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The Headache: The Science of a Most Confounding Affliction―and a Search for Relief
A sometimes harrowing and frequently humorous journey into the author’s own excruciating headaches, and the science behind these surprisingly mysterious disorders
Virtually everyone has experienced a headache—a nuisance arising from occasional stress or as payback for last night’s overindulgence. But for hundreds of millions of people, there are headaches, and then there are headaches. From blinding migraines to severe headaches known as “clusters,” chronic head pain can upend entire seasons of life. Perhaps owing to the ordinariness of the very word “headache,” these disorders are frequently trivialized.
In The Headache veteran science journalist Tom Zeller Jr. takes readers on an odyssey both intimate and panoramic, through his own decades-long struggle with cluster headaches and across the scientific landscape of a group of disorders. He visits cutting-edge clinics; interviews dozens of doctors, neurologists, and fellow headache patients; participates in clinical trials for multi-million-dollar new medicines; and even experiments with psilocybin in search of relief. Along the way Zeller traces the longer arc of mystery around headaches to reveal how they became one of the most under-researched afflictions in medicine—and how that is slowly starting to change.
Virtually everyone has experienced a headache—a nuisance arising from occasional stress or as payback for last night’s overindulgence. But for hundreds of millions of people, there are headaches, and then there are headaches. From blinding migraines to severe headaches known as “clusters,” chronic head pain can upend entire seasons of life. Perhaps owing to the ordinariness of the very word “headache,” these disorders are frequently trivialized.
In The Headache veteran science journalist Tom Zeller Jr. takes readers on an odyssey both intimate and panoramic, through his own decades-long struggle with cluster headaches and across the scientific landscape of a group of disorders. He visits cutting-edge clinics; interviews dozens of doctors, neurologists, and fellow headache patients; participates in clinical trials for multi-million-dollar new medicines; and even experiments with psilocybin in search of relief. Along the way Zeller traces the longer arc of mystery around headaches to reveal how they became one of the most under-researched afflictions in medicine—and how that is slowly starting to change.
336 pages, Paperback
First published July 15, 2025
108 people are currently reading
3393 people want to read
About the author
Tom Zeller Jr.
3 books20 followersTom Zeller Jr. is an American journalist, former New York Times reporter and columnist, and current editor in chief of the digital science magazine Undark. His debut book, The Headache: The Science of a Most Confounding Condition (HarperCollins/Mariner in July, 2025), is part memoir, part scientific whodunnit, and ultimately the author's quest for the origins of his own headaches. Along the way, it becomes a journey into the inner workings of the human nervous system and an illuminating look at the nature of pain itself. At times harrowing, and at others, hilarious, the book has been heralded as "required reading for anyone with a head." (—Mary Roach)
Tom was born in northeastern Ohio, studying English and Political Science at Cleveland State University before earning a masters degree from Columbia University's Graduate School of Journalism. From 1998 to 2007, and again from 2009 to 2011, Tom was a reporter, editor, and columnist for The New York Times, where he covered technology, climate science, energy innovation, and business, among other topics. After brief positions at both The Huffington Post and National Geographic Magazine, Tom was awarded a research fellowship with the Knight Science Journalism program at MIT in 2013. Two years later, he co-founded, with Pulitzer prizewinning author Deborah Blum, the digital science magazine Undark, which explores science as it "intersects in complicated ways with people’s everyday lives."
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Displaying 1 - 30 of 61 reviews
July 30, 2025
As a “migraineur,” a delightful word this book taught me, I absolutely needed to request The Headache when I saw it. It turned out to be full of information about the history and current state of headache science, such as why headaches have remained stigmatized and understudied for so long (sexism) and why rizatriptan magically makes my migraines disappear (just kidding, no one knows, but at least I have a MUCH better idea of all the theories floating around).
I also really liked how each chapter opened with a quote from a headache sufferer the author interviewed as part of his research. In my opinion, Zeller’s own experience with cluster headaches gave this book a lot of credibility and allowed him to empathize with his subjects. His poetic musings on how it feels to be in pain really resonated with me, not just on the topic of migraines, but on chronic pain in general. I felt that he managed to strike the delicate balance of inserting himself into the story the exact right amount.
Where this book sadly falls short is in its organization. While each chapter has a title pulled from some part of its subject matter, the chapters wander around between science, history, philosophy, and memoir without much regard to theme or time period. Someone obviously taught Zeller to suck the reader in with a story at the beginning, but not how to ultimately satisfy them; for instance, the first chapter begins with the author participating in an experiment to see if a headache can be artificially induced with a certain chemical, but this storyline is apparently forgotten until it is tucked into a throwaway line near the end of the book. The author’s experience desperately overdosing on drugs is (IMO) thematically linked with that of the young man who loses hope and takes his own life, but these are far apart in the book and barely compared with each other in the text. Wouldn’t these have more effect together in one chapter about the hopelessness and desperation of pain?
This lack of organization leads to additional problems: important facts are repeated, almost word for word, in abutting chapters, and then again later on. Moving through the various topics that headache science encompasses systematically, chapter by chapter, in the style of Mary Roach’s recent Repleaceable You, would have allowed both writer and reader to store and absorb pertinent information where it belonged. Similarly, the writing style often shifts unexpectedly from florid to dry to wry over a few paragraphs as the subject matter changes within the chapter. I often had to force myself to pick up the book again because there was no particular topic or style advertised ahead that I could look forward to reading.
So ultimately, because of the way my brain works I had to read this book, and because of the way my brain works I had to find it lacking. (Free will who?) But it is still probably the most thorough and up-to-date resource on headache disorders that you will find, so if you’re willing to overlook the issues above, you may find it worthwhile.
Thank you to Netgalley and the publisher for giving me a copy of this book in exchange for an honest review.
I also really liked how each chapter opened with a quote from a headache sufferer the author interviewed as part of his research. In my opinion, Zeller’s own experience with cluster headaches gave this book a lot of credibility and allowed him to empathize with his subjects. His poetic musings on how it feels to be in pain really resonated with me, not just on the topic of migraines, but on chronic pain in general. I felt that he managed to strike the delicate balance of inserting himself into the story the exact right amount.
Where this book sadly falls short is in its organization. While each chapter has a title pulled from some part of its subject matter, the chapters wander around between science, history, philosophy, and memoir without much regard to theme or time period. Someone obviously taught Zeller to suck the reader in with a story at the beginning, but not how to ultimately satisfy them; for instance, the first chapter begins with the author participating in an experiment to see if a headache can be artificially induced with a certain chemical, but this storyline is apparently forgotten until it is tucked into a throwaway line near the end of the book. The author’s experience desperately overdosing on drugs is (IMO) thematically linked with that of the young man who loses hope and takes his own life, but these are far apart in the book and barely compared with each other in the text. Wouldn’t these have more effect together in one chapter about the hopelessness and desperation of pain?
This lack of organization leads to additional problems: important facts are repeated, almost word for word, in abutting chapters, and then again later on. Moving through the various topics that headache science encompasses systematically, chapter by chapter, in the style of Mary Roach’s recent Repleaceable You, would have allowed both writer and reader to store and absorb pertinent information where it belonged. Similarly, the writing style often shifts unexpectedly from florid to dry to wry over a few paragraphs as the subject matter changes within the chapter. I often had to force myself to pick up the book again because there was no particular topic or style advertised ahead that I could look forward to reading.
So ultimately, because of the way my brain works I had to read this book, and because of the way my brain works I had to find it lacking. (Free will who?) But it is still probably the most thorough and up-to-date resource on headache disorders that you will find, so if you’re willing to overlook the issues above, you may find it worthwhile.
Thank you to Netgalley and the publisher for giving me a copy of this book in exchange for an honest review.
July 10, 2025
I’ve read a handful of books in my lifetime that validate my life experiences enough to elicit what others may interpret as maniacal giddiness. As a longtime sufferer of life-altering migraines, Zeller’s book felt like the dark, quiet room I’ve always needed with the compassion I rarely receive.
