The Headache summary

For most of our history, headaches weren’t seen as medical conditions but as warnings from the gods, signs of sin, or symptoms of nervous weakness. People were so desperate that in ancient times, trepanation – drilling a hole right into the skull – was one desperate attempt to relieve the pressure. Later, Greek and Roman physicians linked head pain to imbalances in the body’s “humors.” By the Enlightenment, theories grew more elaborate but not necessarily more accurate. For instance, one eighteenth-century doctor blamed masturbation – and another blamed meat pies.

As science evolved, so did ideas about what actually caused a migraine. For centuries, a lot of people believed the gut was to blame. The term “sick headache” reflected how often nausea and digestive issues accompanied the pain. There’s actually still some truth to that – modern research has explored a possible “gut-brain axis” – but early treatments ranged from food avoidance to vomiting, bleeding, and plasters made with animal parts. Even food triggers like butter or black pepper were treated as character flaws rather than medical facts.

For years, Zeller held on to a doctor who couldn’t cure him but tried. This man misdiagnosed him, prescribed dubious treatments, and ultimately left medicine in disgrace – but he did one important thing: he listened. And for someone lost in the world of headache disorders, that mattered. The medical journey for headache patients is rarely linear. People bounce from physician to physician, often for years, before finding someone who validates their pain.

Stories like Kathy O’Shea’s are unfortunately all too common. Her first neurologist, during a brutal onset at 14, assumed her headaches were psychological. He asked if she wanted her mother to leave the room so she could “talk about what’s really going on at home.” Later, another specialist even implied she might be an addict. It’s a familiar loop: pain, dismissal, overmedication, and isolation.

In 2020, 24-year-old Will Erwin took his own life after one last final, fruitless search for relief from cluster headaches. His parents, devastated by how little medical science seemed to know or care about the disorder, founded a research initiative in his name. One such research study, based at Yale, is now searching for genetic clues to cluster headaches. Emmanouil Dermitzakis, a renowned Swiss geneticist leading similar research in Europe, had never heard of the condition before being approached by colleagues. That level of obscurity reflects how marginalized headache disorders remain – even in elite scientific circles.

Patients with chronic headache disorders – especially cluster headaches – often feel abandoned by the medical system. Their pain doesn’t show up on scans, and standard tests can’t explain it. Many patients report being dismissed, misdiagnosed, or told their pain isn’t real – especially women, who are more likely to have their symptoms attributed to stress or emotion. In that vacuum, online support groups have become a kind of underground healthcare network – places to trade treatment tips, swap names of trusted specialists, and share frustration with a system that too often shrugs.

Despite being one of the most burdensome medical conditions on the planet, migraine remains near the bottom of the National Institutes of Health’s priority list. For decades, advocates have pushed for better. Congress has even added formal language to budget reports urging the NIH to act. But inside the agency, those requests often go ignored or brushed aside.

The reason why, according to critics, is both structural and cultural. It works like this: NIH funding follows demand: grants go where proposals go, and proposals go where funding has historically flowed. Since headache research was never a priority, it’s stuck in a vicious loop – few researchers apply, so few grants are awarded, reinforcing the idea that the field lacks promise. And when proposals do come in, they’re measured against those from better-funded disciplines, making it harder to compete.