my window
I pray you pass once more.

And again, a rushing sound, “as if the streets were running,” accompanied by loss of vision (an eclipse at the window). The last line – mixing fresher air – may be the dancing or moving appearance of the scotoma:

It sounded as if the streets were running,
And then the streets stood still.
Eclipse was all we could see at the window,
And awe was all we could feel.

By and by the boldest stole out of his covert,
To see if time was there.
Nature was in her beryl apron,
Mixing fresher air.
She hears thunder “nearer than the sky,” though there was no storm; and is struck by lightning (which is not real lightning, as it struck only her). It is a “crash without a sound”:
THE FARTHEST thunder that I heard
Was nearer than the sky,
And rumbles still, though torrid noons
Have lain their missiles by.
The lightning that preceded it
Struck no one but myself,
But I would not exchange the bolt
For all the rest of life.
Indebtedness to oxygen
The chemist may repay,
But not the obligation
To electricity.
It founds the homes and decks the days,
And every clamor bright
Is but the gleam concomitant
Of that waylaying light.
The thought is quiet as a flake,—
A crash without a sound;
How life’s reverberation
Its explanation found!

Sensitivity to light, blindness, visual effects

Whether migraine or epilepsy, we know that Dickinson was sensitive to light – in 1864 Dickinson spent over half the year in Boston for a medical problem thought to have been an eye disorder. Gordon reports, “Dr. Williams was enthusiastic about a cure, and ordered Emily Dickinson to avoid sunlight as well as snow light – the glitter coming off the snow affected her eyes” (128). So we can hardly fail to take Emily literally, at her word, when she writes that “a certain slant of light” causes her “heavenly hurt” in her brain (where the meanings are):

There’s a certain slant of light,
On winter afternoons,
That oppresses, like the weight
Of cathedral tunes.

Heavenly hurt it gives us;
We can find no scar,
But internal difference
Where the meanings are.

None may teach it anything,
‘Tis the seal, despair,-
An imperial affliction
Sent us of the air.

When it comes, the landscape listens,
Shadows hold their breath;
When it goes, ‘t is like the distance
On the look of death.

Again she mixes sight with hearing – the light “oppresses like the weight of cathedral tunes”. She is describing a pain without a scar; a difference somewhere in the site of the brain – caused by nothing, sent by “air”. (It is no wonder that her comments on God paint him as a cold and distant tyrant, when she needs to suffer this inexplicable pain). She describes silence and shadow – not the wild frenzy of epilepsy, but the calm horror of migraine.

In a similar poem, she tries to figure out this “divine clew” which leaves her baffled. She begins by describing how “colors tease” and her “cocoon tightens.” She experiences skin discomfort and the feeling of being restricted by her clothing:

MY cocoon tightens, colors tease,
I’m feeling for the air;
A dim capacity for wings
Degrades the dress I wear.

A power of butterfly must be
The aptitude to fly,
Meadows of majesty concedes
And easy sweeps of sky.

So I must baffle at the hint
And cipher at the sign,
And make much blunder, if at last
I take the clew divine.

And again – while she feels cool, numb and removed from time, she witnesses the dancing of colors:
As far from pity as complaint,
As cool to speech as stone,
As numb to revelation
As if my trade were bone.
As far from time as history,
As near yourself to-day
As children to the rainbow’s scarf,
Or sunset’s yellow play
To eyelids in the sepulchre.
How still the dancer lies,
While color’s revelations break,
And blaze the butterflies!

She frequently reports loss of sight; in the following poem she contrasts herself with the animals, who are “incautious of the sun”:

BEFORE I got my eye put out,
I liked as well to see
As other creatures that have eyes,
And know no other way.

But were it told to me, to-day,
That I might have the sky
For mine, I tell you that my heart
Would split, for size of me.

The meadows mine, the mountains mine,—
All forests, stintless stars,
As much of noon as I could take
Between my finite eyes.

The motions of the dipping birds,
The lightning’s jointed road,
For mine to look at when I liked,—
The news would strike me dead!

So, safer, guess, with just my soul
Upon the window-pane
Where other creatures put their eyes,
Incautious of the sun.

She records a eye dying, becoming cloudy and foggy:

I ’VE seen a dying eye
Run round and round a room
In search of something, as it seemed,
Then cloudier become;
And then, obscure with fog,
And then be soldered down,
Without disclosing what it be,
’T were blessed to have seen.

