In a sort of catatonic concentration so intense that in ten hours I scarcely moved a muscle or wet my lips, I read steadily through the five hundred pages of Megrim. As I did so, it seemed to me almost as if I were becoming Liveing himself, actually seeing the patients he described. At times I was unsure whether I was reading the book or writing it. I felt myself in the Dickensian London of the 1860s and ’70s. I loved Liveing’s humanity and social sensitivity, his strong assertion that migraine was not some indulgence of the idle rich but could affect those who were poorly nourished and worked long hours in ill-ventilated factories. In this way, his book reminded me of Mayhew’s great study of London’s working classes, but equally, one could tell how well Liveing had been trained in biology and the physical sciences, and what a master of clinical observation he was. I found myself thinking, This represents the best of mid-Victorian science and medicine; it is a veritable masterpiece! The book gave me what I had been hungering for during the months that I had been seeing patients with migraine, frustrated by the thin, impoverished articles which seemed to constitute the modern “literature” on the subject. At the height of this ecstasy, I saw migraine shining like an archipelago of stars in the neurological heavens.

But a century had passed since Liveing worked and wrote in London. Rousing myself from my reverie of being Liveing or one of his contemporaries, I came to and said to myself, Now it is the 1960s, not the 1860s. Who could be the Liveing of our time? A disingenuous clutter of names spoke themselves in my mind. I thought of Dr. A. and Dr. B. and Dr. C. and Dr. D., all of them good men but none of them with that mix of science and humanism that was so powerful in Liveing. And then a very loud internal voice said, “You silly bugger! You’re the man!”

On every previous occasion when I had come down after two days of amphetamine-induced mania, I had experienced a severe reaction in the other direction, feeling an almost narcoleptic drowsiness and depression. I would also have an acute sense of folly, thinking that I had endangered my life for nothing — amphetamines in the large doses I took would give me a sustained pulse rate close to 200 and a blood pressure of I know not what; several people I knew had died from overdoses of amphetamines. I would feel that I had made a crazy ascent into the stratosphere but had come back empty-handed and had nothing to show for it; that the experience had been as empty and vacuous as it was intense. This time, though, when I came down, I retained a sense of illumination and insight; I had had a sort of revelation about migraine. I had a sense of resolution, too, that I was indeed equipped to write a Liveing-like book, that perhaps I could be the Liveing of our time.

The next day, before I returned Liveing’s book to the library, I photocopied the whole thing. Then, bit by bit, I started to write my own book. The joy I got from doing this was real — infinitely more substantial than the vapid mania of amphetamines — and I never took amphetamines again.

1. Curiously, lower plants — cycads, conifers, ferns, mosses, and seaweeds — lack hallucinogenic substances.

Some nonflowering plants, however, contain stimulants, as the Mormons, among others, discovered. Mormons are forbidden to use tea or coffee. But on their long march along the Mormon Trail to Utah, the pioneers who were to found Salt Lake City, the new Zion, noticed a simple herb by the roadside, an infusion of which (“Mormon tea”) refreshed and stimulated the weary pilgrims. The herb was ephedra, which contains ephedrine, chemically and pharmacologically akin to the amphetamines.

2. Quite by accident, Hofmann discovered the hallucinogenic powers of LSD when he synthesized a new batch of the chemical in 1943. He must have absorbed some through his fingertips, for later that day he began to feel odd and went home, thinking he had a cold. As he lay in bed, he experienced “an uninterrupted stream of fantastic images of extraordinary plasticity and vividness and accompanied by an intense kaleidoscopic play of colors.” Jay Stevens, in his book Storming Heaven: LSD and the American Dream, recounted what came next:

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