It used to be that Americans wondered if a woman could be taken seriously as a presidential candidate. They also questioned if modern society would ever elect someone who's been divorced. Hey, just last week, Larry David asked why we haven't had any bald presidents.
So what's the new roadblock du jour? Migraines.
Roughly 36 million Americans suffer from this neurological condition - including about 18 percent of women. And candidate Michele Bachmann is one of them. (In full disclosure, so am I.) And, now, her politics aside, critics are seriously questioning whether this one factor is enough to disqualify her from the pursuing the presidency.
Yesterday, The Daily Caller published a story with the screaming headline, "Stress-Related Condition 'Incapacitates' Bachmann; Heavy Pill Use Alleged." Without actually naming any of the medications she takes to keep her condition under control, former staffers portrayed her as a pill seeker who may not be up to the stresses of the presidency.
And while the overall health of political candidates is usually fair game, this particular story feels like just another example of the widespread stigma about migraines, with decidedly sexist undertones.
I researched the topic of migraine stigma for an article in May, and spoke to Jason Rosenberg, M.D., assistant professor of neurology at John Hopkins Medicine and director of The Johns Hopkins Headache Center in a phone interview. He offered this theory on the longstanding stigma surrounding a very real condition, which afflicts women three times as often as men:
One explanation, Rosenberg says, may be that the medical profession historically looked at migraines as attacking a certain "type" of person -- the overachieving, oversensitive petite woman. "It's often thought of as a weakness of character as opposed to a biological disease," he says. And even though we now know that there's no link between personality traits and migraine, it's become a "viral meme," as Rosenberg puts it.
And it's that "weakness of character" that I feel is the "wink-wink" between-the-lines meaning behind these allegations Michele Bachmann's not "up for" the stress of a presidency.
In reality, migraines are a very specific type of neurological condition that tend to run in families -- the condition itself is not caused by stress or a particular personality type. Instead, people who already are predisposed to migraines will find that certain situations, including physical or emotional stress, certain odors, bright lights, menstruation or menopause can trigger an attack.
Following the allegations yesterday, Bachmann's team responded in a statement, explaining that her headaches were "easily controlled with medication" and "will not affect my ability to serve as commander in chief." Her son, a medical resident at the University of Connecticut also told the New York Times that she takes three medications -- two when she is actually having symptoms and one used to prevent attacks in the first place. (Bachmann also released a physician's note on Wednesday in response to the widespread media coverage.)
So while the severity of the condition obviously remains firmly in "he said, she said territory," it's important to remember that migraines do tend to fall across a spectrum. Different people are affected with varying frequency and intensity.
"While there is no cure, for most patients, migraines are manageable, just like any other chronic medical condition," Dr. Rosenberg wrote in a follow-up email on Wednesday. "For a small percentage, the disease precludes any meaningful employment at all. Presumably, someone running for the office of president is not one of these"
So far the attacks don't seem to have slowed her down, he points out.
"I would note that despite her alleged migraines, according to her bio, Ms. Bachmann has managed to get a JD, an LLM, work as an attorney, raise as well as foster numerous children, hold down a job as a prominent member of congress on various committees, become a de facto Tea Party spokesperson, and launch a presidential campaign," Dr. Rosenberg wrote. "How many of us can do that, even without migraines?"
And while he believes that medical issues related to her capacity to fulfill her role as president are, of course, fair game, Rosenberg (a migraineur himself) agrees that a migraine diagnosis does tend to carry a stigma, as the condition can "substitute for character -- or gender related issues," he notes. "... thus by releasing information about her migraines, even if well-controlled, a negative light is cast upon Ms. Bachmann to those susceptible to this type of bias, changing perceptions of the candidate for the worse, whether consciously or not."
On top of that, Paula Kamen, a Chicago feminist and author of "All In My Head," a memoir of her odyssey to cure a 15-year-long migraine, says she fears migraines have a double standard, particularly for women.
"It's very misunderstood," she told me over the phone. "For so many years, it was considered to be psychosomatic, women wanting attention."
Kamen, a self-described "liberal feminist" who jokes that one of the few things she probably has in common with Bachmann are migraines, compared the contrast between this round of media hysteria and the much calmer coverage of Chief Justice John Roberts' second seizure in 2007. With speculation that he may receive a diagnosis of epilepsy, Time reported that, if prescribed medication, Roberts would have about 20 to choose from -- "All have to be taken daily, but have relatively mild side effects."
Ironically, one common prophylactic migraine treatment is actually a much smaller dose of a certain type of epilepsy drug, Kamen points out. While we don't know if that's what migraine medication Bachmann is taking, she highlights the contradiction of jumping to conclusions that the candidate is popping pills that will interfere with her capacity to run a country. "People with chronic pain are often portrayed as pill users," Kamen says.
Dr. Rosenberg brought up a similar theme during our conversation in May, explaining that migraine sufferers can become labeled as "narcotic-seeking patients" in emergency rooms, especially if they show up with pain more than once -- he's even provided patients with notes explaining that what they're suffering from is a completely legitimate condition.
Without knowing more than the surface details, I can only speculate from my own experience with migraines that Michele Bachmann probably has found a combination of behavioral techniques, coping mechanisms and, yes, prescribed medication to keep her pain under control. I can say that, for me, our modern-day medical innovations truly do keep the crushing pain to a minimum. And when an attack does happen, I have found ways to meet my deadlines, achieve work goals and, generally, carry out the major responsibilities and commitments in my life. Others have done it before us, and often with fewer resources than we have today -- it's widely believed, for instance, that Thomas Jefferson's frequent headaches were actually what we know today to be migraines.
On top of that, any presidential candidate has the potential to become sick in a key moment, whether it's from migraines or not, making the people they choose to surround them an important consideration when casting a vote.
"Presidents have different styles, some delegating more than others, some sleeping more than others, some vacationing more than others," Dr. Rosenberg pointed out in his email. "Is a president who cannot be entirely clear-thinking after being up all night incapable of serving? How about two nights in a row? Three? Is someone with more physical stamina and endurance necessarily better suited for the office?"
So, I say, let's separate the issues. Instead of obsessing over the neurological condition that makes Bachmann's head ache, let's focus on the ideas she has in her head. Instead of looking at migraines through a feminist and gendered lens, let's look at Bachmann's approach to feminist and gender issues as they pertain to her political platform in order to make educated decisions about the legitimacy of her candidacy. No matter my personal political beliefs, I believe that with the information we have now, Bachmann does not deserve to be judged by migraines alone. (Of course, I concede that there are instances where chronic headaches could possibly interfere with daily life of just about any job, let alone the presidency -- Kamen admitted that she herself wouldn't be able to keep the rigorous travel schedule of someone like President Obama with her current pain.)
Perhaps Michele Bachmann will capitalize on this opportunity to join other well-known migraine sufferers, such as Cindy McCain, to make migraine research and innovation a top priority. As Dr. Rosenberg explained in our interview:
The best way to end the stigma on a more global level would be to find a scan or a test that can prove people have migraines. "It would suddenly legitimize the disease to others," Rosenberg says. In the meantime, continuing to find new classes of designer drugs for both prevention and treatment can help to legitimize that migraines are a very real and painful condition.
Here's hoping that Bachmann will become an advocate for sufferers, instead of letting this become just one more political headache.