Of course it is quite possible that – especially in the last poem – Emily is really talking about watching someone die; but when viewed in conjunction with the previous poem (before I got my eye put out) it is clear that she has personal experience of a similar phenomenon.

The Ictus – Throbbing, Pounding Headache

This section deals with the most obvious symptom of migraine – a “splitting” or “pounding” or “piercing” headache. Emily describes the progression of brain-pain with creative imagery, again accompanied by the sounds of a bell:

I felt a Funeral, in my Brain,
And Mourners to and fro
Kept treading – treading – till it seemed
That Sense was breaking through –

And when they all were seated,
A Service, like a Drum –
Kept beating – beating – till I thought
My Mind was going numb –

And then I heard them lift a Box
And creak across my Soul
With those same Boots of Lead, again,
Then Space – began to toll,

As all the Heavens were a Bell,
And Being, but an Ear,
And I, and Silence, some strange Race
Wrecked, solitary, here –

And then a Plank in Reason, broke,
And I dropped down, and down –
And hit a World, at every plunge,
And Finished knowing – then –

Although the break down in reason and the “I dropped down, and down…” may seem to point to epilepsy, the rhythmic beat of the rest of the poem is indicative of migraine. As Levy notes,

She’s got the step-by-step of the headache absolutely right, the movement from a soft pulsating pain (“treading—treading—”) to a pounding throb (“beating—beating—”). She describes the traumatized responses of the self to what envelops it: the growing despair (“Sense was breaking through”), then the degraded numbness, then the otherworldly solitude, the self and the “toll” of pain together occupying some appallingly exclusive cosmos. And then, the final stage: the wordlessness, the thoughtlessness. (92-93)
As we’ve seen, this inability to join thoughts or recall memories may be experienced with either disorder; however the stillness, the blindness, the coldness, and most importantly the introspective ability to be aware of the process, can only be found in migraine:

From Blank to Blank —
A Threadless Way
I pushed Mechanic feet —
To stop — or perish — or advance —
Alike indifferent–6
I felt a cleaving in my Mind–
As if my Brain had split —
I tried to match it — Seam by Seam —
But could not make them fit.
The Thought behind, I strove to join
Unto the thought before —
But Sequence ravelled out of Sound
Like Balls — upon a Floor.7
Icicles upon my Soul
Prickled Blue and Cool —
Bird went praising everywhere
Only Me — was still — …8
If end I gained,
It ends beyond
Indefinitely disclosed–
I shut my eyes — and groped as well
’twas light — to be Blind –9

She characterizes the pain as being played or forged by a divine hand, stunned by degrees and beaten by hammers; it grows and grows until she feels “scalped”:

HE fumbles at your spirit
As players at the keys
Before they drop full music on;
He stuns you by degrees,

Prepares your brittle substance
For the ethereal blow,
By fainter hammers, further heard,
Then nearer, then so slow

Your breath has time to straighten,
Your brain to bubble cool,—
Deals one imperial thunderbolt
That scalps your naked soul.

Compare the last poem with this migraine experience:
I had a similar experience around a year ago… I was asleep, dreaming, when suddenly I experienced (in the context of my dream) what felt like a ‘HUGE’ jolt of electricity at the base of my skull… simultaneous with this I experienced a huge, echoing hum/zap/boom (hope you get the idea here) sound. I awoke ‘immediately’, with the sound of the ‘jolt’ still seeming to echo in my ears… for the rest of the day I felt a bit ‘out of it’ cognitively… (Migraine Aura Foundation)

Emily’s emphasis is not on the fear or panic of an expected fit, but rather on describing the pain as vividly as possible:

A weight with needles on the pounds –
To Push, and pierce, besides –
That if the Flesh resists the Heft –
The Puncture coolly tries…

It struck like a lightning bolt and burned like a fire (interestingly, it seems to be worsened by “every morning’s beam” – again a reference to light sensitivity):

IT struck me every day
The lightning was as new
As if the cloud that instant slit
And let the fire through.

It burned me in the night,
It blistered in my dream;
It sickened fresh upon my sight
With every morning’s beam.

I thought that storm was brief,—
The maddest, quickest by;
But Nature lost the date of this,
And left it in the sky.

