August 5, 2025 • 10 mins
In THE HEADACHE: The Science of a Most Confounding Affliction-and a Search for Relief (Mariner Books; on sale 7/15/2025), veteran science journalist Tom Zeller Jr. delivers a deeply reported journey into the world of headaches-equal parts gripping memoir, cutting-edge science, and insightful exploration of what it means to live with severe, unexplained, and recurrent head pain.For decades, Zeller has battled excruciating cluster headaches, a disorder so painful it is sometimes described as "suicide headache" in the scientific literature. But instead of succumbing to despair, he used his unique skills as a journalist to dig deeper. THE HEADACHE chronicles his personal quest for answers-from experimental drug trials to groundbreaking research on brain function, and even the unexpected possibilities of psychedelic therapy. Zeller's captivating narrative explores the history of headache treatment, the science behind the nervous system, and how modern medicine is finally starting to take these conditions seriously
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I have Tom Zeller Junior, who's talking to us straight
from Montana. You're kidding, men, that's perfect and you have
till till nine forty. Go ahead where you at, Tom,
Because I grew up in buildings, Montana.
Speaker 2 (00:14):
Okay, I'm a little further west in sort of the
Zula area bitter Root Valley.
Speaker 1 (00:18):
Oh my god, you know you know the Bitterroot Valley
is where that that show Yellowstone is actually filmed. And man,
I'll tell you what when I when I had the
chance to talk with them, I mean, I called them
out instantly because I know that mountain scene and it
was like, dude, you are not in Yellowstone at all.
Speaker 2 (00:34):
No, No, they actually filmed it right up here. There's
a warehouse at the end of my street here where
they kept all the sets for Yellowstone.
Speaker 1 (00:42):
Wow.
Speaker 2 (00:43):
So yeah, it was all up and down here. I'm
in the town called Lolo.
Speaker 1 (00:46):
I don't know if you know, absolutely I do, man,
because we would talk about Lolo all the time on
the radio station. Is because of your windshield factor and
all the wind that came through there and all that
kind of stuff.
Speaker 2 (00:54):
Yeah, yeah, that's where I am.
Speaker 1 (00:57):
Not to be a pain here today, But are you
getting a hit talking about all these headaches with everybody
across the country.
Speaker 2 (01:03):
I'm not, no, but it's actually a lot of fun.
Speaker 1 (01:07):
What has taken so long to find something like this?
Because this is the type of book that I would
like to see at the pharmacy or a grocery store,
because this is what people are going to be paging through.
Speaker 2 (01:17):
Yeah, I mean, it was sort of remarkable to me
when I decided to pitch this book that there really
wasn't anything quite like it out there. I can't really
explain why that's the case, but you know, I think
part of the issue is that we use the word
a headache for these disorders. So there are headaches that
we all get. You know, you have a little too
much to drink the night before, or you get a
little dehydrated, you get a headache. But that's not what
(01:39):
we're talking about here. That the word is also used
to refer to disorders like the first order diseases like
migraine or cluster headache that I have, where the pain
is actually the sort of signature of the disease, and
those are you know, well outside the reach of a
couple of tile and all they uprooted whole seasons of
(02:01):
your life, and you know we frankly, I don't think
we talk about them enough.
Speaker 1 (02:04):
Dude. I work with a girl who just had brain
surgery because of her headaches. I mean they, I mean
to see those staples in her head was it was
so scary for me. Wow, she had migrains or it
was constant migrains. It just wouldn't go away. And when
and when she finally came up and told me, she says,
I have to go have surgery because they say that
there's something that's pushing on whatever in the brain. I
(02:24):
don't know these big fifteen letter words, but they actually
I mean, oh my god, the incision was hideous.
Speaker 2 (02:31):
Wow. Yeah, it sounds like she might have had a
tumor that was actually causing her head which in case,
if that's the case, then you know, hopefully this will
have taken care of it. Is she better now? She is?
Speaker 1 (02:40):
And the thing is, though, she says that what you
don't realize is that when you have head surgery, your
whole entire body hurts. It's almost like your brain is
saying no, all of me hurts.
Speaker 2 (02:50):
Mm. Yeah, I mean, you know, the whole connection between
the brain, which by the way, I mean, we sort
of learned this in one on one biology. But the
brain itself doesn't feel pain. It interprets pain from the
rest of the body, but it's it doesn't hurt itself.
So that's part of the mystery of like, what is
causing a migraine or a cluster headache? Is that a
lot of scientists I talk to, they even disagree on
(03:12):
where the pain is coming from.
