Cloth $85.00 ISBN: 9780226179018 Published October 2014
Paper $27.50 ISBN: 9780226179155 Published October 2014
E-book $7.00 to $27.50 About E-books ISBN: 9780226179292 Published October 2014

Not Tonight

Migraine and the Politics of Gender and Health

Joanna Kempner

Joanna Kempner

232 pages | 13 halftones, 3 figures, 1 table | 6 x 9 | © 2014
Cloth $85.00 ISBN: 9780226179018 Published October 2014
Paper $27.50 ISBN: 9780226179155 Published October 2014
E-book $7.00 to $27.50 About E-books ISBN: 9780226179292 Published October 2014
Pain. Vomiting. Hours and days spent lying in the dark. Migraine is an extraordinarily common, disabling, and painful disorder that affects over 36 million Americans and costs the US economy at least $32 billion per year. Nevertheless, it is frequently dismissed, ignored, and delegitimized.

In Not Tonight, Joanna Kempner argues that this general dismissal of migraine can be traced back to the gendered social values embedded in the way we talk about, understand, and make policies for people in pain. Because the symptoms that accompany headache disorders—like head pain, visual auras, and sensitivity to sound—lack an objective marker of distress that can confirm their existence, doctors rely on the perceived moral character of their patients to gauge how serious their complaints are. Kempner shows how this problem plays out in the history of migraine, from nineteenth-century formulations of migraine as a disorder of upper-class intellectual men and hysterical women to the influential concept of “migraine personality” in the 1940s, in which women with migraine were described as uptight neurotics who withheld sex, to contemporary depictions of people with highly sensitive “migraine brains.” Not Tonight casts new light on how cultural beliefs about gender, pain, and the distinction between mind and body influence not only whose suffering we legitimate, but which remedies are marketed, how medicine is practiced, and how knowledge about disease is produced.
Charles E. Rosenberg | Harvard University
“An important contribution to our understanding of the multi-dimensional process through which society perceives and construes pain and disability. Her study of headache and especially migraine powerfully demonstrates the way in which gender, stakeholder interests (including those of status-oriented physicians and profit-oriented pharmaceutical manufacturers), and the very elusiveness of pain interact to create that social entity we call migraine—an entity that shapes attitudes, self-perceptions, and access to care. Carefully researched and engagingly written, this study should be of interest to anyone concerned with the social aspects of medicine. And anyone who suffers from the curse of headache pain.”
Elizabeth Mitchell Armstrong | Princeton University
“This insightful and eloquent account of our evolving understandings of migraine, from a condition of weak-nerved women, to a “real” neurobiological disease, does far more than document the cultural framing of headache. Kempner illuminates the complex, tangled relationship between medicine, morality, and meaning making in contemporary American society as she demonstrates that despite its biomedicalization and a shift from thinking of migraine as ‘all in the head’ to a genuine brain disease, migraine remains a disorder of personhood—and a particularly gendered one at that. The acuity of her sociological analysis is matched by her compassion for migraine sufferers and their fellow travelers on the quest for legitimacy and a cure.”
Linda Blum | Northeastern University
“Kempner’s incisive work analyzes migraine medicine and its gendered subtext as practitioners sought to make sense of the mind/body actions or interactions causing the common, yet devastating pain of sufferers. The book is beautifully written, with a moving preface in which Kempner locates herself as a fellow migraine sufferer as well as ethnographic observer.”
List of Illustrations
List of Abbreviations
Chapter 1. All in Her Mind
Chapter 2. All in Her Brain
Chapter 3. Embracing the Migraine Brain
Chapter 4. Gendering the Migraine Market
Chapter 5. Men in Pain
Appendix A. International Classification of Headache Disorders
Appendix B. Methods
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