The headache The science of a most confounding affliction--and a search for relief

Headaches can be "among the worst pain disorders known to human beings," according to studies journalist Zeller cites in his moving debut. Noting that he has suffered from cluster headaches for over 30 years, Zeller recounts "writhing on the bathroom floor" and collapsing unconscious from pain, and traces the history of treatments for cluster headaches and the more common migraine (around 12,000 years ago, sufferers often underwent trepanation, or the drilling of a hole in the skull to relieve pressure). Contending that remarkably little is actually understood about headaches, Zeller points out that basic questions about their causes remain unresolved, and that they are frequently dismissed as "just a headache." He explains the current landscape of solutions and cures, including stress reduction and relaxation therapy, and writes that while these may help, for most people, they're as practical as "meditating your way out of cancer." Zeller is a strong writer, especially when it comes to describing pain: "It's all just poetry in the end--like trying to describe the color of an atom, or the texture of gravity, or the shape of sadness." The result is an eye-opening study of an all-too-common affliction. Agent: Mackenzie Brady Watson, Stuart Krichevsky Literary. (July)

It's not just in his head. Zeller, a formerNew York Times journalist, dives into a topic whose central feature is, in the words of author Elaine Scarry's description of all pain, its "unsharability…its resistance to language." Zeller's excellent debut book is largely about migraines, an affliction that plagues millions, derails careers, threatens lives, and yet is largely overlooked by the vast biomedical research community. Zeller recounts the long history of migraines, from ancient Egyptians to Darwin, and the often brutal measures applied to relieve the pain. The most disturbing part of the book is his personal story, and the stories of dozens of sufferers, who all pay the price of a life diminished by sudden, unrelenting, excruciating pain. The author reports that there are roughly 700 headache specialists with diplomas in the world. "In Montana, where I now live," he writes, "there is one." Yet the affected population is estimated to be 50 million people. Direct and indirect costs, according to a 2018 estimate, is about $28 billion annually. Even with such enormous health and economic consequences, federal research investments fall far short of matching the burden of the disorder. Zeller reviews the available treatments, some prescribed, most not, and a few illegal. His personal experience with many of them and his investigation leave him with the view that most don't work, some work in the short term, and a handful of newly approved (and expensive) medications don't have a track record of effectiveness. Headache patients, he writes, must often endure a "long, zigzagging journey through a pharmacological forest." Zeller's search to explore the frontiers of headache research takes him to a few leaders in the field who are pursuing tantalizing new findings. While they are engaged in intense competition, their numbers are few, their resources comparatively meager, and their progress uncertain. A sharp--and funny--account of one man's attempt to understand why so many of us suffer head pain. Copyright (c) Kirkus Reviews, used with permission.