I don't get it. The prevalence of headaches must mean some doctors also get headaches. How do they reconcile their symptoms with their practice?
Same goes for women's health. Surely some typically painful routine procedures are experienced by the very doctors that perform them. Again, how do they reconcile their experience with how they practice?
That's good because I wasn't asking them to do anything about it. I was asking to understand an apparent emotional-empathy contradiction. I don't think you would be able to answer it unless you had personal experience being in that situation.
Patients seeking solutions often experience frustration and desperation. They visit neurologists, anesthesiologists, pain-management specialists, alternative healers, and online chat groups, trying to find explanations and relief.
Given the base-rate, surely some doctors must also experience these maladies themselves. How do they resolve the apparent contradiction of presumably their own frustration and desperation as a patient and while also being in some way the creator of it as a doctor?
This is not uncommon. There's lots of issues where there are no easy answer and even if you know most answers, the solutions are "there is ~20% chance this will help, if not there is ~15% chance this will help, ... etc.". And that's assuming you can identify the real problem not masking as something else. Dealing with the uncertainty is part of the job. Ideally you'd want the doctor to explain it to the patients too. But I wouldn't say they create the frustration as such. The frustration is that nobody know better answers.
> How do they resolve the apparent contradiction of presumably their own frustration and desperation as a patient and while also being in some way the creator of it as a doctor?
Those are typically different people, so there is no contradiction.
I understand they are different people. But, you would agree sometimes doctors have headaches where they are then are a patient treated by another doctor, right?
How would that person understand the contradiction of sometimes being in a role where they dismiss patients, but also sometimes being in the role of the patient where they are being dismissed?
I've wondered if it comes down to a game theory result where if you have x amount of time to distribute amongst y problems, there's more net social utility in applying a simple solution to everyone, and accepting that difficult problems will be missed. Versus spending detailed time on each problem, and as a result solving fewer problems but better.
Of course, when money comes into play, it seems as though you're going to be financially required to rush everyone through the door in 15 minutes, or else your business will lose to someone who adopts this strategy. Leaving anyone with a complex problem dead.
I spend a lot of time on migraine and pain subreddits and there is an air of deference to the medical authority to know what to do. But if your case is complex, you just can't fit into the simple flow chart, and need to advocate and problem solve for yourself. Which leads people into the path of pseudoscience and exploitation.
”The greatest benefit reported was for psilocybin taken during a remission period, with the average length of that remission period between headaches extending for 91% of participants.”
The author is a New yorker columnist, and seems to be a practicing / ex-practicing doctor. They talk about their experience with their various doctors and being passed around different medications with various side effects, to some degree of success. Despite all their expertise and expense, they still cannot find a root cause (which may not exist at all), and struggle to find a medication protocol that works for them.
If you really want a bad trip, head over to the r/migraine and r/chronicpain subreddits. These subreddits are full of people, with none of the resources or experiences as the author, betrayed entirely by the medical system which does not serve them, and condemned to chronic pain. The complexity and range of headache and migraine causes does not lend itself well to a 15 minute GP appointment every few months, and without the technical expertise these people turn to alternative medicine, online pseudoscience, and opiates.
I can't speak for others, but I've found my severe headaches are sometimes migrains, other times sinus headaches, retina pain, and/or iris pain. Most of the time, a couple over the counter "migraine" pills helps if I catch it early, most commonly starts in the morning as I wake up. If that doesn't work, in a couple hours a prescribed migraine pill... if I notice my irises are pin hole sized (as closed as can be), I have dilation drops that help. If that doesn't cut it, I'll take a cannabis gummy and just try to sleep until it goes away.
A couple times a year, it lasts for a day or more. That's when it really sucks. I keep on top of taking mucus relief and allergy pills, which keeps down the sinus headaches... but I'm never quite sure what it is, as it's all just sever pain inside my head. Often coming with nausea, severe pain, dizziness and sometimes panic attacks.
I also have chronic back and hip pain as well. I don't like opiates at all, they tend to come with excessive nausea.
Because there are no pain receptors in the brain, so if you have headache, you are just hallucinating your own pain through some positive feedback mechanism.
