For writer EvaWiseman, debilitating migraines are a dark reality. Here, she turns to the experts shedding new light on pain.
My first memories of migraine aren’t characterised by pain, instead by the frightening realisation, lying in bed, that I could no longer remember how to read. As years passed I grew to recognise the signs that a migraine was coming: a shimmering blind spot that slowly spreads across my vision; a yawning day of quite psychedelic déjà vu. And then slowly, the pain, which slides into the room and there settles sleepily against me.
Over the course of my conversation with Dr Munglani, two things surprised me. The first was the vast fiddly-ness of the discipline: the way pain affects different people differently and the fact that each case is subjective. Despite MRI scanners, Munglani says, “None of us can feel another person’s pain. So, in a way, pain is what the patient says it is.” It is, he stresses, “not a disease. It is part of the normal human experience.
It’s recognised now that pain has “biopsychosocial” influences, meaning a person’s feelings shape their experience of it. What’s becoming clear, too, is that doctors’ perception of patients shapes how they manage them. “There’s a long-held assumption that Black and minority patients are more robust and therefore have a higher pain threshold, ” says Halima Begum, chief executive of the Runnymede Trust, the UK’s leading independent race equality think tank.
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