Migraine as inspiration

Photo by Flickr user Auntie P. Click for sourceI’ve just found a brief but interesting study finding that migraines are much more common in neurologists than the general public which inspired an interesting reply by Oliver Sacks.

The prevalence of migraine in neurologists

Neurology. 2003 Nov 11;61(9):1271-2.

Evans RW, Lipton RB, Silberstein SD.

To assess the prevalence of migraine among neurologists and neurologist headache specialists, the authors performed a survey of neurologists who attended a headache review course. The 1-year and lifetime prevalences of migraine in the 220 respondents were as follows: male neurologists, 34.7%, 46.6%; male headache specialists, 59.3%, 71.9%; female neurologists, 58.1%, 62.8%; and female headache specialists, 74.1%, 81.5%. Migraine is much more prevalent among neurologists than in the general population.

Sacks later wrote to the journal to mention an earlier study finding much higher levels of migraine-related visual disturbances in doctors than other people. He also wonders:

Speculating on the possible reasons for the prevalence of migraine in neurologists, and particularly headache specialists, Evans et al. wonder, among other possibilities, whether “a personal history of migraines might stimulate an interest in neurology and headache as a subspecialty.” For myself, with a personal history of classical migraines (and, more often, isolated visual ones) going back to childhood, the extraordinary phenomena of the aura (which for me included transient or partial achromatopsia, akinetopsia, as well as visual agnosias, alexias, etc), excited an interest in the brain, and especially in visual processing, at an early age. These migraines were certainly one of the reasons I was attracted to neurology, why I chose migraine as the subject of my first book, and why I devoted a large part of this book to illustrating the varied presentations of visual auras in my patients

However, he gets short shrift from the researchers who curtly point out that their survey asked whether neurologists’ experience of migraine had influenced their career choice and they said no, so it can’t be true.

This is clearly not the finest psychological reasoning in the world and I remain fascinated by whether personal experience shapes the specialisation of clinicians.

It only happens in some cases of course. It’s probably rare that neurologists had their interest sparked after major brain damage or oncologists after experiencing cancer.

We do know, however, that psychiatrists are more likely to have experienced mental illness than other doctors and I wonder how many other links between clinical speciality and illness experience there might be.

Link to PubMed entry for study (via @anibalmastobiza)

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