Er, no. There are no pain receptors in the brain, but there are pain receptors in the head (particularly, the meninges, periosteum, and scalp), and those are the receptors which produce headaches.
I’ve had many headaches, some of which respond exactly like you’d expect if the source of pain was receptors in the scalp, others of which do not.
The meninges and periosteum, which I mentioned also have pain receptors which can be involved in headaches, are very much not the same thing as the scalp.
The idea that the brain doesn't have pain receptors implies that headaches are just hallucinated pain is just completely nonsense.
BLARG!
there is a very very good chance that there are other mechanisms for triggering pain responses, like unnatural chemicals, such as concentrated ethenol or diesel fuel, photo copier fluid, etc, that can cross the blood brain barier, causing intense pain in many cases, but have little effect if applied topicaly.
on the flip side, one rather interesting thing about pain, is that it impossible to trigger pain from a memory, but then there are cases of symptoms of phantom pain in lost limbs, so I feel strongly that there will be new knowledge soon about pain, especialy as there a number of promising non opiod pain relievers that use completly different pathways to block pain.
I started getting migraines in the 1960s. Thanks for the link.
While a cup of coffee often helped me feel better in years past, I've found eliminating coffee from my diet has reduced my headache frequency. Triptans help when I get the occasional headache now.
I was disappointed that the article didn't talk about the variety of migraine manifestations. Some of the manifestations can be confused with transient ischemic attacks.
Decaffinated coffee is getting better and better every year; that could be a way for you to keep enjoying its benefits (mostly unrelated to caffeine) without the drawbacks.
https://archive.is/20250813193253/https://www.newyorker.com/...
I don't get it. The prevalence of headaches must mean some doctors also get headaches. How do they reconcile their symptoms with their practice?
Same goes for women's health. Surely some typically painful routine procedures are experienced by the very doctors that perform them. Again, how do they reconcile their experience with how they practice?
> I don't get it. The prevalence of headaches must mean some doctors also get headaches. How do they reconcile their symptoms with their practice?
I don't get what you or the OP expects them to do about it. There is no secret cure for migraines they are hiding from the rest of us.
That's good because I wasn't asking them to do anything about it. I was asking to understand an apparent emotional-empathy contradiction. I don't think you would be able to answer it unless you had personal experience being in that situation.
> How do they reconcile their symptoms with their practice?
What do you mean by that?
The article describes this:
Patients seeking solutions often experience frustration and desperation. They visit neurologists, anesthesiologists, pain-management specialists, alternative healers, and online chat groups, trying to find explanations and relief.
Given the base-rate, surely some doctors must also experience these maladies themselves. How do they resolve the apparent contradiction of presumably their own frustration and desperation as a patient and while also being in some way the creator of it as a doctor?
This is not uncommon. There's lots of issues where there are no easy answer and even if you know most answers, the solutions are "there is ~20% chance this will help, if not there is ~15% chance this will help, ... etc.". And that's assuming you can identify the real problem not masking as something else. Dealing with the uncertainty is part of the job. Ideally you'd want the doctor to explain it to the patients too. But I wouldn't say they create the frustration as such. The frustration is that nobody know better answers.
> How do they resolve the apparent contradiction of presumably their own frustration and desperation as a patient and while also being in some way the creator of it as a doctor?
Those are typically different people, so there is no contradiction.
I understand they are different people. But, you would agree sometimes doctors have headaches where they are then are a patient treated by another doctor, right?
How would that person understand the contradiction of sometimes being in a role where they dismiss patients, but also sometimes being in the role of the patient where they are being dismissed?
I've thought about this problem a lot too.
I've wondered if it comes down to a game theory result where if you have x amount of time to distribute amongst y problems, there's more net social utility in applying a simple solution to everyone, and accepting that difficult problems will be missed. Versus spending detailed time on each problem, and as a result solving fewer problems but better.
Of course, when money comes into play, it seems as though you're going to be financially required to rush everyone through the door in 15 minutes, or else your business will lose to someone who adopts this strategy. Leaving anyone with a complex problem dead.
I spend a lot of time on migraine and pain subreddits and there is an air of deference to the medical authority to know what to do. But if your case is complex, you just can't fit into the simple flow chart, and need to advocate and problem solve for yourself. Which leads people into the path of pseudoscience and exploitation.