Although one particular storm may seem brief, others drag on and on:

The Mystery of Pain
Pain has an element of blank;
It cannot recollect
When it began, or if there were
A day when it was not.

It has no future but itself,
Its infinite realms contain
Its past, enlightened to perceive
New periods of pain.

And just when she thought the storm was over and she could see the shore, the pain resumed:

I MANY times thought peace had come,
When peace was far away;
As wrecked men deem they sight the land
At centre of the sea,

And struggle slacker, but to prove,
As hopelessly as I,
How many the fictitious shores
Before the harbor lie.

Again Dickinson laments her loss of sight and writes that she is “dying”:

How well I knew the light before!
I could not see it now.
‘Tis dying, I am doing; but
I’m not afraid to know

The Postdrome, Euphoria/Malaise

After surviving through the pain (or as some migraineurs put it, “weathering the storm”) there is an intense stillness:

After great pain,
a formal felling comes —
The Nerves sit ceremonious,
Like Tombs — …

But there is also joy and elation (euphoria) from getting through the episode, as well as a heightened sense of life’s power and mystery. Dickinson returns from the voyage – again using the sea/sailor metaphor – eager to share the “supernatural” things she’s witnessed and promising to “tarry” longer next time:

Just lost when I was saved!
Just felt the world go by!
Just girt me for the onset with eternity,
When breath blew back,
And on the other side
I heard recede the disappointed tide!
Therefore, as one returned, I feel,
Odd secrets of the line to tell!
Some sailor, skirting foreign shores,
Some pale reporter from the awful doors
Before the seal!
Next time, to stay!
Next time, the things to see
By ear unheard,
Unscrutinized by eye.
Next time, to tarry,
While the ages steal, —
Slow tramp the centuries,
And the cycles wheel.

Again, she depicts the pain as a heavenly blacksmith, hammering her soul (rhythmically, but in silence) to perfection:

DARE you see a soul at the white heat?
Then crouch within the door.
Red is the fire’s common tint;
But when the vivid ore

Has sated flame’s conditions,
Its quivering substance plays
Without a color but the light
Of unanointed blaze.

Least village boasts its blacksmith,
Whose anvil’s even din
Stands symbol for the finer forge
That soundless tugs within,

Refining these impatient ores
With hammer and with blaze,
Until the designated light
Repudiate the forge.

The “bliss” builds inside her, then fades:

I HAD a daily bliss
I half indifferent viewed,
Till sudden I perceived it stir,—
It grew as I pursued,

Till when, around a crag,
It wasted from my sight,
Enlarged beyond my utmost scope,
I learned its sweetness right.

She is drunk off “a liquor never brewed”:

I taste a liquor never brewed,
From tankards scooped in pearl;
Not all the vats upon the Rhine
Yield such an alcohol!
Inebriate of air am I,
And debauchee of dew,
Reeling, through endless summer days,
From inns of molten blue.
When landlords turn the drunken bee
Out of the foxglove’s door,
When butterflies renounce their drams,
I shall but drink the more!
Till seraphs swing their snowy hats,
And saints to windows run,
To see the little tippler
Leaning against the sun!

She is used to pain, but a little bit of joy overwhelms:

I can wade Grief—
Whole Pools of it—
I’m used to that—
But the least push of Joy
Breaks up my feet—
And I tip—drunken—
Let no Pebble—smile—
‘Twas the New Liquor—
That was all!

‘T is so much joy! ‘T is so much joy!
If I should fail, what poverty!
And yet, as poor as I
Have ventured all upon a throw;
Have gained! Yes! Hesitated so
This side the victory!
Life is but life, and death but death!
Bliss is but bliss, and breath but breath!
And if, indeed, I fail,
At least to know the worst is sweet.
Defeat means nothing but defeat,
No drearier can prevail!
And if I gain, — oh, gun at sea,
Oh, bells that in the steeples be,
At first repeat it slow!
For heaven is a different thing
Conjectured, and waked sudden in,
And might o’erwhelm me so!

