Patterns

By Oliver Sacks

I have had migraines for most of my life; the first attack I remember occurred when I was 3 or 4 years old. I was playing in the garden when a brilliant, shimmering light appeared to my left �?dazzlingly bright, almost as bright as the sun. It expanded, becoming an enormous shimmering semicircle stretching from the ground to the sky, with sharp zigzagging borders and brilliant blue and orange colors. Then, behind the brightness, came a blindness, an emptiness in my field of vision, and soon I could see almost nothing on my left side. I was terrified �?what was happening? My sight returned to normal in a few minutes, but these were the longest minutes I had ever experienced.
I told my mother what had happened, and she explained to me that what I had had was a migraine �?she was a doctor, and she, too, was a migraineur. It was a “visual migraine,�?she said, or a migraine “aura.�?The zigzag shape, she would later tell me, resembled that of medieval forts, and was sometimes called a “fortification pattern.�?Many people, she explained, would get a terrible headache after seeing such a “fortification�?�?but, if I were lucky, I would be one of those who got only the aura, without the headache.
I was lucky here, and lucky, too, to have a mother who could reassure me that everything would be back to normal within a few minutes, and with whom, as I got older, I could share my migraine experiences. She explained that auras like mine were due to a sort of disturbance like a wave passing across the visual parts of the brain. A similar “wave�?might pass over other parts of the brain, she said, so one might get a strange feeling on one side of the body, or experience a funny smell, or find oneself temporarily unable to speak. A migraine might affect one’s perception of color, or depth, or movement, might make the whole visual world unintelligible for a few minutes. Then, if one were unlucky, the rest of the migraine might follow: violent headaches, often on one side, vomiting, painful sensitivity to light and noise, abdominal disturbances, and a host of other symptoms.
In her memoir, “Giving Up the Ghost,�?the British novelist Hilary Mantel describes the migraines she started to have in early childhood:
My eyes are drawn to a spot. �?I can’t see anything, not exactly see: except the faintest movement, a ripple, a disturbance of the air. I can sense a spiral, a lazy buzzing swirl, like flies; but it is not flies. There is nothing to see. There is nothing to smell. There is nothing to hear. But its motion, its insolent shift, makes my stomach heave. I can sense �?at the periphery, the limit of all my senses �?the dimensions of the creature. It is as high as a child of two. Its depth is a foot, fifteen inches. �? It has no edges, no mass, no dimension, no shape except the formless; it moves. �? Within the space of a thought it is inside me, and has set up a sick resonance within my bones and in all the cavities of my body.