Through personal anecdotes, insight from medical professionals, and interviews with fellow sufferers and their families, the book seamlessly weaves together an intricate fabric of headache history-- from our truly archaic understanding of neurology to today’s promising futuristic treatments. Equipped with a Maglite, Zeller takes readers on a journey to explore the dark and mysterious underground world of headaches with the hopes of answering the one question migraineurs ask in the midst of an attack—does anyone really care?
You’ve been forewarned: the author’s findings are maddening at times, as the search for an answer exposes the inadequacies of our fractured educational and healthcare systems as well as the confines of modern science, all amidst a backdrop of capitalist politics-- minus the inflammatory partisan commentary (although undoubtedly warranted at times).
The author clearly conveys the historical, social, and political complexity of this confounding affliction as well as the associated societal implications; however, the book is not a mere yawn-inducing list of dates and names like many in this genre. Zeller temporarily veers off course from the heaping pile of statistical debris and scientific jargon allowing the reader to welcome timely side quests where the highway of objective analysis is left behind for the bumpy back roads of subjective experience. This is where Zeller’s style shines because the topic necessitates a non-linear journalistic approach only attained by highly creative and well-researched science journalists. This undeniably holistic investigation, combined with Zeller’s first-hand experience as a cluster headache sufferer, leaves no rock unturned and nothing up to the imagination.
Whether you’re into tripping face or putting triptans in your face, there’s something here for everyone. So, buckle up, get your CNS schematic from A&P out, and be prepared to understand that jelly-like blob in your skull on a more cerebral level. I assure you-- your head is in good hands.
Through personal anecdotes, insight from medical professionals, and interviews with fellow sufferers and their families, the book seamlessly weaves together an intricate fabric of headache history-- from our truly archaic understanding of neurology to today’s promising futuristic treatments. Equipped with a Maglite, Zeller takes readers on a journey to explore the dark and mysterious underground world of headaches with the hopes of answering the one question migraineurs ask in the midst of an attack—does anyone really care?
You’ve been forewarned: the author’s findings are maddening at times, as the search for an answer exposes the inadequacies of our fractured educational and healthcare systems as well as the confines of modern science, all amidst a backdrop of capitalist politics-- minus the inflammatory partisan commentary (although undoubtedly warranted at times).
The author clearly conveys the historical, social, and political complexity of this confounding affliction as well as the associated societal implications; however, the book is not a mere yawn-inducing list of dates and names like many in this genre. Zeller temporarily veers off course from the heaping pile of statistical debris and scientific jargon allowing the reader to welcome timely side quests where the highway of objective analysis is left behind for the bumpy back roads of subjective experience. This is where Zeller’s style shines because the topic necessitates a non-linear journalistic approach only attained by highly creative and well-researched science journalists. This undeniably holistic investigation, combined with Zeller’s first-hand experience as a cluster headache sufferer, leaves no rock unturned and nothing up to the imagination.
Whether you’re into tripping face or putting triptans in your face, there’s something here for everyone. So, buckle up, get your CNS schematic from A&P out, and be prepared to understand that jelly-like blob in your skull on a more cerebral level. I assure you-- your head is in good hands.
July 23, 2025
When I saw that this book was being offered on NetGalley for review, I had to request it. As a long-time migraine sufferer, I have a personal interest in the subject.
And the book “The Headache: The Science of a Most Confounding Affliction―and a Search for Relief” did not disappoint.
Unlike other books I have read of late, this book is well put together and compelling to read. Author Tom Zeller is a sufferer of cluster headaches who details his experiences with having this kind of headache as well as the history of headache research. Thankfully, I don’t suffer from that kind of headache or know of anyone who does, because one of the informal names it goes by is the “suicide headache.”
I could appreciate his approach to trying anything and everything to quell the intense pain his cluster headaches caused him. In my case, after an intense migraine attack, I was quickly diagnosed and given Maxalt (the generic name is rizatriptan, part of the Triptan family of medications), which despite the side effects of drowsiness and stomach upset, quelled the intense pain.
Following my retirement from working in an office, I subsequently found that the bright florescent lights caused most of my problems, though I still suffer from what I call “mini-graines” on occasion and, for those, over the counter migraine medications work acceptably.
I suspect that most readers of this book will take prescription medication but never thought about the research that went into bringing the medication to market. There’s a chapter in the book on bringing the newest treatment to market, Calcitonin Gene-Related Peptide (CGRP), which is a recently discovered molecule involved in migraine pain and inflammation.
I always read the end notes and author Tom Zeller provides detailed ones. He also provides an extensive list of books for further reading and research. I have read a few of these books and agree that they are very well worth reading for further information, with the understanding that some of the information provided may have been superseded by subsequent research.
I highly recommend this book to anyone who suffers from head pain, knows someone who is afflicted by migraines or cluster headaches, or with even a passing interest in this field of study.
5/5 stars
[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion, which I have given here.]
And the book “The Headache: The Science of a Most Confounding Affliction―and a Search for Relief” did not disappoint.
Unlike other books I have read of late, this book is well put together and compelling to read. Author Tom Zeller is a sufferer of cluster headaches who details his experiences with having this kind of headache as well as the history of headache research. Thankfully, I don’t suffer from that kind of headache or know of anyone who does, because one of the informal names it goes by is the “suicide headache.”
I could appreciate his approach to trying anything and everything to quell the intense pain his cluster headaches caused him. In my case, after an intense migraine attack, I was quickly diagnosed and given Maxalt (the generic name is rizatriptan, part of the Triptan family of medications), which despite the side effects of drowsiness and stomach upset, quelled the intense pain.
Following my retirement from working in an office, I subsequently found that the bright florescent lights caused most of my problems, though I still suffer from what I call “mini-graines” on occasion and, for those, over the counter migraine medications work acceptably.
I suspect that most readers of this book will take prescription medication but never thought about the research that went into bringing the medication to market. There’s a chapter in the book on bringing the newest treatment to market, Calcitonin Gene-Related Peptide (CGRP), which is a recently discovered molecule involved in migraine pain and inflammation.
I always read the end notes and author Tom Zeller provides detailed ones. He also provides an extensive list of books for further reading and research. I have read a few of these books and agree that they are very well worth reading for further information, with the understanding that some of the information provided may have been superseded by subsequent research.
I highly recommend this book to anyone who suffers from head pain, knows someone who is afflicted by migraines or cluster headaches, or with even a passing interest in this field of study.
5/5 stars
[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion, which I have given here.]
October 21, 2025
Well-written and extensively researched, the book provides an exhaustive amount of information in a way that maintains interest all the way to the end. It’s interesting in part because the author writes about his own experiences with cluster headaches and the relief he sought through the years, as well as interviews with many other chronic headache sufferers. Whether you want to better understand the history, treatments, medical and scientific exploration of headaches out of sheer curiosity, or due to firsthand experiences or those of friends or family, it’s well worth the read.
October 19, 2025
Tom Zeller Jr is an American journalist who, for decades, has suffered from cluster headaches, an extremely painful type of headaches marked by excruciating pain that arise in clusters lasting days, weeks, or months followed by remission periods. His 2025 book The Headache is based on his personal experience and extensive interviews he conducted with fellow headache sufferers (largely focusing on others with cluster headaches as well as migraine sufferers), researchers, healthcare providers, and other subject matter experts.
Listening to the first 77% of this 10 hour audiobook gave me a deeper appreciation for never having personally experienced a migraine or cluster headache, despite migraines running in my family. The closest I have come is around half a dozen episodes of scintillating scotoma (aka aura without migraine), which for me have been triggered by intense exercise and feature a strobing neon zig-zaggy semicircle in my left visual field that lasts for anywhere between 15-60 minutes before spontaneously resolving. These visual auras are painless -- just very distracting -- though I'm very grateful they haven't progressed to migraines (at least not yet).
That being said, as the book continued, I stopped and restarted listening multiple times due to repetitiveness (mostly around the various reasons why migraines and cluster headaches are still poorly understood and why treatments are so hard to obtain and achieve efficacy, and story after story that essentially recapitulated the same information), and ultimately decided I had extracted maximal yield at the 77% mark.