Speaker 1 (03:13):
Wow, now, how did you jump into this project? What
were you on Google or chat GPT?
Speaker 2 (03:19):
No? I actually, well, as I said, I have headaches myself,
and I went looking for a book or for an
explanation as to why we don't really know that much
about these disorders, given that so many people have them,
And I was surprised to find that, you know, they
aren't really taken very seriously in neuroscience and neurology circles
(03:41):
for reasons that I think are cultural more than anything.
They don't receive a lot of funding from the NIH
to address. And yet you know, you could easily estimate
that that migraines and clusters and headache disorders like that
drain billions of dollars off the economy every year, with
people being absent or unable to work, and so it's
surprising that we wouldn't spend more money trying to understand
(04:02):
them and crack them. Well, it's changing of Yeah.
Speaker 1 (04:05):
This book is coming out at such a perfect time
because we are living in the most uncertain times in
our life, and anxiety has got to be that one
thing that is driving a lot of headaches into into
our present life.
Speaker 2 (04:16):
It's definitely something. It's one trigger, it's one it's one
aspect of headaches. But I would be loath to say that,
you know, stress for instance, in my case, you know,
I would often get attacked by headaches at my most
serene moments. There's no there's no rhyme or yes, yes,
you know. I think, particularly with migraines, it's it's a whole.
(04:38):
It's definitely a sensory disorder. So you know, sites, sounds, sense, stress, hormones,
all of these things play a role and sort of
generating a cascade that results in a migraine, probably a
cluster headache two. But it's it's it's really sort of
hard to just say, oh, stress is your in fact,
(05:00):
and part of I said, the reason I emphasize that
is because it's too often, particularly with women, we say, well,
if you had just learned to calm down a little bit,
your headaches would get better. And I can't tell you
how often I've heard women complain about being told this
by their doctors.
Speaker 1 (05:16):
Please do not move. There's more with Tom Zeller Junior
coming up next. We're talking headaches. Oh, we are back
with Tom Zeller Junior. My wife when she gets a headache,
the first thing I do is I say take your
blood pressure, and sure enough that stuff is up high.
And I use that as because I look at at
headaches as being not a source of bad energy, but
(05:39):
rather a symptom of something that is going wrong or
is wrong.
Speaker 2 (05:44):
Yeah, I think that's true. It's definitely the case. I
think one scientist put it to me this way. Everybody
has the hardware to get migrain and headaches, or to
get cluster headaches, but not everybody has the software. So
we all sort of have the same sorts of general
structures in us, the central nervous system that could cause
these headaches, but only in a certain percentage of people
(06:04):
with the right sort of genetic makeup. Get this, this
sort of sensory breakdown where that results in great pain.
Blood pressure may have some role to play in it.
For one of the things that I learned in the
book is that blood pressure may not actually play a
role in it at all. They've done studies of Yeah,
(06:24):
they've actually done studies in migraine patients where they're in
the throes of a headache and the blood in the
head it remains at a baseline level. It's just the same.
So there's they're still getting this headache, but there's it
has nothing to do with the blood vessels.
Speaker 1 (06:39):
So yeah, maybe it's the martial artist in me. But
I love to people watch and read body language. When
when you speak of the headache, I see your fingers
pointing towards your body. So therefore you're telling me that
your entire body hurts when you get one of these
these cluster headaches.
Speaker 2 (06:55):
Well, for me, I feel it. I mean, my entire
body reacts. I will say that. But the pain for me,
for a cluster headache, the pain is directly behind my
right eyeball. Oh, like like a nuclear explosion, right there
inside the temple behind my eye. It's very very intense,
and like migraine, it's always on one side, which should
(07:17):
give us some indication that you know, this is a
central nervous system issue. Why would a pain be felt
strictly on one side unless it involved the central nervous
system in some way. And yeah, and it's like an
inferno for a hot you know, hour or two, and
then it just evaporates as magically as it appeared.
Speaker 1 (07:36):
Is that the reason why most people do not go
to the doctor for their migraines. Oh, I'll get over it.
I'm fine, I'll sit here, I'll wait it through.
Speaker 2 (07:43):
I think it's because they feel judged. I think a
lot of them avoid that. They feel like they either
you know, they did something wrong, or if they just relaxed,
or maybe if they just didn't eat that chocolate or
drinking a glass of wine or whatever it is. And also,
you know, the word headache, We use it to talk
about very mundane things, right. Traffic is a headache. Doing
(08:05):
your bills is a headache. Doing paperwork as headache. So
it's sort of this cultural sort of signal to a
headache sufferer that what you're having everybody has and it
shouldn't it shouldn't be laying you low. It shouldn't be
like such trouble for you. And I think that's part
of the reason why a lot of migrainers like hesitate,
(08:25):
like going and talking about it to a doctor because
they feel embarrassed by it, which is part of the
reason I wrote this book, is like, come on, these
are real diseases.