Because psilocybin cannot be patented.
https://www.cambridge.org/core/journals/european-psychiatry/...
i don't need to read that article to tell you it absolutely unquestionably does not resolve chronic headaches, not even for a day.
for someone, sometimes? sure, probably. even placebos do that.
there are a bajillion of causes of headaches. there is no one solution. that's the problem.
”The greatest benefit reported was for psilocybin taken during a remission period, with the average length of that remission period between headaches extending for 91% of participants.”
Maybe you actually need to read the article.
The author is a New yorker columnist, and seems to be a practicing / ex-practicing doctor. They talk about their experience with their various doctors and being passed around different medications with various side effects, to some degree of success. Despite all their expertise and expense, they still cannot find a root cause (which may not exist at all), and struggle to find a medication protocol that works for them.
If you really want a bad trip, head over to the r/migraine and r/chronicpain subreddits. These subreddits are full of people, with none of the resources or experiences as the author, betrayed entirely by the medical system which does not serve them, and condemned to chronic pain. The complexity and range of headache and migraine causes does not lend itself well to a 15 minute GP appointment every few months, and without the technical expertise these people turn to alternative medicine, online pseudoscience, and opiates.
I can't speak for others, but I've found my severe headaches are sometimes migrains, other times sinus headaches, retina pain, and/or iris pain. Most of the time, a couple over the counter "migraine" pills helps if I catch it early, most commonly starts in the morning as I wake up. If that doesn't work, in a couple hours a prescribed migraine pill... if I notice my irises are pin hole sized (as closed as can be), I have dilation drops that help. If that doesn't cut it, I'll take a cannabis gummy and just try to sleep until it goes away.
A couple times a year, it lasts for a day or more. That's when it really sucks. I keep on top of taking mucus relief and allergy pills, which keeps down the sinus headaches... but I'm never quite sure what it is, as it's all just sever pain inside my head. Often coming with nausea, severe pain, dizziness and sometimes panic attacks.
I also have chronic back and hip pain as well. I don't like opiates at all, they tend to come with excessive nausea.
Because there are no pain receptors in the brain, so if you have headache, you are just hallucinating your own pain through some positive feedback mechanism.
Er, no. There are no pain receptors in the brain, but there are pain receptors in the head (particularly, the meninges, periosteum, and scalp), and those are the receptors which produce headaches.
I don't think that you had headache before, because that you would know that would hurts is not a scalp.
I’ve had many headaches, some of which respond exactly like you’d expect if the source of pain was receptors in the scalp, others of which do not.
The meninges and periosteum, which I mentioned also have pain receptors which can be involved in headaches, are very much not the same thing as the scalp.
The idea that the brain doesn't have pain receptors implies that headaches are just hallucinated pain is just completely nonsense.
In my understanding of the term pain in the scalp is not a headache, that would be pain in the scalp.
BLARG! there is a very very good chance that there are other mechanisms for triggering pain responses, like unnatural chemicals, such as concentrated ethenol or diesel fuel, photo copier fluid, etc, that can cross the blood brain barier, causing intense pain in many cases, but have little effect if applied topicaly. on the flip side, one rather interesting thing about pain, is that it impossible to trigger pain from a memory, but then there are cases of symptoms of phantom pain in lost limbs, so I feel strongly that there will be new knowledge soon about pain, especialy as there a number of promising non opiod pain relievers that use completly different pathways to block pain.
Pain Brain Film covers the new pain reprocessing therapy which might be linked to untreatable headaches.
I started getting migraines in the 1960s. Thanks for the link.
While a cup of coffee often helped me feel better in years past, I've found eliminating coffee from my diet has reduced my headache frequency. Triptans help when I get the occasional headache now.
I was disappointed that the article didn't talk about the variety of migraine manifestations. Some of the manifestations can be confused with transient ischemic attacks.
Decaffinated coffee is getting better and better every year; that could be a way for you to keep enjoying its benefits (mostly unrelated to caffeine) without the drawbacks.
the Aspirin lobby won't allow that (presumably, article is paywalled, so who knows)