My statistics:
Book 316 for 2025
Book 2242 cumulatively
Listening to the first 77% of this 10 hour audiobook gave me a deeper appreciation for never having personally experienced a migraine or cluster headache, despite migraines running in my family. The closest I have come is around half a dozen episodes of scintillating scotoma (aka aura without migraine), which for me have been triggered by intense exercise and feature a strobing neon zig-zaggy semicircle in my left visual field that lasts for anywhere between 15-60 minutes before spontaneously resolving. These visual auras are painless -- just very distracting -- though I'm very grateful they haven't progressed to migraines (at least not yet).
That being said, as the book continued, I stopped and restarted listening multiple times due to repetitiveness (mostly around the various reasons why migraines and cluster headaches are still poorly understood and why treatments are so hard to obtain and achieve efficacy, and story after story that essentially recapitulated the same information), and ultimately decided I had extracted maximal yield at the 77% mark.
My statistics:
Book 316 for 2025
Book 2242 cumulatively
August 4, 2025
I was tempted to give this a 4 instead of a 5, but concluded that my inability to understand the sciency parts had nothing to do with the author, his extensive interviews, and his excellent research. I obviously found the anecdotal parts more compelling - there was a lot about molecules and neuropeptides and prodromes and trigeminovascular activation that was beyond my understanding.
That said, I understood more than enough to feel vindicated that my headaches aren’t “just headaches.” And more than enough to feel frustrated and angry. I’m angry at the narrow-minded scientists who refuse to consider alternatives to their pet theories to the exclusion of possible solutions. I’m angry at the NIH for limiting the funding for headache research. I’m frustrated that because headaches are boring, doctors are discouraged from studying them. I’m frustrated that there isn’t a more successful cure and, more importantly, prevention.
As science author Mary Roach’s blurb says on the cover, this should be “required reading for anyone with a head.”
That said, I understood more than enough to feel vindicated that my headaches aren’t “just headaches.” And more than enough to feel frustrated and angry. I’m angry at the narrow-minded scientists who refuse to consider alternatives to their pet theories to the exclusion of possible solutions. I’m angry at the NIH for limiting the funding for headache research. I’m frustrated that because headaches are boring, doctors are discouraged from studying them. I’m frustrated that there isn’t a more successful cure and, more importantly, prevention.
As science author Mary Roach’s blurb says on the cover, this should be “required reading for anyone with a head.”
October 2, 2025
I've had debilitating migraines with aura since I was 15, so I was genuinely excited to read about similar experiences, and see how far the science has come. Sadly, this book fell short for me.
The information felt scattered and the author constantly flipped between explaining lengthy theories and research to then immediately debunk them as false, which made it difficult to follow the central message. I don't care that historically people thought migraines were linked to personality traits.
In the end, I didn’t come away with any new insights, it just reverberated what I already knew, that we still don't know much (Or maybe any new insights were lost in the jumble of words.)
For a book aimed at people with headache disorders, I wish it had more structure to a storyline so it wasn't such a taxing cognitive load on our already overloaded brain.
The information felt scattered and the author constantly flipped between explaining lengthy theories and research to then immediately debunk them as false, which made it difficult to follow the central message. I don't care that historically people thought migraines were linked to personality traits.
In the end, I didn’t come away with any new insights, it just reverberated what I already knew, that we still don't know much (Or maybe any new insights were lost in the jumble of words.)
For a book aimed at people with headache disorders, I wish it had more structure to a storyline so it wasn't such a taxing cognitive load on our already overloaded brain.
April 22, 2025
This was an interesting examination of the headache, from the condition's history in primary source writings to the cutting-edge innovations of today. Unfortunately, headache does have a public connotation as a "woman's disease" and is easily not taken seriously in common society. The reality is there are a lot of different types, including the one Zeller suffers from--cluster headache--and they all vary in intensity. I personally struggle with horrible sinus headaches, although I have no idea if the pain is as bad as it is for migraine sufferers. It sounds like cluster headache is a thing of its own. Anyway, this is a very interesting book, and it should be in public library health collections (especially since there is so little published about specific conditions anymore).
December 6, 2025
The Headache is a book documenting the author's and other headache patients' struggle with headaches and their fight to get proper treatment. This book went through the history of the headache research and treatment. As someone who only gets infrequent tension headaches, I feel very lucky to not have the experiences delineated in this book. I cannot imagine what it is like to deal with cluster headaches or migraines. This book definitely help me to imagine that and was very well written. 4/5 stars.
Thank you to NetGalley for providing me with a free ARC of this book. All opinions expressed are my own.
Thank you to NetGalley for providing me with a free ARC of this book. All opinions expressed are my own.
July 24, 2025
The Headache by Tom Zeller Jr. is part memoir, part science journalism, and part social commentary on how one of the world’s most common ailments remains so widely misunderstood and still too often dismissed. Zeller, a veteran science writer, uses his own decades-long battle with cluster headaches as a starting point for a deep dive into the world of chronic head pain, weaving personal narrative with reporting that spans medical history, pharmaceutical research, and the often frustrating world of clinical care.
The book's greatest strength lies in its accessibility. Zeller does a commendable job breaking down complex neurological science and exploring how cultural perceptions of pain—especially invisible pain—contribute to the marginalization of headache sufferers. His descriptions of cluster headaches are harrowing and vivid, bringing to life what is often an invisible condition. His voice is empathetic and clear-eyed, especially in his interviews with other sufferers and researchers.
That said, the blend of memoir and research isn't seamless. At times, the many personal digressions—while heartfelt—slow the narrative momentum or detract from the more investigative parts of the book. Readers looking for a focused scientific account might find the structure a little meandering, while memoir fans may occasionally get bogged down in the medical detail.
Still, The Headache is an important contribution to health literature. It advocates for greater awareness and research without slipping into sensationalism or self-pity. For those living with migraines, cluster headaches, or even just trying to understand someone who does, this book offers not just insight, but validation.
Recommended for: readers of narrative nonfiction, science writing, medical memoirs, and anyone who has ever had to explain that a headache is so much more than “just” a headache. Three and a half stars rounded up.
The book's greatest strength lies in its accessibility. Zeller does a commendable job breaking down complex neurological science and exploring how cultural perceptions of pain—especially invisible pain—contribute to the marginalization of headache sufferers. His descriptions of cluster headaches are harrowing and vivid, bringing to life what is often an invisible condition. His voice is empathetic and clear-eyed, especially in his interviews with other sufferers and researchers.
That said, the blend of memoir and research isn't seamless. At times, the many personal digressions—while heartfelt—slow the narrative momentum or detract from the more investigative parts of the book. Readers looking for a focused scientific account might find the structure a little meandering, while memoir fans may occasionally get bogged down in the medical detail.
Still, The Headache is an important contribution to health literature. It advocates for greater awareness and research without slipping into sensationalism or self-pity. For those living with migraines, cluster headaches, or even just trying to understand someone who does, this book offers not just insight, but validation.
Recommended for: readers of narrative nonfiction, science writing, medical memoirs, and anyone who has ever had to explain that a headache is so much more than “just” a headache. Three and a half stars rounded up.
September 20, 2025
Very interesting and informational. I hate that so many people, including myself, have to live with headache-related afflictions because it's not seen as "real" enough. The only people that believe that are the ones who have never had to experience the pain on a regular basis.
After much trial and error, my NP and I have settled on daily Qulipta doses for me. I get headaches and migraines occasionally, usually as a direct result of an environmental/stress factor, but the past year has been so staggeringly better in regards to head pain.
Anyway, I found this to be a great book to listen to. If you suffer from head pain or have any interest in understanding the subject I really recommend it. I listened to the audiobook and thought the narrator did an excellent job.
After much trial and error, my NP and I have settled on daily Qulipta doses for me. I get headaches and migraines occasionally, usually as a direct result of an environmental/stress factor, but the past year has been so staggeringly better in regards to head pain.
Anyway, I found this to be a great book to listen to. If you suffer from head pain or have any interest in understanding the subject I really recommend it. I listened to the audiobook and thought the narrator did an excellent job.
August 2, 2025
As a lifelong chronic headache/migraine sufferer, this book was an interesting read. The roller coaster journey Zeller describes is certainly relatable and makes you feel less alone tackling yours. For an affliction affecting so many, he points out how underfunded, under-researched, misunderstood and just generally neglected this disorder is. I found the history of treatments rather interesting.