Speaker 1 (08:32):
But aren't you opening up our eyes to what is
creating a headache? Because I mean, here in the South,
I would say, oh, it's my allergies or oh my god,
I've got another cold again. That's the reason why it
starts behind my ear and moves to my throat. I mean,
it seems like we want to sit there and say
I'm in pain because of something else other than what
you're talking about.
Speaker 2 (08:52):
Yeah, I mean I think that those also lead to headaches,
but those tend to have those that tend to be
symptoms of some other thing. And I think that that's
the distinction between you know, a headache that comes with
your allergies, or a headache that comes from a sinus
infection or an abscessed tooth, versus a headache that just
we don't actually know what's causing it and we can't
(09:12):
even figure out where the pain is coming from. That's
the distinction and I think that that's part of what
I hope the book will do well.
Speaker 1 (09:19):
In writing this book, did it relieve some of the
pressure inside your head because you're being open and you're
being honest and transparent with those that are going to
pick up the book.
Speaker 2 (09:30):
It's too soon to say, I have to tell you, ero.
I mean, I was happy to get out the book
for me. You know, the headaches have a mind of
their own. They will come when they come, and they
depart when they depart. Whether the book actually ended up
being a help in that regard, I guess I would
say it remains to be seen.
Speaker 1 (09:48):
Wow, ten minutes with you is not enough. But just
let me know though. Is that ten million dollar silver
dollar bar still over there on that highway or is
that on I ninety it is?
Speaker 2 (09:56):
It is heading out west? Yes, yes it is, dude.
Speaker 1 (10:00):
I was in that place when I was ten years old,
so I'm sixty three now. So man, that place is
still going.
Speaker 2 (10:05):
Huh wow, it's still going. It's growing like gangbusters too. Wow. Wow.
Speaker 1 (10:10):
Where can people go to find out more about you?
Because you're just scratching the surface here today.
Speaker 2 (10:15):
Well, if they want to find out about me, they
can go to Tom Zeller dot com and they'll also
find links to the book there.
Speaker 1 (10:22):
Please come back to this show anytime in the future.
The door is always going to be open for you. Tom.
Speaker 2 (10:27):
Thank you, Erro. I appreciate your interest.
Speaker 1 (10:28):
Will you be brilliant today?
Speaker 2 (10:30):
Okay, yeah, you too,
I have Tom Zeller Junior, who's talking to us straight
from Montana. You're kidding, men, that's perfect and you have
till till nine forty. Go ahead where you at, Tom,
Because I grew up in buildings, Montana.
Speaker 2 (00:14):
Okay, I'm a little further west in sort of the
Zula area bitter Root Valley.
Speaker 1 (00:18):
Oh my god, you know you know the Bitterroot Valley
is where that that show Yellowstone is actually filmed. And man,
I'll tell you what when I when I had the
chance to talk with them, I mean, I called them
out instantly because I know that mountain scene and it
was like, dude, you are not in Yellowstone at all.
Speaker 2 (00:34):
No, No, they actually filmed it right up here. There's
a warehouse at the end of my street here where
they kept all the sets for Yellowstone.
Speaker 1 (00:42):
Wow.
Speaker 2 (00:43):
So yeah, it was all up and down here. I'm
in the town called Lolo.
Speaker 1 (00:46):
I don't know if you know, absolutely I do, man,
because we would talk about Lolo all the time on
the radio station. Is because of your windshield factor and
all the wind that came through there and all that
kind of stuff.
Speaker 2 (00:54):
Yeah, yeah, that's where I am.
Speaker 1 (00:57):
Not to be a pain here today, But are you
getting a hit talking about all these headaches with everybody
across the country.
Speaker 2 (01:03):
I'm not, no, but it's actually a lot of fun.
Speaker 1 (01:07):
What has taken so long to find something like this?
Because this is the type of book that I would
like to see at the pharmacy or a grocery store,
because this is what people are going to be paging through.
