The World's Greatest Doctor

(Excerpt from "The Expat's Pajama's: Barcelona")

The cluster migraines hit me in my mid-thirties, clamping on to the folds of my brain and refusing to let go for the next ten years.

When the migraines started I had good medical coverage and access to great doctors, but nothing seemed to work.  After an uneventful CAT scan, we tried every drug available—some with great recreational potential—but no cluster-buster emerged. 

I tried meditation. I tried warm baths. I tried meditating in a warm bath but I fell asleep and nearly drowned. I tried Tai Chi, but it was so slow and boring it only added to my stress. I experimented with varying my diet, systematically removing everything until only beer remained, but I never found the demonic ingredient that was causing the cluster bombs to explode inside my head.

I eventually found a formula that helped take the edge off—a concoction I called the “migraine mocha:” a cocktail of a controlled substance known as “Fiorinal,” dark chocolate and espresso. In retrospect, this was probably the world’s first “energy drink.”

I should have licensed it to Starbucks.

Many painful years rolled by, slowly. In 2000 I moved to Barcelona, Spain where, to my delight, Fiorinal was available over-the-counter in unlimited quantities at one-tenth the price it cost back home. I was in migraine heaven.

“Would you like codeine with that?” the Spanish pharmacist would ask, but I preferred my Fiorinal straight up with a coffee chaser.

My long-term migraine management strategy became simple: I’d buy lifetime’s supply of medication, have my visiting mother carry it home in her luggage, and pray that she didn’t get caught. Just before I turned my law-abiding mom into an international drug smuggler, I learned that Barcelona was the home to a world-renowned migraine specialist named Dr. Titus.

I decided to give the medical establishment one more chance to stop the intifada that had been raging in my head for the last ten years.

Dr. Titus was in demand so I had to make an appointment months in advance and then, due to business travel, I had to keep re-scheduling. A Fiorinal-filled year passed before I could finally see the legendary Dr. Titus.

When the day of my appointment arrived, I made the mistake of driving to the clinic and got trapped in the eternal gridlock of Spanish traffic. The roads had contracted like the spiteful arteries in my head.

“I’ll be a few minutes late,” I said, calling on my cell phone, the one with the intermittent battery. Fortunately, it was still working that day.

“Tranquilo,” the receptionist said.  “No problem.”

After a fruitless search for a parking spot, I finally parked illegally on a side street too narrow for tow-trucks. I was now a half-hour late and a mile away from the clinic.

I began to run, crossing against red lights, dodging oncoming cars and oil-burning Vespas. A cloud of cigarette wielding of teenagers billowed out of a schoolyard. I gasped for breath and tried to see my way through the second-hand haze.

Half way there, I called again. “I’m coming as fast as I can,” I said.

“Tranquilo,” the receptionist said, and I began to worry.

Tranquilo? I knew exactly what that meant. It meant I would arrive late and the same tranquilo office tyrant would tell me to reschedule my visit for the following century. She’d charge me double for wasting the doctor’s time, and probably charge me in advance for the next visit.

I was sweating and out of breath when I finally arrived in Dr. Titus’ crowded waiting room. To compensate for patients’ general lack of punctuality, many Spanish doctors schedule all visits for the exact same time. This strategy assures that the doctor’s time isn’t wasted and patients stay entertained  arguing over who’s next—unless one of the patients happens to be a clueless foreigner, in which case he goes last.

By the time my turn came, the office was empty and I was so hungry that my stomach started digesting my small intestines.

Dr. Titus was a tiny man, easily in his late seventies. He asked me a few questions in simple Spanish and then gave me his diagnosis: “Eres tenso” he said. “You’re tense.”

“Tense?”

“Tense,” he said, “you’re tense. That’s why you have migraines.”

“Of course I’m tense,” I said, nearly blowing a head-gasket. In frantic Spanish, I proceeded to tell him about the traffic jam and every other injustice I’d suffered that afternoon. “You’d be tense after trying to find a parking place in this town!”

“It’s OK to be tense,” he said.

 Dr. Titus, a man of few words, none of them helpful.

“Is that your entire diagnosis?” I demanded.  Was he really one of the world’s great migraine experts? Had I just paid a hundred and fifty Euros for him to tell me I was tense?

“Some people are just tense,” he said. “You’re one of them.”

I was ready to start shouting, but I didn’t want to confirm his diagnosis.  I took a deep breath and tried to remember my old mantra, the one that had almost killed me in the bathtub.   

“That’s it? We’re done?” 

He nodded, stood up, shook my hand and escorted me to the door. “Stop taking all that medicine,” he said, “and give your self permission to be tense.”

So I did. I ramped down the medication. I reminded myself daily that it was OK to be tense, and within a month, the migraines disappeared.

Years later, I’m still tense. But my head feels fine.