Pain gave Emily Dickinson’s life meaning and purpose; and yet this pain was still unexplained, undiagnosed, and mysterious. She found herself comparing her grief to everyone else’s, trying to “baffle at the hint and cipher at the sign” – in other words, to figure out why this terrible pain came and went seemingly without any pattern, cause or remedy (“And though I may not guess the kind –
Correctly – yet to me”). Her grief is worse than death, it hurts to live, and in a rare religious sentiment, she compares her suffering to Jesus’ crucifixion:

I measure every Grief I meet
With narrow, probing, eyes –
I wonder if It weighs like Mine –
Or has an Easier size.

I wonder if They bore it long –
Or did it just begin –
I could not tell the Date of Mine –
It feels so old a pain –

I wonder if it hurts to live –
And if They have to try –
And whether – could They choose between –
It would not be – to die –

I note that Some – gone patient long –
At length, renew their smile –
An imitation of a Light
That has so little Oil –

I wonder if when Years have piled –
Some Thousands – on the Harm –
That hurt them early – such a lapse
Could give them any Balm –

Or would they go on aching still
Through Centuries of Nerve –
Enlightened to a larger Pain –
In Contrast with the Love –

The Grieved – are many – I am told –
There is the various Cause –
Death – is but one – and comes but once –
And only nails the eyes –

There’s Grief of Want – and grief of Cold –
A sort they call “Despair” –
There’s Banishment from native Eyes –
In sight of Native Air –

And though I may not guess the kind –
Correctly – yet to me
A piercing Comfort it affords
In passing Calvary –

To note the fashions – of the Cross –
And how they’re mostly worn –
Still fascinated to presume
That Some – are like my own

One of the most frustrating things about migraine disorder – and this is true even today – is that it is very poorly understood. Although migraine sufferers now have access to preventive and abortive medications, experiencing the bizarre and frightening effects (hearing voices and music, seeing lights and colors, the intense, throbbing headaches) can be a lonely and traumatic experience. Only in the past decade or two have sufferers been able to “Google” their symptoms in order to quickly reach a self-diagnosis. Before the internet, finding a solution meant first confiding in your friends and family that you were, in effect, “losing your mind.”

Perhaps Dickinson’s corpus is a practice that many migraineurs continue in the form of keeping a “migraine journal”; a record of these magnificent and otherworldly cerebral episodes, with the hope of detecting some kind of pattern or cause by which triggers can be detected and the migraines can be avoided.

Allowing such a reading of Emily Dickinson does not detract from her esteemed place in literary studies, but only transforms her – from a unique visionary who experienced things as no other mortal could, to a woman who has shared the common pain of an affliction suffered by more than 10% of the human race, and let the inspiration gleaned invest her writing with power, reflection and meaning.

As Levy writes,

“It might be both depressing and reductive to say that Dickinson’s “I felt a Funeral, in my Brain” is about a headache. It is, but like many Dickinson poems, it is also about spirit, nature, sex, power, family, madness, and truth. It’s about what Virginia Woolf meant when she told us that we may glimpse “undiscovered countries,” the “wastes and deserts of the soul,” from even “a slight attack of influenza”—if only we’d pay attention. Dickinson’s genius is that she found a way to write about these larger things in such a way that she revealed the common configuration of experience across a range of what makes us human, and that head pain, amazingly, was banded together with these larger things. That the truth would blow off the top of your head, like orgasm, like pain, like God, like lightning, like beauty. Headache, Dickinson tells us, is one of the universals, or near it.” (102)