I would recommend this book to any headache sufferer, anyone who has a relationship with a headache sufferer or anyone interested in the subject of chronic or invisible illness.
I would recommend this book to any headache sufferer, anyone who has a relationship with a headache sufferer or anyone interested in the subject of chronic or invisible illness.
August 28, 2025
Book written by one of the 50 million people in U.S. with a headache disorder. As someone who has suffered from chronic migraines for 25+ years, this book both made me feel seen and was also frustrating. The book showcases the long scientific struggle and how understudied and underfunded headache disorders are in the medical field. I can only hope there is more understanding of the biological mechanisms in the future.
July 26, 2025
Very well written narrative on headaches. The author introduces how little we actually know about what causes headaches and does a good job of pairing his experiences with cluster headaches to the science behind it. At times this book can be a lot to handle in terms of its jargon but thats no fault to the author as this was written for someone who is inclined in the world of anatomy of the brain. Good book overall
January 4, 2026
A little in the weeds in some sections, but overall valuable for laypeople and healthcare providers alike.
July 16, 2025
E-ARC generously provided by Netgalley in exchange for an honest review! Thank you!
Overall, this was a profound book about headaches and migraines. As someone who is affected by this, it caught my interest in learning about it from the history, procedures, trials, and science behind it. It was heartbreaking to hear the familiar stories from other sufferers about trying to deal with headaches with migraines. The author went into fantastic depth and research on the topic, where I learned that some treatments work for one person but do not always work for another, and the stigma behind the invisible pain. The headache and migraine still contain many questions that scientists are still trying to figure out, especially in their classification. Pain is also relative to just yourself and differs from person to person. This was a good book that was so fulfilling and telling of headache and migraine sufferers.
Overall, this was a profound book about headaches and migraines. As someone who is affected by this, it caught my interest in learning about it from the history, procedures, trials, and science behind it. It was heartbreaking to hear the familiar stories from other sufferers about trying to deal with headaches with migraines. The author went into fantastic depth and research on the topic, where I learned that some treatments work for one person but do not always work for another, and the stigma behind the invisible pain. The headache and migraine still contain many questions that scientists are still trying to figure out, especially in their classification. Pain is also relative to just yourself and differs from person to person. This was a good book that was so fulfilling and telling of headache and migraine sufferers.
July 9, 2025
There is so much to love about this book. I was given an early copy by a friend, because they know that I have headaches, migraines to be exact. I'm not much of a nonfiction reader, though I do like science, and so was hoping that this wouldn't be too technical and it's not! The author/narrator's voice is curious and funny, and his own experience with headache (cluster headaches, which are different from migraine but as he says probably has similar roots) sounds awful, but he doesn't wallow in it. The biggest takeaway is that we know less than we should scientifically about headaches, in part because so many women have them, and women's health has often been overlooked. But in more recent times there is some very exciting science happening, including the new CGRP meds, which I think have helped me somewhat, though not perfectly. The author is a journalist and he speaks to a lot of people, including lots of headache patients and scientists, and it's easy to feel how grateful people are for having the chance to talk openly about headaches, which most of us try to hide. Now we don't have to!
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September 3, 2025In "The Headache" by Tom Zeller Jr., the author takes readers on a journey through one of the most misunderstood yet devastating medical conditions. While headaches are often brushed off as routine nuisances, Zeller demonstrates just how destructive and life-altering they can be, particularly in the case of chronic migraine and cluster headaches. His own story, woven into a broader exploration of medical history and modern science, brings home the reality that what many dismiss as 'just a headache' is, for millions, a condition that dominates lives, ruins careers, and at times even drives people to despair. Through anecdotes, history, and scientific reporting, Zeller paints a portrait of both suffering and resilience, while exposing how medicine and society have long failed to take headache disorders seriously.
Zeller begins by grounding the narrative in his own harrowing experience with cluster headaches. These attacks, sometimes referred to as 'suicide headaches,' come suddenly and with unbearable intensity. His personal search for relief, from conventional medicine to desperate experiments with psychedelics, illustrates just how little progress has been made in treating the condition effectively. The book emphasizes that the true cruelty of headache disorders lies not just in the pain itself but also in their invisibility. From the outside, a patient can appear perfectly normal, but inside, they may be experiencing searing agony. This invisibility often breeds disbelief, isolation, and years of misdiagnosis.
The narrative expands to include others who have endured similar struggles, particularly migraine patients. Migraine, while more common than cluster headache, is still widely misunderstood and often minimized by both physicians and the general public. Its symptoms are complex, ranging from light sensitivity and nausea to disabling pain that can last for days. Yet medical science has struggled to pin down its precise cause. Some theories suggest vascular changes, others point to neural misfiring, and newer research explores immune responses or genetic predispositions. Zeller makes it clear that the lack of consensus has slowed progress, leaving patients stuck with incomplete answers and inconsistent treatment options.
Looking back at history, the book reveals how medicine’s evolving theories about headaches have often been misguided. In ancient times, extreme practices like trepanation - drilling holes in the skull - were attempted in the hope of releasing pressure or evil spirits. Later, physicians blamed 'imbalances' in the body’s humors or even moral failings. By the eighteenth and nineteenth centuries, theories grew more elaborate yet often more stigmatizing: headaches were linked to gluttony, sexual habits, or psychological weakness. Women, in particular, bore the brunt of this pseudoscience, with their suffering frequently dismissed as hysteria or emotional instability. Zeller traces how these cultural assumptions influenced treatment and perception well into the modern era, shaping the stigma that still lingers today.
The book also examines some curious moments in medical history that reveal both the creativity and the missteps of researchers. One striking example is Harold Wolff’s mid-twentieth-century experiments, inspired by a trapeze artist who noticed her headaches lessened when she performed upside down. This led to tilt-table studies and the development of the vascular theory of migraine, which dominated for decades. While these experiments produced insights, they also reinforced harmful stereotypes, with Wolff characterizing migraine sufferers - especially women - as neurotic overachievers. Such biases not only hindered scientific understanding but also deepened the stigma that patients faced in seeking care.
A turning point came in the 1990s with the discovery of serotonin’s role in migraine and the creation of sumatriptan, a drug that provided fast relief for many. This marked a major advance, but not a universal solution. Triptans remain inaccessible for some due to cost, side effects, or contraindications, and even for those who can take them, the relief is not guaranteed. More recent developments, such as CGRP inhibitors and noninvasive nerve-stimulating devices, offer hope, but the book emphasizes how far medicine still has to go in providing consistent, effective, and widely available treatments.
Alongside medical exploration, Zeller highlights the profound human toll of being disbelieved. Patients recount stories of being dismissed by doctors, accused of exaggerating, or misdiagnosed as having psychological issues. This disbelief can be more damaging than the pain itself, eroding self-confidence and leaving patients to feel abandoned by the very systems meant to help them. For some, like Will Erwin, the struggle ends in tragedy. Erwin’s suicide at age 24 after years of battling cluster headaches spurred his family to fund new research, underscoring the urgent need for greater awareness and investment.
The narrative also confronts the systemic barriers that keep headache research marginalized. Despite the enormous social and economic burden of migraines and related disorders, the National Institutes of Health has historically ranked them low in funding priority. This creates a vicious cycle: with limited funds, few researchers dedicate their careers to the field, which in turn keeps the research base thin and reinforces the perception that headaches are a lesser concern. Advocates have spent decades pushing for change, pointing out that effective treatments could restore massive amounts of lost productivity and reduce healthcare costs. Yet progress remains slow, with much of the momentum driven by private pharmaceutical companies whose priorities often align more with profit than public health.
Zeller does not shy away from showing how fragmented the science remains. Some researchers still focus on vascular changes, others on serotonin, others on the trigeminal nerve or cortical waves. Rarely do these camps collaborate, leading to siloed findings rather than a holistic picture. The result is a field in which breakthroughs emerge sporadically but a unifying theory of headache disorders remains elusive. This lack of integration mirrors the fragmented experiences of patients, who must cobble together their own solutions from an array of inconsistent advice, treatments, and home remedies.
