Book Review: All in my Head

I wasn’t going out of my way to read yet another work of non-fiction, but the cover of Paula Kamen’s “All in my Head” caught my eye. A larger-than-life white pill against a rich yellow background beckoned me to give this memoir a second look. I’ve always had a penchant for disability narratives and immigration stories and this one fit neatly into the former category.

This is Kamen’s dark, funny, sometimes optimistic, mostly depressing, poignant account of her experience with Chronic Daily Headache. Her battle with this diagnosis began at the tender age of 27 and followed her to the time of the writing, at least a decade later. Kamen, who had established herself as a feminist writer prior to this work, talks not only about her personal experience with Headache but also takes a critical look at the way physicians treat female chronic pain patients, in contrast to their male counterparts.

She researches a variety of conditions beside Chronic Daily Headache that generally strike women more than men, such as fibromyalgia and multiple sclerosis. She states that Western medicine has traditionally classified any disorder whose mechanism was unknown as psychosomatic. In a society where mental illness is still stigmatized, this obviously introduces a whole new set of problems for the patient who is not only experiencing severe pain, but is now considered mentally ill by many medical professionals. According to Kamen’s research, before science revealed multiple sclerosis to be a legitimate degenerative neurological disease, it was thought to be psychosomatic in nature. I never knew that, but upon reading that I was able to fill in the blanks regarding an offhand comment made by an older physical therapist with whom I had the misfortune to work. In reference to a multiple sclerosis patient we were both treating, he muttered “She has a real MS (multiple sclerosis) personality.” I never quite knew what he meant by that until I read this book. I must confess though, that I have been guilty of condemning the fibromyalgia patient. They are typically manipulative and dramatic, and are generally likely to moan and groan about their pain. No I did not do any formal research or document any of this, so take it for what its worth. Its just my observation over the past 5 years in my work as an occupational therapist. I felt guilty when Kamen called me out. Well, not me specifically, but she points a finger at the medical community, and rightly so. Armed with her medical records, Kamen found that her doctors didn’t take her seriously when she was visibly in pain. She describes in great detail, how she grew teary while describing the intractable shooting pain behind her left eye (as if there were a piece of glass perpetually stuck there) and how it sucked up all her energy, making it virtually impossible for her to work or show up for social engagements, in her neurologist’s office. His report indicated that he judged her to be mentally unstable. She raises a good point, that after that experience, in order to be taken seriously by doctors, she would go out of her way to act like she was not in pain. I was ashamed of myself for identifying with the physician instead of the patient in this scenario.

Although the parts about Western Medicine’s misogyny were interesting, I did find Kamen’s tone to be whiny at times. I confess I skimmed through some of that part. However I really enjoyed Kamen’s stories about all the deperate measures she took to alleviate her pain. She talks in great detail about her unrelenting struggles to indentify medications that take the edge off, only to find she needs more and more to get the same releif, ends up addicted, then has to go through withdrawal as she gets off medications. When Western medicine fails her, Kamen outlines her journeys through Chicago’s city streets and outlying suburbs, experimenting with just about everything, including yoga, massage therapy, acupuncture, physical therapy, biofeedback, and meditation, to name a few. She discusses her low periods of depression and isoliation, and her frustration with not being able to live the life she desires. One of her greatest frustrations is the invisible nature of her condition. She compares herself to an amputee at one point; The amputee has to deal with constantly being defined by her disability, yet she manages to do everything she wants to do. Kamen on the other hand, feels that her disability is not considered legitimate by others and keeps her from doing most of what she wants to do.
Kamen’s insights are often sharply funny and sarcastic. At times I think she is the type of person I would like to be friends with. At other times, I am not so sure; lets just say I did a fair amount of skimming. I liked what she had to say, I just think she said it in a variety of different ways, on far too many occasions. If I were her editor I would have asked that she condense it by about a hundred pages.

All in all though, it was an enlightening read. It gave me some insight to the experience of chronic pain and depression, which is not only interesting to me but valuable to me professionally, as I see this type of patient now and again. Although it didn’t have a happy ending, it did have what I would call a resolution. Don’t worry I didn’t give anything away. It says right on the book jacket that she doesn’t end up “beating” the pain.

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