Works Cited

Bernstein, Carolyn; McArdle, Elaine (2008-09-16). The Migraine Brain (Kindle Locations 721-723). Simon & Schuster, Inc. Kindle Edition.
Engel, Jerome. Seizures and epilepsy. Philadelphia: F.A. Davis Co., 1989. Print.
Fisher, RS, and SC Schachter. “The Postictal State: A Neglected Entity in the Management of Epilepsy.” Epilepsy & Behavior 1.1 (2000): 52-59. Print.
GROSSMAN, LEV . “A Brain Wider Than the Sky by Andrew Levy.” TIME. N.p., n.d. Web. 2 Jan. 2012. <http://www.time.com/time/magazine/article/0,9171,1901472,00.html>.
Gordon, Lyndall. Lives like loaded guns: Emily Dickinson and her family’s feuds. New York: Viking, 2010. Print.
Haut, MD, Sheryl. “Differentiating Migraine from Epilepsy.” Advanced Studies in Medicine 5 (2005): S658-S665. Print.
Hirschhorn MD, Norbert . “A REVIEW OF THE ROLES OF GLYCERINE AND CHLORAL HYDRATE IN 19 TH CENTURY PHARMACOTHERAPY.” Bertz Poet. N.p., n.d. Web. 2 Jan. 2012. <www.bertzpoet.com/essays/pdfs/reviewGlycerine.pdf>.
Kirk, Connie Ann . “Emily Dickinson conference at Oxford fuels biography debate – National Emily Dickinson | Examiner.com.” Examiner.com. N.p., n.d. Web. 3 Jan. 2012. <http://www.examiner.com/emily-dickinson-in-national/emily-dickinson-conference-at-oxford-fuels-biography-debate>.
Levy, Andrew. A Brain Wider Than the Sky A Migraine Diary. New York: Simon & Schuster, 2010. Print.
Lippman, C. W. “Certain hallucinations peculiar to migraine.” Journal of Nervous and Mental Disease 116 (1952): 346-351. Print.
“Migraine sensitivity to sound symptoms.” Migraine.com. N.p., n.d. Web. 3 Jan. 2012. <http://migraine.com/migraine-symptoms/sensitivity-to-sound/>.
Pedersen, Donald M., William M. Wilson, George L. White, Jr., Richard T. Murdock, and Kathleen B. Digre. “Migraine aura without headache.” Life & Health Library. Journal of Family Practice, n.d. Web. 3 Jan. 2012. <http://findarticles.com/p/articles/mi_m0689/is_n5_v32/ai_10881173/>.
Podoll, Klaus. “Auditory aura symptoms.” Migraine Aura Foundation. N.p., n.d. Web. 2 Jan. 2012. <www.migraine-aura.org/content/e27891/e27265/e26585/e26596/index_en.html>.
R., Jenny. “Anyone have skin hypersensitivity that have migraines?.” HealthBoards . N.p., n.d. Web. 3 Jan. 2012. <http://www.healthboards.com/boards/showthread.php?t=409712>.
Rose, F. Clifford. Neurology of music. London: Imperial College Press ;, 2010. Print.
Silberstein, SD, and RB Lipton. “Migraine & Epilepsy : Epilepsy.com/Professionals.” Epilepsy and seizure information for healthcare professionals : Epilepsy.com/Professionals. N.p., n.d. Web. 3 Jan. 2012. <http://professionals.epilepsy.com/page/migraine.html>.
it!, Share. A Brain Wider Than the Sky: A Migraine Diary. New York: Simon & Schuster, 2010. Print.

About Derek Murphy

I help authors and artists turn their passions into full-time businesses, make a bigger impact, and blaze a luminous trail of creative independence. Right now I'm in Taiwan finishing a PHD in Literature, writing several books, and managing a handful of online businesses. Find me
  • Elise Logan

    This is fascinating. When I was trying to figure out what was going on with my headaches, I came across a theory that suggested that Byron, for example, suffered from cluster headaches, not epilepsy as suggested by Nietzche. The discussion on this point also posited that sufferers of cluster headaches (also called “suicide headaches”) often tended to be very creative, probably because they self-medicated using alcohol or drugs.

    Cluster headaches are physiologically different from migraines and don’t have the “auras” or “halos” and are also not typically light-sensitive, so in the history they often end up as “possible epilepsy” rather than migraines.

    In any case, it’s interesting to see someone else making this connection. As a side note, while most of the literature says there is no treatment for cluster headaches (aside from big drugs), there is a strong link to triggers, in the same manner that migraines are often connected to triggers.

    • Interesting – I wonder sometimes whether we’ve killed genius off with medication. Personally I’m not willing to suffer through the pain in return for inspiration… I like my meds. I can’t get anything done when I have a headache or migraine, and it can easily waste a whole day. But I was probably more enthusiastically creative when I was younger and less medicated. (I take preventative meds now, and experiment with migraine meds when I get a bad one, though I haven’t found anything that really works.

      • Elise Logan

        With my cluster headaches, there simply aren’t big enough drugs. The only thing they can do is basically knock you out until it passes. Not really good for creative endeavor. On the other hand, once I figured out what my main trigger was, I started avoiding it – and haven’t had any cluster headaches since then.

        I don’t know if you have triggers for your migraines, but if you can figure out what triggers you may have, that can go a long way toward keeping them from showing up in the first place.

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