The Headache by Tom Zeller Jr. The Most Confounding Affliction – And a Search for Relief
What's it about?
The Headache (2025) is a deep exploration of one of the most common – and most misunderstood – human ailments. It blends personal experience with scientific investigation to reveal why headache disorders are so often dismissed, and how that’s finally beginning to change.
One sunny day in Montana, high on hope and a large dose of psychedelic mushrooms, the author, Tom Zeller Jr., found himself zipping up a mountain road on an e-bike, convinced that this bold experiment might finally quiet the agony inside his skull. Cluster headaches – sometimes called “suicide headaches” – had taken over his days and nights, and nothing else seemed to work. As the drug took hold, the hills shimmered, the balsam root flowers seemed to cheer, and he imagined accepting an award for finally conquering his invisible tormentor. It would have been a triumphant scene – if the next headache hadn’t hit the very next day.
For millions of people, headaches are more than an occasional nuisance – they’re chronic, often debilitating conditions that disrupt lives and defy easy explanation. From migraines to cluster headaches and rarer disorders, these conditions remain poorly understood and frequently dismissed, in part because the word “headache” sounds too ordinary to reflect the suffering they cause. The pain is real, often extreme, but still invisible, and that invisibility can isolate those who live with it.
In this lesson, you’ll uncover the surprising gaps in headache science, and meet the researchers working to change that. You’ll also gain a new understanding of what these misunderstood disorders really are – and why they matter more than you think.
The first time it happened, Zeller thought he was having a stroke. Out of nowhere, a searing pain exploded behind one eye. It dropped him to the floor and left him gasping. When it happened again weeks later – and then again, and again – it began to feel like a haunting. The attacks always came without warning and vanished just as suddenly, leaving only exhaustion and dread in their wake. He’d later learn that these were called cluster headaches.
That’s exactly how it starts for many people. The pain is sudden, one-sided, and nearly indescribable – sharp, deep, and urgent. It can hit in the middle of the night, driving people from their beds to pace, rock, cry, or slam their heads against the wall in a frantic search for relief. Over-the-counter painkillers do nothing. Some try injections. Others, like Zeller, try psychedelics. Desperation pushes people to experiment. Nothing feels too strange when you’re in that much pain.
Headaches are so common, so ordinary in name, that even the most extreme versions are often dismissed or downplayed. You may look fine. Your scans may be clean. But inside your skull, something is tearing you apart.
And the pain doesn’t wait for privacy. Once, while traveling in India, Zeller curled into a narrow train bunk during his fourth attack in 24 hours, biting down on a towel to muffle his cries so he wouldn’t scare the children nearby. The attack passed – but the isolation lingered.
This kind of suffering is invisible – and that’s part of what makes it so isolating. You can’t show someone what it feels like. You can only describe it, often awkwardly, while hoping they believe you. For many, it’s a long time before anyone truly does.
And it’s not just cluster headaches. Migraine, which affects a much larger number of people, is also deeply disabling – and still poorly understood. Even researchers can’t fully agree on where the pain comes from, or what part of the brain is misfiring. The signals involved are complex. The treatments, often borrowed from other conditions, are hit-or-miss. And the funding for studying these disorders barely scratches the surface of their global impact.
Still, there are signs of change. New medications are being developed that target headache-specific mechanisms. Scientists are finally mapping out what might be going wrong inside the nervous system. And people who’ve lived for years in the shadow of these attacks are beginning to see a glimmer of hope.
For most of our history, headaches weren’t seen as medical conditions but as warnings from the gods, signs of sin, or symptoms of nervous weakness. People were so desperate that in ancient times, trepanation – drilling a hole right into the skull – was one desperate attempt to relieve the pressure. Later, Greek and Roman physicians linked head pain to imbalances in the body’s “humors.” By the Enlightenment, theories grew more elaborate but not necessarily more accurate. For instance, one eighteenth-century doctor blamed masturbation – and another blamed meat pies.
