migraine fragment 1: on pain scale

Note: I am in the process of archiving my writings disperced across social media platforms on my own website here. This is a mirror post of “migraine fragment 1“ on my Substack page (cringe) processing.

On a scale from one to ten, how would you rate your migraine pain?

I have been asked this question exactly twice in my life.

The first time was maybe 2018 or 2019 when I was a grad student routinely telling my school doctor about my migraines.

The second time was early 2025 when I had to see my new primary care doctor with some weird medical conditions after intense stress of teaching, applications, and campus visits.

For both times, the question really flustered me. I didn’t know how to answer.

Woman surrounded by stars, 1981, Migraine Art Competition. Source: Welcome Collection. © Wellcome Collection

Parts of me were so confused. What do you mean that I have to rate my pain? How am I supposed to give you an accurate number when I have had this condition for so damn long without proper diagnosis, tracking, and it varied so much anyway? How am I supposed to give you an objective number on a scale from 1 to 10 when I haven’t experienced all levels of pain there is to have in this world?

Sure, so many moments of my life had been hell with migraines but I also know for a fact, based on the migraine subreddit, that plenty of people with migraines have had it way worse than me. So when the doctor asked this question early last year, I froze.

More than fifteen years of migraines, and I had no answer.

How could I possibly know?

Compared to what?

Compared to whom?

Compared to the worst pain I had ever felt, or the worst pain anyone had ever felt?

I couldn’t have possibly said any of that. So I simply answered around 5, right in the middle.

I figured 5 would be a safe number to say as I didn’t want to oversell or undersell my pain. Then I forgot all about it…until a few days later during one of my therapy sessions.

My therapist Angela and I were doing some sort of exercises during which she asked me to rate how tense I feel on a numerical scale. I was starting to tense up and panic about not knowing how to accurately assess myself. I laughed nervously and started saying: “I don’t know…”

It was then that I connected this moment of panic to my recent doctor’s visit. “I feel instantly a lot more stressed when being asked to assess and rate. I don’t know how to rate from a scale of 1 to 10. I was being asked to rate my pain recently at the doctor’s office…”

I went on and on to recount the experience and my frustration with not knowing how to rate my pain. Within a couple minutes, I reached the point of asking Angela to walk me through how to rate. There were plenty of insights from that conversation, but I will save it for another day.

Circling back to being asked to rate my pain, I realize now that frustration wasn’t the only feeling that surfaced.

There was sadness.

There was anger.

What do you mean that somebody is curious about my pain level?

What do you mean that I have to document and assess my experience?

If only I knew.

If only I had parents who knew how to take care of me.

If only someone—anyone—had taught me how to notice, care for, and advocate for my body.

Oh gosh. I’m getting sleepy again.

Every time I try to write about these difficult memories, I become overwhelmingly fatigued. I don’t know whether my body is trying to protect me from something or whether this is simply what remembering asks of me.

I guess I’d better stop here.