Speaker 2 (01:17):
Yeah, I mean, it was sort of remarkable to me
when I decided to pitch this book that there really
wasn't anything quite like it out there. I can't really
explain why that's the case, but you know, I think
part of the issue is that we use the word
a headache for these disorders. So there are headaches that
we all get. You know, you have a little too
much to drink the night before, or you get a
little dehydrated, you get a headache. But that's not what
(01:39):
we're talking about here. That the word is also used
to refer to disorders like the first order diseases like
migraine or cluster headache that I have, where the pain
is actually the sort of signature of the disease, and
those are you know, well outside the reach of a
couple of tile and all they uprooted whole seasons of
(02:01):
your life, and you know we frankly, I don't think
we talk about them enough.
Speaker 1 (02:04):
Dude. I work with a girl who just had brain
surgery because of her headaches. I mean they, I mean
to see those staples in her head was it was
so scary for me. Wow, she had migrains or it
was constant migrains. It just wouldn't go away. And when
and when she finally came up and told me, she says,
I have to go have surgery because they say that
there's something that's pushing on whatever in the brain. I
(02:24):
don't know these big fifteen letter words, but they actually
I mean, oh my god, the incision was hideous.
Speaker 2 (02:31):
Wow. Yeah, it sounds like she might have had a
tumor that was actually causing her head which in case,
if that's the case, then you know, hopefully this will
have taken care of it. Is she better now? She is?
Speaker 1 (02:40):
And the thing is, though, she says that what you
don't realize is that when you have head surgery, your
whole entire body hurts. It's almost like your brain is
saying no, all of me hurts.
Speaker 2 (02:50):
Mm. Yeah, I mean, you know, the whole connection between
the brain, which by the way, I mean, we sort
of learned this in one on one biology. But the
brain itself doesn't feel pain. It interprets pain from the
rest of the body, but it's it doesn't hurt itself.
So that's part of the mystery of like, what is
causing a migraine or a cluster headache? Is that a
lot of scientists I talk to, they even disagree on
(03:12):
where the pain is coming from.
Speaker 1 (03:13):
Wow, now, how did you jump into this project? What
were you on Google or chat GPT?
Speaker 2 (03:19):
No? I actually, well, as I said, I have headaches myself,
and I went looking for a book or for an
explanation as to why we don't really know that much
about these disorders, given that so many people have them,
And I was surprised to find that, you know, they
aren't really taken very seriously in neuroscience and neurology circles
(03:41):
for reasons that I think are cultural more than anything.
They don't receive a lot of funding from the NIH
to address. And yet you know, you could easily estimate
that that migraines and clusters and headache disorders like that
drain billions of dollars off the economy every year, with
people being absent or unable to work, and so it's
surprising that we wouldn't spend more money trying to understand
(04:02):
them and crack them. Well, it's changing of Yeah.
Speaker 1 (04:05):
This book is coming out at such a perfect time
because we are living in the most uncertain times in
our life, and anxiety has got to be that one
thing that is driving a lot of headaches into into
our present life.
Speaker 2 (04:16):
It's definitely something. It's one trigger, it's one it's one
aspect of headaches. But I would be loath to say that,
you know, stress for instance, in my case, you know,
I would often get attacked by headaches at my most
serene moments. There's no there's no rhyme or yes, yes,
you know. I think, particularly with migraines, it's it's a whole.
(04:38):
It's definitely a sensory disorder. So you know, sites, sounds, sense, stress, hormones,
all of these things play a role and sort of
generating a cascade that results in a migraine, probably a
cluster headache two. But it's it's it's really sort of
hard to just say, oh, stress is your in fact,
(05:00):
and part of I said, the reason I emphasize that
is because it's too often, particularly with women, we say, well,
if you had just learned to calm down a little bit,
your headaches would get better. And I can't tell you
how often I've heard women complain about being told this
by their doctors.
Speaker 1 (05:16):
Please do not move. There's more with Tom Zeller Junior
coming up next. We're talking headaches. Oh, we are back
with Tom Zeller Junior. My wife when she gets a headache,
the first thing I do is I say take your
blood pressure, and sure enough that stuff is up high.
And I use that as because I look at at
headaches as being not a source of bad energy, but
(05:39):
rather a symptom of something that is going wrong or
is wrong.
Speaker 2 (05:44):
Yeah, I think that's true. It's definitely the case. I
think one scientist put it to me this way. Everybody
has the hardware to get migrain and headaches, or to
get cluster headaches, but not everybody has the software. So
we all sort of have the same sorts of general
structures in us, the central nervous system that could cause
these headaches, but only in a certain percentage of people
(06:04):
with the right sort of genetic makeup. Get this, this
sort of sensory breakdown where that results in great pain.