What gives the book its strength, however, is not just the critique of science but also the resilience of patients and advocates. Online support communities have become vital resources for those who feel let down by mainstream medicine, offering spaces to share advice, encouragement, and practical tips. Stories of people finding creative ways to access treatments - whether through welding tanks repurposed for oxygen therapy or experimental use of psychedelics - highlight both the desperation and the determination of this community. Patients are no longer waiting quietly in the shadows; they are demanding recognition, resources, and respect.
Ultimately, "The Headache" is both a personal story and a call to action. Zeller reminds readers that headache disorders are among the most disabling conditions on earth, yet they remain among the least respected in medicine. He challenges the notion that 'ordinary' means 'harmless,' showing instead that the ordinariness of the word 'headache' has allowed extraordinary suffering to go unseen. The book emphasizes that progress will require not only better science but also cultural change - replacing disbelief and minimization with empathy and urgency.
In conclusion, "The Headache" by Tom Zeller Jr. illuminates the profound gap between the lived reality of headache patients and the medical world’s response to their suffering. By blending memoir with history and science, Zeller demonstrates how this common but confounding affliction has long been ignored, stigmatized, and underfunded, and why that must change. Headaches are not minor inconveniences but major neurological disorders that rob people of dignity, stability, and hope. While modern science has begun to deliver glimmers of progress through new drugs and research initiatives, the true breakthrough will come when society finally sees headache disorders for what they are: urgent, life-altering conditions worthy of serious attention. Until then, patients will continue to shoulder both their pain and the burden of disbelief, waiting for the day when relief is not just possible but expected.
Zeller begins by grounding the narrative in his own harrowing experience with cluster headaches. These attacks, sometimes referred to as 'suicide headaches,' come suddenly and with unbearable intensity. His personal search for relief, from conventional medicine to desperate experiments with psychedelics, illustrates just how little progress has been made in treating the condition effectively. The book emphasizes that the true cruelty of headache disorders lies not just in the pain itself but also in their invisibility. From the outside, a patient can appear perfectly normal, but inside, they may be experiencing searing agony. This invisibility often breeds disbelief, isolation, and years of misdiagnosis.
The narrative expands to include others who have endured similar struggles, particularly migraine patients. Migraine, while more common than cluster headache, is still widely misunderstood and often minimized by both physicians and the general public. Its symptoms are complex, ranging from light sensitivity and nausea to disabling pain that can last for days. Yet medical science has struggled to pin down its precise cause. Some theories suggest vascular changes, others point to neural misfiring, and newer research explores immune responses or genetic predispositions. Zeller makes it clear that the lack of consensus has slowed progress, leaving patients stuck with incomplete answers and inconsistent treatment options.
Looking back at history, the book reveals how medicine’s evolving theories about headaches have often been misguided. In ancient times, extreme practices like trepanation - drilling holes in the skull - were attempted in the hope of releasing pressure or evil spirits. Later, physicians blamed 'imbalances' in the body’s humors or even moral failings. By the eighteenth and nineteenth centuries, theories grew more elaborate yet often more stigmatizing: headaches were linked to gluttony, sexual habits, or psychological weakness. Women, in particular, bore the brunt of this pseudoscience, with their suffering frequently dismissed as hysteria or emotional instability. Zeller traces how these cultural assumptions influenced treatment and perception well into the modern era, shaping the stigma that still lingers today.
The book also examines some curious moments in medical history that reveal both the creativity and the missteps of researchers. One striking example is Harold Wolff’s mid-twentieth-century experiments, inspired by a trapeze artist who noticed her headaches lessened when she performed upside down. This led to tilt-table studies and the development of the vascular theory of migraine, which dominated for decades. While these experiments produced insights, they also reinforced harmful stereotypes, with Wolff characterizing migraine sufferers - especially women - as neurotic overachievers. Such biases not only hindered scientific understanding but also deepened the stigma that patients faced in seeking care.
A turning point came in the 1990s with the discovery of serotonin’s role in migraine and the creation of sumatriptan, a drug that provided fast relief for many. This marked a major advance, but not a universal solution. Triptans remain inaccessible for some due to cost, side effects, or contraindications, and even for those who can take them, the relief is not guaranteed. More recent developments, such as CGRP inhibitors and noninvasive nerve-stimulating devices, offer hope, but the book emphasizes how far medicine still has to go in providing consistent, effective, and widely available treatments.
Alongside medical exploration, Zeller highlights the profound human toll of being disbelieved. Patients recount stories of being dismissed by doctors, accused of exaggerating, or misdiagnosed as having psychological issues. This disbelief can be more damaging than the pain itself, eroding self-confidence and leaving patients to feel abandoned by the very systems meant to help them. For some, like Will Erwin, the struggle ends in tragedy. Erwin’s suicide at age 24 after years of battling cluster headaches spurred his family to fund new research, underscoring the urgent need for greater awareness and investment.
The narrative also confronts the systemic barriers that keep headache research marginalized. Despite the enormous social and economic burden of migraines and related disorders, the National Institutes of Health has historically ranked them low in funding priority. This creates a vicious cycle: with limited funds, few researchers dedicate their careers to the field, which in turn keeps the research base thin and reinforces the perception that headaches are a lesser concern. Advocates have spent decades pushing for change, pointing out that effective treatments could restore massive amounts of lost productivity and reduce healthcare costs. Yet progress remains slow, with much of the momentum driven by private pharmaceutical companies whose priorities often align more with profit than public health.
Zeller does not shy away from showing how fragmented the science remains. Some researchers still focus on vascular changes, others on serotonin, others on the trigeminal nerve or cortical waves. Rarely do these camps collaborate, leading to siloed findings rather than a holistic picture. The result is a field in which breakthroughs emerge sporadically but a unifying theory of headache disorders remains elusive. This lack of integration mirrors the fragmented experiences of patients, who must cobble together their own solutions from an array of inconsistent advice, treatments, and home remedies.
What gives the book its strength, however, is not just the critique of science but also the resilience of patients and advocates. Online support communities have become vital resources for those who feel let down by mainstream medicine, offering spaces to share advice, encouragement, and practical tips. Stories of people finding creative ways to access treatments - whether through welding tanks repurposed for oxygen therapy or experimental use of psychedelics - highlight both the desperation and the determination of this community. Patients are no longer waiting quietly in the shadows; they are demanding recognition, resources, and respect.
Ultimately, "The Headache" is both a personal story and a call to action. Zeller reminds readers that headache disorders are among the most disabling conditions on earth, yet they remain among the least respected in medicine. He challenges the notion that 'ordinary' means 'harmless,' showing instead that the ordinariness of the word 'headache' has allowed extraordinary suffering to go unseen. The book emphasizes that progress will require not only better science but also cultural change - replacing disbelief and minimization with empathy and urgency.
In conclusion, "The Headache" by Tom Zeller Jr. illuminates the profound gap between the lived reality of headache patients and the medical world’s response to their suffering. By blending memoir with history and science, Zeller demonstrates how this common but confounding affliction has long been ignored, stigmatized, and underfunded, and why that must change. Headaches are not minor inconveniences but major neurological disorders that rob people of dignity, stability, and hope. While modern science has begun to deliver glimmers of progress through new drugs and research initiatives, the true breakthrough will come when society finally sees headache disorders for what they are: urgent, life-altering conditions worthy of serious attention. Until then, patients will continue to shoulder both their pain and the burden of disbelief, waiting for the day when relief is not just possible but expected.
November 12, 2025
I can tell the author did his research but the execution was very unorganized and hard to follow.
July 11, 2025
As someone plagued by migraines and strong headaches that cripple me, books like this are treasure. I suggest this book to anyone who suffers from headaches or migraines.
*I won this book in a Goodreads giveaway. The rating and opinion are my own.*
*I won this book in a Goodreads giveaway. The rating and opinion are my own.*
November 7, 2025
Well written but really didn’t like the structure. Either commit to a biography or just focus on the science. Mixing the two was not an effective narrative device.
