Oliver Sacks writes exhilarating tales of people in the throes of neurological disorder. In An Anthropologist on Mars, for instance, his patients seem to transform themselves into artists of their own lives: "For if [diseases] destroy particular paths, particular ways of doing things, they may force the nervous system into making other paths and ways, force on it an unexpected growth and evolution."

When my neurologist informed me that the condition afflicting me with intense facial pain was trigeminal neuralgia, however, the last thing I felt was anticipatory euphoria. I did breathe a sigh of relief. After all, it took many HMO-prompted months before CAT-scans, x-rays, and batteries of tests ruled out the usual suspects, including the grim reaper, brain tumor. Still, there were nights I would have settled for a slight decapitation so I could reacquaint myself with sleep.

Hardly an uncommon disease, trigeminal neuralgia (TN) is not well known by the public or well understood by experts. Though nobody on ER has ever been wheeled into the capable hands of Nurse Hathaway or Dr. Peter Benton complaining of the condition's symptoms, there are hundreds of web sites dedicated to TN, as well as support groups and national associations dedicated to research. The causes remain undetermined, but it is a disorder of the fifth cranial nerve which engenders paralyzing paroxysmal facial pain. Depending upon your sources, TN strikes mostly women over forty, or mostly men over fifty. To read around in the chat rooms, it may have connection to the all-purpose villain stress. There is no doubt about this: TN debilitates some sufferers to the point of despair. To read around in literature, too, TN also assumes a significant place in the lives of some of our most notorious and mysterious characters. More about literary TN in a moment.

At the time of onset I was a man mostly over forty who had assumed a pressure-packed and preternaturally unsatisfying job, and suddenly I was randomly shocked by coruscating flashes of pain, sometimes while chairing committee meetings or during conferences when I fell silent and dizzy and held on waiting for the misery to subside.

Conventional TN treatment is by way of the same drugs employed for epilepsy, though in severe cases a microvascular decompression operation, that is, brain surgery, is indicated as a last resort. For years, I used these powerful, mood-altering, idea-bending, sleep-inducing, memory-impairing, word-erasing drugs, and was advised that I would be on such medication for the rest of my life. Fortunately—as I will explain—that has not turned out to be the case.

Almost as startling to me as the affliction itself was my discovering how my TN has put me in the company of some of my favorite, shady literary characters—though TN used to be known by a more wicked, elegant name, tic douloureux.

Freud's famous patient Anna O. enjoys unparalleled status in the Malpractice Hall of Fame. For Freud, she became a study in hysteria, though in reality she was undergoing psychoanalysis when she should have been treated for her TN. The mercurial Dr. Lydgate of Middlemarch, perhaps the first extended character treatment of a physician in English Literature, also has a case of TN. We learn about his addictions, his sordid past, his depression, his mood swings, and his unhappy end—and, considering the malady, his behaviors seem less surprising, to me at least, than they once did.

Humbert Humbert's TN is so prominent that Lolita loves to make fun of his spasmodic facial disfigurations. Humbert himself uses his TN as an excuse not to socialize with Big Haze when she seductively invites him: "Shall we take these candles with us and sit for a while on the piazza, or do you want to go to bed and nurse that tooth?" "Nurse that tooth," Humbert begs off. Of course, he did not take Lolita's mother's suggestion to visit the "excellent" local dentist, Dr. Quilty. Who knows what might have happened to Humbert had his condition been appropriately treated? Later on, when Humbert is tracking down Lolita, he does visit Dr. Quilty: "I told Dr. Quilty that, in hope of alleviating facial neuralgia, I had decided to have all my teeth removed." But while this visit is a pretext for tracking down the "famous nephew" and demonic adversary, such decision-making is understandable to someone suffering from TN-induced panic and dread. (Nabokov seems particularly interested in TN. Charles Kinbote of Pale Fire makes a crack about TN, and Nabokov himself testifies he "was laid up with a severe case of intercostal neuralgia" when "the first little throb of Lolita went through me late in 1939 or 1940, in Paris." Wait a second. In French, tic means "bad habit" as well as "twitching," and douloureux, "painful" or "sad." Is the reason Humbert the Hummer does not invoke classic medical terminology that it admits of an execrable pun?)

Perhaps the most eminent TN-patient of them all is Captain Ahab. As Stubb, the second mate, says, "A hot old man! I guess he's got what some folks ashore call a conscience; it's a kind of Tic-Dolly-row they say--worse nor a toothache. Well, well; I don't know what it is, but the Lord keep me from catching it. He's full of riddles...." Could it be that it isn't monomania, or displacement, or compulsivity, or repressed homosexuality (repressed?), or the Civil War, or the imaginative failure of God that sinks the Pequod and generates Moby Dick? Could it be the tic douloureux? No wonder Ahab cries out, "God! Stave my brain." As I think about it, TN is something like a harpoon.

The sharpest instrument in my personal acquaintance is not the harpoon but the acupuncturist's needle. And it has been regular acupuncture and Chinese herbal remedies, along with massage and Tai Chi, that have in combination supplanted the nine pills a day that once constituted my drug cocktail of Tegretol and Bachlofen. (Leaving that job was no hindrance to health, either.) Those psychotropic drugs stemmed attacks, but they also had side-effects: they stole from me an hour or two every afternoon when I could do nothing but nap, and befuzzed my brain to the point that I would search for the furtive word that I hoped still existed, sometimes getting it, and sometimes, terrifyingly, not. And weaning myself from those drugs was a trial unto itself: it caused months of occasionally hallucinatory withdrawal. My wonderful medical doctor, who is also a leading acupuncturist, has more than once reminded me I am very lucky indeed alternative treatment worked for me. As if I needed to be reminded.

Then again, considering the doleful company I seem to keep, maybe it's crucial to be reminded. This all puts me in mind of George Herbert, the exquisite 17th-century poet of ruin, affliction, and faith. In his astonishing poem "The Flower," he concludes his meditation on regeneration and suffering this way:

	And now in age I bud again,
After so many deaths I live and write;
	I once more smell the dew and rain,
And relish versing: O my onely light,
		It cannot be
		That I am he
	On whom thy tempests fell all night.
	

Joseph Di Prisco has published poems, essays, and reviews in numerous journals. His latest volume of poetry, Poems In Which, is the winner of the Dorothy Brunsman Prize 2000. His novel, Confessions of Brother Eli, is published by MacAdam/Cage.

Letters to Webzine In Which: address email to submissions@diprisco.com