Blood pressure may have some role to play in it.
For one of the things that I learned in the
book is that blood pressure may not actually play a
role in it at all. They've done studies of Yeah,
(06:24):
they've actually done studies in migraine patients where they're in
the throes of a headache and the blood in the
head it remains at a baseline level. It's just the same.
So there's they're still getting this headache, but there's it
has nothing to do with the blood vessels.
Speaker 1 (06:39):
So yeah, maybe it's the martial artist in me. But
I love to people watch and read body language. When
when you speak of the headache, I see your fingers
pointing towards your body. So therefore you're telling me that
your entire body hurts when you get one of these
these cluster headaches.
Speaker 2 (06:55):
Well, for me, I feel it. I mean, my entire
body reacts. I will say that. But the pain for me,
for a cluster headache, the pain is directly behind my
right eyeball. Oh, like like a nuclear explosion, right there
inside the temple behind my eye. It's very very intense,
and like migraine, it's always on one side, which should
(07:17):
give us some indication that you know, this is a
central nervous system issue. Why would a pain be felt
strictly on one side unless it involved the central nervous
system in some way. And yeah, and it's like an
inferno for a hot you know, hour or two, and
then it just evaporates as magically as it appeared.
Speaker 1 (07:36):
Is that the reason why most people do not go
to the doctor for their migraines. Oh, I'll get over it.
I'm fine, I'll sit here, I'll wait it through.
Speaker 2 (07:43):
I think it's because they feel judged. I think a
lot of them avoid that. They feel like they either
you know, they did something wrong, or if they just relaxed,
or maybe if they just didn't eat that chocolate or
drinking a glass of wine or whatever it is. And also,
you know, the word headache, We use it to talk
about very mundane things, right. Traffic is a headache. Doing
(08:05):
your bills is a headache. Doing paperwork as headache. So
it's sort of this cultural sort of signal to a
headache sufferer that what you're having everybody has and it
shouldn't it shouldn't be laying you low. It shouldn't be
like such trouble for you. And I think that's part
of the reason why a lot of migrainers like hesitate,
(08:25):
like going and talking about it to a doctor because
they feel embarrassed by it, which is part of the
reason I wrote this book, is like, come on, these
are real diseases.
Speaker 1 (08:32):
But aren't you opening up our eyes to what is
creating a headache? Because I mean, here in the South,
I would say, oh, it's my allergies or oh my god,
I've got another cold again. That's the reason why it
starts behind my ear and moves to my throat. I mean,
it seems like we want to sit there and say
I'm in pain because of something else other than what
you're talking about.
Speaker 2 (08:52):
Yeah, I mean I think that those also lead to headaches,
but those tend to have those that tend to be
symptoms of some other thing. And I think that that's
the distinction between you know, a headache that comes with
your allergies, or a headache that comes from a sinus
infection or an abscessed tooth, versus a headache that just
we don't actually know what's causing it and we can't
(09:12):
even figure out where the pain is coming from. That's
the distinction and I think that that's part of what
I hope the book will do well.
Speaker 1 (09:19):
In writing this book, did it relieve some of the
pressure inside your head because you're being open and you're
being honest and transparent with those that are going to
pick up the book.
Speaker 2 (09:30):
It's too soon to say, I have to tell you, ero.
I mean, I was happy to get out the book
for me. You know, the headaches have a mind of
their own. They will come when they come, and they
depart when they depart. Whether the book actually ended up
being a help in that regard, I guess I would
say it remains to be seen.
Speaker 1 (09:48):
Wow, ten minutes with you is not enough. But just
let me know though. Is that ten million dollar silver
dollar bar still over there on that highway or is
that on I ninety it is?
Speaker 2 (09:56):
It is heading out west? Yes, yes it is, dude.
Speaker 1 (10:00):
I was in that place when I was ten years old,
so I'm sixty three now. So man, that place is
still going.
Speaker 2 (10:05):
Huh wow, it's still going. It's growing like gangbusters too. Wow. Wow.
Speaker 1 (10:10):
Where can people go to find out more about you?
Because you're just scratching the surface here today.
Speaker 2 (10:15):
Well, if they want to find out about me, they
can go to Tom Zeller dot com and they'll also
find links to the book there.
Speaker 1 (10:22):
Please come back to this show anytime in the future.
The door is always going to be open for you. Tom.
Speaker 2 (10:27):
Thank you, Erro. I appreciate your interest.
Speaker 1 (10:28):
Will you be brilliant today?
Speaker 2 (10:30):
Okay, yeah, you too,
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