October 30, 2025
Probably the most important book I've read. And one I'd put off for some time, because, why spend time reading about head pain in those rare instances when I don't have some form of head pain?
I sadistically calculated that I've had migraine for 91% of my life. At 46 the mind boggles at how many attacks I've had over the years, how much medication taken, how much time lost. This book was a hard read as it highlighted a lot of questions I've had over that time, exposed how little it's still understood but strangely, re-assuring that there are people out there that understand the level of pain we endure - be it physical, emotional and mental. And crucially, that there's people still committed to better understand the condition and how to fight it. My experience with health care practitioners often led me to believe it's not a disease that holds any merit for a cure and that respite from it will only come with death.
I feel better equipped from reading this book, there is so much resource here that the next time a neurologist suggests I try to "think about not having a migraine attack" as an abortive action, I'll have something more constructive and less hostile to say back to them.
I sadistically calculated that I've had migraine for 91% of my life. At 46 the mind boggles at how many attacks I've had over the years, how much medication taken, how much time lost. This book was a hard read as it highlighted a lot of questions I've had over that time, exposed how little it's still understood but strangely, re-assuring that there are people out there that understand the level of pain we endure - be it physical, emotional and mental. And crucially, that there's people still committed to better understand the condition and how to fight it. My experience with health care practitioners often led me to believe it's not a disease that holds any merit for a cure and that respite from it will only come with death.
I feel better equipped from reading this book, there is so much resource here that the next time a neurologist suggests I try to "think about not having a migraine attack" as an abortive action, I'll have something more constructive and less hostile to say back to them.
October 23, 2025
I learned some things from this book but I cannot say I enjoyed it. You can really tell that the author's main trade is articles and not books, as this book is more of a collection of articles rather than a single coherent whole.
But it was not bad. I think it had a lot of interesting information for someone who wants to know why plenty of us still suffer with a headache and how much hope there is in the future for a cure.
PS: I will say my headache occurrence increased while I was listening to this book. Don't know if it was a coincidence or thinking about it brought it on. So maybe if you are a fellow sufferer that does not want to trigger an attack you'll skip this one. :D
But it was not bad. I think it had a lot of interesting information for someone who wants to know why plenty of us still suffer with a headache and how much hope there is in the future for a cure.
PS: I will say my headache occurrence increased while I was listening to this book. Don't know if it was a coincidence or thinking about it brought it on. So maybe if you are a fellow sufferer that does not want to trigger an attack you'll skip this one. :D
November 13, 2025
The author effectively weaved together personal narrative, history, and science throughout this book which covers a neglected subject in a greater depth than I had seen.
May 23, 2025
My thanks to NetGalley and Mariner Books for an advance copy of this book that is looks at a malady that effects the health and personal lives of so many people, one that people laugh about, one tha doctors put off as stress, a pain that can ruin days, lives, and affect the lives of others, and one that we are still trying to understand today.
My father used to get migraines, headaches that stopped the world cold. Not just for him, but for us. My father could only sit up and the only chair that seemed to help was in the living room. So my father would sit there, blinds pulled, a pillow over his head, and wait for the pain to go away. Many a time I would come home from school, open the door, and see him sitting there. Which meant no television, a cold dinner, and lots of reading. We didn't want to bother him, and in turn this made him feel worse. Noise hurt, smells hurt. Everything hurt. What hurt him worse he told me years later was hurting us. We couldn't have friends over, we couldn't cook, we couldn't play, we just went to our rooms and tried to be quiet. Dad did everything, acupuncture, acupressure, hypnosis, pills, caffeine pills with pain pills. Nothing ever worked and he suffered headaches for 45 of his 55 years. Reading this book gave me more of an insight to what he went through, and the misery that he and so many go through, including the author. And how much medical science still understands why. The Headache: The Science of a Most Confounding Affliction—and a Search for Relief by reporter and headache sufferer Tom Zeller Jr is both a memoir, a look at the science of headaches and a call to both arms, and a shout to others that they are not alone, and that they are not too blame for what they experience.
The book begins with a bike ride, a few mushrooms and an author in search of a solution. Zeller has suffered from cluster headaches for quite a while, and as a writer with some knowledge of science is surprised by how little the medical community knows or understands the debilitating pain that headaches can cause. Zeller looks at how many doctors view headaches as a woman's problem, with an interview with a woman who sufferers from headaches laying out all ther treatment and medical history to one doctor, just to be told well stress. Zeller travels to places where headache research is being conducted, looking at new ideas as well as old. From prehistoric trepanation, to digital MRI, and the use of new drugs, including psychedelics. Zeller discusses his own treatment, and interviews many sufferers, which give insight to those who have been lucky not to deal with this constant pain, as well as wonder why so many people are suffering, and what can be done.
Zeller does a really good job of both covering the science and the human factor. Many science books love to cover the ideas, without including the human factor. As a person with cluster headaches, that show no sigh of easing, Zeller can understand the cost, the pain, the personal feelings, and the fact that many in the medical community just shrug at their pain. Zeller has a very nice style, making everything easy to understand, with lots of empathy and understanding. One never feels lost in this tour of the brain and its aches and pain. I came away with a better understanding of what my father, and a few of my friends who also suffer from migraines feel like. Hopefully I can use this understanding to help them more.
A book that was so much more than I thought it would be. I was hoping to get an idea of why my father had headaches, this gave me that and a hope that maybe other people might be helped soon. As I wrote my Dad's headaches began at 10 and I know he was happy when both my brother and I never showed signs of having sharing his burden. After reading this I get why. A very helpful and rewarding book. I hope Tom Zeller finds something that helps his headaches.
My father used to get migraines, headaches that stopped the world cold. Not just for him, but for us. My father could only sit up and the only chair that seemed to help was in the living room. So my father would sit there, blinds pulled, a pillow over his head, and wait for the pain to go away. Many a time I would come home from school, open the door, and see him sitting there. Which meant no television, a cold dinner, and lots of reading. We didn't want to bother him, and in turn this made him feel worse. Noise hurt, smells hurt. Everything hurt. What hurt him worse he told me years later was hurting us. We couldn't have friends over, we couldn't cook, we couldn't play, we just went to our rooms and tried to be quiet. Dad did everything, acupuncture, acupressure, hypnosis, pills, caffeine pills with pain pills. Nothing ever worked and he suffered headaches for 45 of his 55 years. Reading this book gave me more of an insight to what he went through, and the misery that he and so many go through, including the author. And how much medical science still understands why. The Headache: The Science of a Most Confounding Affliction—and a Search for Relief by reporter and headache sufferer Tom Zeller Jr is both a memoir, a look at the science of headaches and a call to both arms, and a shout to others that they are not alone, and that they are not too blame for what they experience.
The book begins with a bike ride, a few mushrooms and an author in search of a solution. Zeller has suffered from cluster headaches for quite a while, and as a writer with some knowledge of science is surprised by how little the medical community knows or understands the debilitating pain that headaches can cause. Zeller looks at how many doctors view headaches as a woman's problem, with an interview with a woman who sufferers from headaches laying out all ther treatment and medical history to one doctor, just to be told well stress. Zeller travels to places where headache research is being conducted, looking at new ideas as well as old. From prehistoric trepanation, to digital MRI, and the use of new drugs, including psychedelics. Zeller discusses his own treatment, and interviews many sufferers, which give insight to those who have been lucky not to deal with this constant pain, as well as wonder why so many people are suffering, and what can be done.
Zeller does a really good job of both covering the science and the human factor. Many science books love to cover the ideas, without including the human factor. As a person with cluster headaches, that show no sigh of easing, Zeller can understand the cost, the pain, the personal feelings, and the fact that many in the medical community just shrug at their pain. Zeller has a very nice style, making everything easy to understand, with lots of empathy and understanding. One never feels lost in this tour of the brain and its aches and pain. I came away with a better understanding of what my father, and a few of my friends who also suffer from migraines feel like. Hopefully I can use this understanding to help them more.
A book that was so much more than I thought it would be. I was hoping to get an idea of why my father had headaches, this gave me that and a hope that maybe other people might be helped soon. As I wrote my Dad's headaches began at 10 and I know he was happy when both my brother and I never showed signs of having sharing his burden. After reading this I get why. A very helpful and rewarding book. I hope Tom Zeller finds something that helps his headaches.
August 11, 2025
The Headache by Tom Zeller is full of information about an affliction too often dismissed by too many as “just” a headache (something Zeller does a great job of refuting), as well as about the history of its treatment, including the most up-to-date medicines that seem to bear great potential (cross fingers). All this information is humanized by Zeller’s own decades-long struggle with cluster headaches, along with stories/quotes from people who suffer frequent debilitating pain that that interferes with living a normal life, whether we’re talking careers, social lives, parenting, relationships, etc. I’m not sure Zeller quite nails the balance between personal and informative, and the book could probably do with some better organization, but overall, I found it mostly informative and engaging, both as someone who reads popular science generally and also as someone who suffers from occasional migraines that have led to missed days of work, stunted social plans, and late nights rocking back and forth moaning/chanting on bathroom floors. And I’ve got it way, way, way, easier than the people Zeller is really focused here.
Early on the stage is set for just how widespread headache disorders are. Roughly 50 million sufferers in the US alone, roughly 1.2 billion worldwide, with women suffering migraines about three times the rate of men, while men are more likely to face the rarer cluster headache syndrome. That women suffer more often from headache disorders and that headache disorders have been routinely trivialized is not a coincidence (be prepared to be appalled by early “medical” viewpoints on why women get headaches, such as how the ones that do tend to have nice figures and are “petite.” We also learn about the economic effect — tens of billions of dollars annually.
The book is wide-ranging, covering the history of migraines through references in primary documents, such as ancient Egyptian or Greek texts, and literary references. Across the book we chart the various theories behind their cause from the silly to the completely logical but wrong to the ongoing debates. Unfortunately for those who suffer from migraines, one thing readers quickly learn is we know next to nothing about what causes migraines/cluster headaches and how to treat them long-term, or even why treatments that do work at least temporarily relieve symptoms/occurrences. In some ways, the medical information is fascinating but depressing, especially when one learns that not only do treatments tend to stop working after a year or two, some can actually worsen both frequency and intensity of migraines after prolonged usage. At lease we have moved on from one potential early method — drilling holes in the head. Baby steps . . . . I don’t want to leave the impression that the book is wholly disheartening; there are positive treatments currently on the market and in the pipeline. But it’s mixed success at best, and I appreciated Zeller’s honesty about this versus some undeserved hype.
As noted, the book can be a bit disorganized, feeling a little all over the map as we shift in time and focus and even style. The seams show a bit more than I’d prefer, and I’d say some of the personal experience slows the book in spots, and there’s some repetition here and there. It could probably have been shorter, but I say that about a lot of books so hardly a unique issue. And as much as the personal wasn’t fully balanced with the informative, I greatly appreciated having a guide who knows what the pain is like, how utterly incapacitating it is, and who won’t dismiss it as “just a headache.” Recommended for sufferers and non-sufferers, since everyone should know not to be dismissive of the issue.
Early on the stage is set for just how widespread headache disorders are. Roughly 50 million sufferers in the US alone, roughly 1.2 billion worldwide, with women suffering migraines about three times the rate of men, while men are more likely to face the rarer cluster headache syndrome. That women suffer more often from headache disorders and that headache disorders have been routinely trivialized is not a coincidence (be prepared to be appalled by early “medical” viewpoints on why women get headaches, such as how the ones that do tend to have nice figures and are “petite.” We also learn about the economic effect — tens of billions of dollars annually.
The book is wide-ranging, covering the history of migraines through references in primary documents, such as ancient Egyptian or Greek texts, and literary references. Across the book we chart the various theories behind their cause from the silly to the completely logical but wrong to the ongoing debates. Unfortunately for those who suffer from migraines, one thing readers quickly learn is we know next to nothing about what causes migraines/cluster headaches and how to treat them long-term, or even why treatments that do work at least temporarily relieve symptoms/occurrences. In some ways, the medical information is fascinating but depressing, especially when one learns that not only do treatments tend to stop working after a year or two, some can actually worsen both frequency and intensity of migraines after prolonged usage. At lease we have moved on from one potential early method — drilling holes in the head. Baby steps . . . . I don’t want to leave the impression that the book is wholly disheartening; there are positive treatments currently on the market and in the pipeline. But it’s mixed success at best, and I appreciated Zeller’s honesty about this versus some undeserved hype.
As noted, the book can be a bit disorganized, feeling a little all over the map as we shift in time and focus and even style. The seams show a bit more than I’d prefer, and I’d say some of the personal experience slows the book in spots, and there’s some repetition here and there. It could probably have been shorter, but I say that about a lot of books so hardly a unique issue. And as much as the personal wasn’t fully balanced with the informative, I greatly appreciated having a guide who knows what the pain is like, how utterly incapacitating it is, and who won’t dismiss it as “just a headache.” Recommended for sufferers and non-sufferers, since everyone should know not to be dismissive of the issue.
June 24, 2025
I had a headache reading "The Headache."
It's way too much history and detail, but I don't suffer from migraines and I rarely get any headaches, so I'm the wrong audience.
However, there's a big audience for this book: "Migraine is the 2nd leading cause of US and global disability, affecting more than 17 percent of Americans."
What's the book about?
Zeller writes: "What I offer you here is a sweeping and, I hope, accessible and (sometimes) entertaining look at the curious history and long-running scientific struggle to understand, diagnose, and treat headache disorders. For readers who live with them, I hope it is informative and affirming. If it’s someone you love who is unlucky, I hope the book opens new avenues of understanding."
It does open up avenues of understanding and compassion.
WHAT IS A MIGRAINE?
“Migraine is essentially a disorder of the way the brain regulates its sensory environment,” the neuroscientist Peter Goadsby told me. “The brain gets light, the same as you, but it overinterprets it. It hears a sound, like you do—the same sound—and overinterprets it."
"'I think the whole thing is about how the brain doesn’t handle—control—what’s coming in.' Not everyone agrees with Goadsby, but it’s indisputable that migraine pain is often (though not always) accompanied by other neurological disturbances that further implicate the nervous system—impaired vision, nausea, dizziness, sound and light sensitivity, and a host of other impacts. Some migraineurs even report losing cognitive function, like the ability to read, as part of their migraine choreography. And of course, there’s the characteristic pain: boring, typically one-sided, lasting for hours, and sometimes for days, driving many of the afflicted—overwhelmingly women, by a greater than three-to-one ratio among adults—to seek stillness, darkness, and solitude."
THERE'S HOPE
"The Nerivio, a “remote electrical neuromodulation” device, attaches to the upper arm, and purportedly works by stimulating nociceptive nerve fibers, delivering signals to pain-regulating parts of the brain stem. This, in turn, activates pain inhibitory responses that flow down descending nervous pathways, easing the pain of a migraine. The patient can control the device, which requires a prescription, with a smartphone. Does it work? A 2019 randomized,9 double-blinded, and placebo-controlled trial involving 252 migraine patients showed some reduction in pain in 66 percent of patients within two hours. About 37 percent reported being pain free within that same window."
CONCLUSION
A sign of a great book is that it engrossed and captivates a disinterested or semi-interested reader.
This book failed to do that.
However, if you what a comprehensive, supremely well-researched history of migraines and headaches, this is the perfect, 5-star book.
It's way too much history and detail, but I don't suffer from migraines and I rarely get any headaches, so I'm the wrong audience.
However, there's a big audience for this book: "Migraine is the 2nd leading cause of US and global disability, affecting more than 17 percent of Americans."
What's the book about?
Zeller writes: "What I offer you here is a sweeping and, I hope, accessible and (sometimes) entertaining look at the curious history and long-running scientific struggle to understand, diagnose, and treat headache disorders. For readers who live with them, I hope it is informative and affirming. If it’s someone you love who is unlucky, I hope the book opens new avenues of understanding."
It does open up avenues of understanding and compassion.
WHAT IS A MIGRAINE?
“Migraine is essentially a disorder of the way the brain regulates its sensory environment,” the neuroscientist Peter Goadsby told me. “The brain gets light, the same as you, but it overinterprets it. It hears a sound, like you do—the same sound—and overinterprets it."
"'I think the whole thing is about how the brain doesn’t handle—control—what’s coming in.' Not everyone agrees with Goadsby, but it’s indisputable that migraine pain is often (though not always) accompanied by other neurological disturbances that further implicate the nervous system—impaired vision, nausea, dizziness, sound and light sensitivity, and a host of other impacts. Some migraineurs even report losing cognitive function, like the ability to read, as part of their migraine choreography. And of course, there’s the characteristic pain: boring, typically one-sided, lasting for hours, and sometimes for days, driving many of the afflicted—overwhelmingly women, by a greater than three-to-one ratio among adults—to seek stillness, darkness, and solitude."
THERE'S HOPE
"The Nerivio, a “remote electrical neuromodulation” device, attaches to the upper arm, and purportedly works by stimulating nociceptive nerve fibers, delivering signals to pain-regulating parts of the brain stem. This, in turn, activates pain inhibitory responses that flow down descending nervous pathways, easing the pain of a migraine. The patient can control the device, which requires a prescription, with a smartphone. Does it work? A 2019 randomized,9 double-blinded, and placebo-controlled trial involving 252 migraine patients showed some reduction in pain in 66 percent of patients within two hours. About 37 percent reported being pain free within that same window."
CONCLUSION
A sign of a great book is that it engrossed and captivates a disinterested or semi-interested reader.
This book failed to do that.
However, if you what a comprehensive, supremely well-researched history of migraines and headaches, this is the perfect, 5-star book.
July 4, 2025
As someone who suffers from chronic migraine ever since a concussion left me with traumatic brain injury, I was interested when I saw the title of this book. I'd never been brave enough to read a book on headaches before. Whether I was afraid I wouldn't understand the science, would find out I didn't experience what others did, or that everyone agreed it was no big deal I couldn't tell you. So I'm not sure what I was expecting when I decided to read Zeller's "The Headache". I'm really glad I did though.
Zeller himself experiences cluster headaches, a condition both similar to and very different from, migraines. This makes him perhaps the perfect person to write a book like this. He isn't only looking at the science, the history, and the current state of the pharmecutical industry. He's looking at the human cost and experience as well. Migraines and cluster headaches cause untold damage to the lives of those who suffer from them- literally because the people with them frequently don't share that they have them for fear of social stigma. But these conditions affect lives, and jobs, in every way and Zeller does an excellent job of blending the science and the human aspect of the headache's impact. I was surprised to discover how little is understood by the scientific community about headaches to this day, let alone how low the scientific community seems to consider research into migraines and headaches. It is a 'soft science', a 'woman's disease'- despite the fact that men suffer them as well and that cluster headaches are primarily experienced by men. The social stigma in both science and the general population is real, and needs to be changed. People need to understand that these are not "just" headaches.
This book should absolutely be read by anyone who suffers migraines and cluster headaches. While some of the lack of knowledge science has is both surprising and disheartening, the interviews Zeller has with other sufferers, as well as explanations on why medications are so iffy to work, I found highly reassuring, and validating. It's also a book I'd recommend for those who know people who suffer from migraines or cluster headaches as a way to understand some of what they go through.
I received an ARC of this book from NetGalley in exchange for an honest review
Zeller himself experiences cluster headaches, a condition both similar to and very different from, migraines. This makes him perhaps the perfect person to write a book like this. He isn't only looking at the science, the history, and the current state of the pharmecutical industry. He's looking at the human cost and experience as well. Migraines and cluster headaches cause untold damage to the lives of those who suffer from them- literally because the people with them frequently don't share that they have them for fear of social stigma. But these conditions affect lives, and jobs, in every way and Zeller does an excellent job of blending the science and the human aspect of the headache's impact. I was surprised to discover how little is understood by the scientific community about headaches to this day, let alone how low the scientific community seems to consider research into migraines and headaches. It is a 'soft science', a 'woman's disease'- despite the fact that men suffer them as well and that cluster headaches are primarily experienced by men. The social stigma in both science and the general population is real, and needs to be changed. People need to understand that these are not "just" headaches.
This book should absolutely be read by anyone who suffers migraines and cluster headaches. While some of the lack of knowledge science has is both surprising and disheartening, the interviews Zeller has with other sufferers, as well as explanations on why medications are so iffy to work, I found highly reassuring, and validating. It's also a book I'd recommend for those who know people who suffer from migraines or cluster headaches as a way to understand some of what they go through.
I received an ARC of this book from NetGalley in exchange for an honest review
March 19, 2025
The Headache is the book you didn’t know you needed—until your next skull-splitting migraine reminds you otherwise. Equal parts science deep-dive, personal odyssey, and cultural critique, Zeller takes us on a journey through the world of chronic head pain, from ancient trepanation (yes, drilling holes in skulls) to cutting-edge treatments that sound more sci-fi than medicine.
Zeller himself is no casual observer—he’s been locked in battle with cluster headaches for decades, making him the perfect guide through the strange and often misunderstood landscape of headache disorders. His writing balances warmth and razor-sharp wit, making even the more technical medical explanations feel engaging rather than like, well, a headache.
Along the way, he chats with experts, fellow sufferers, and even takes a psychedelic detour in search of relief. But this isn’t just a book about one man’s pain—it’s a broader look at why headaches are still treated like minor nuisances when, for millions, they’re life-derailing. Zeller exposes the frustrating gap in medical research and public understanding, reminding us that just because something is common doesn’t mean it isn’t serious.
For anyone who has ever curled into a ball, cursed the light, and contemplated striking a bargain with the pain gods, The Headache is equal parts validation and revelation. Read it for the science, stay for the storytelling.
Many thanks to Edelweiss and Mariner Books for providing an eARC of The Headache prior to publication.
Zeller himself is no casual observer—he’s been locked in battle with cluster headaches for decades, making him the perfect guide through the strange and often misunderstood landscape of headache disorders. His writing balances warmth and razor-sharp wit, making even the more technical medical explanations feel engaging rather than like, well, a headache.
Along the way, he chats with experts, fellow sufferers, and even takes a psychedelic detour in search of relief. But this isn’t just a book about one man’s pain—it’s a broader look at why headaches are still treated like minor nuisances when, for millions, they’re life-derailing. Zeller exposes the frustrating gap in medical research and public understanding, reminding us that just because something is common doesn’t mean it isn’t serious.
For anyone who has ever curled into a ball, cursed the light, and contemplated striking a bargain with the pain gods, The Headache is equal parts validation and revelation. Read it for the science, stay for the storytelling.
Many thanks to Edelweiss and Mariner Books for providing an eARC of The Headache prior to publication.
December 10, 2025
While I thankfully do not have cluster headaches [the author suffers from them], I do suffer from several other kinds of headaches [including migraines] and they are often more debilitating than anything else I deal with health-wise [I was about 6-7yrs old when I first started dealing with headaches]. and I was really looking forward to reading this in hopes I'd learn something that would help me.
Alas, that was not to be, but not all is lost. This is still an excellent book, filled with both extensive research as well as stories from both strangers and the author himself [that made me SO thankful that I do not have cluster headaches and I pray I never get them]. I learned so much from this book, including some questions I need to present to my own doctor in hopes that a way to deal with my own reoccurring headaches and perhaps ease their frequency, and that my friends, makes this book very much worth the read. IF you suffer from any kind of headaches, or know anyone who does, this book is absolutely for you.
Thank you to NetGalley, Tom Zeller Jr. and Mariner Books for providing this ARC in exchange for an honest review.
Alas, that was not to be, but not all is lost. This is still an excellent book, filled with both extensive research as well as stories from both strangers and the author himself [that made me SO thankful that I do not have cluster headaches and I pray I never get them]. I learned so much from this book, including some questions I need to present to my own doctor in hopes that a way to deal with my own reoccurring headaches and perhaps ease their frequency, and that my friends, makes this book very much worth the read. IF you suffer from any kind of headaches, or know anyone who does, this book is absolutely for you.
Thank you to NetGalley, Tom Zeller Jr. and Mariner Books for providing this ARC in exchange for an honest review.
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