As science evolved, so did ideas about what actually caused a migraine. For centuries, a lot of people believed the gut was to blame. The term “sick headache” reflected how often nausea and digestive issues accompanied the pain. There’s actually still some truth to that – modern research has explored a possible “gut-brain axis” – but early treatments ranged from food avoidance to vomiting, bleeding, and plasters made with animal parts. Even food triggers like butter or black pepper were treated as character flaws rather than medical facts.
The real shift in thinking began with the idea that the brain, not the stomach or the soul, might be responsible. Elizabeth Garrett Anderson, the first woman to qualify as a physician and surgeon in Britain, used her exclusion from dissection rooms as motivation to study headaches. In her 1870 thesis, she argued that migraine stems from disordered nerve activity – not simply from what a person eats. She believed the condition was hereditary, hard to cure, and rooted in the brain’s processing systems, not just its inputs.
Her work sparked a long-running debate: Was migraine a disorder of blood vessels or of brain cells? On one side, Peter Latham championed the vascular theory, claiming that constricted blood flow caused the aura, and the rebound dilation led to pain. On the other, Edward Liveing countered with a neurological theory, suggesting migraines were more like seizures or “nerve storms” starting deep in the brain.
Both of these theories shaped the field for decades. But even as newer drugs like ergotamine seemed to support the vascular model, neurologists like William Gowers continued to argue that the problem lay with misfiring nerve cells, not swelling arteries. These competing ideas shaped which treatments got funded, which patients got believed, and which symptoms were misunderstood.
Today, some researchers look back on this long detour as a case study in scientific groupthink. Old paradigms can crowd out better ideas. And with a problem as complex as headache, clinging to the wrong theory both stalls research and prolongs suffering.
For years, Zeller held on to a doctor who couldn’t cure him but tried. This man misdiagnosed him, prescribed dubious treatments, and ultimately left medicine in disgrace – but he did one important thing: he listened. And for someone lost in the world of headache disorders, that mattered. The medical journey for headache patients is rarely linear. People bounce from physician to physician, often for years, before finding someone who validates their pain.
Stories like Kathy O’Shea’s are unfortunately all too common. Her first neurologist, during a brutal onset at 14, assumed her headaches were psychological. He asked if she wanted her mother to leave the room so she could “talk about what’s really going on at home.” Later, another specialist even implied she might be an addict. It’s a familiar loop: pain, dismissal, overmedication, and isolation.
One of the more colorful data points came in 1947 when a trapeze artist told researcher Harold Wolff her migraines eased while performing upside down. Intrigued, Wolff visited the circus to observe her in action, then sent colleagues to question other performers. Another headache sufferer confirmed a similar effect. Back in the lab, Wolff had instructed his team and patients to stand on their heads using a tilt table. Blood flow changed. Pain eased. His experiments helped usher in the vascular theory of migraine, which dominated for decades.
The downside? Wolff also described migraine personalities as overachieving, controlling, and emotionally repressed – especially women, whom he often pathologized through sexist, pseudoscientific stereotypes. That framing stuck, influencing treatment and stigma for generations.
Then came a seismic shift with the discovery of serotonin’s role in migraine. Patrick Humphrey at Glaxo developed sumatriptan – a drug that targeted a specific serotonin receptor. Approved in 1992, it offered fast, effective relief for many migraine patients, revolutionizing treatment. But it didn’t work for everyone, and access was limited by cost, insurance hurdles, and contraindications for those with heart issues.
Despite these breakthroughs, migraine remains misunderstood, often minimized, and stubbornly hard to treat. The history of headache medicine is a story of slow progress, frequent detours, and the human toll of being disbelieved. Today’s treatments – including promising CGRP inhibitors – rest on both brilliant science and the cumulative suffering of those who endured misdiagnosis, medical sexism, and silence. Even now, no one fully understands how triptans work. But at last, the voices of patients – and their pain – are beginning to shape the field they were once excluded from.
In 2020, 24-year-old Will Erwin took his own life after one last final, fruitless search for relief from cluster headaches. His parents, devastated by how little medical science seemed to know or care about the disorder, founded a research initiative in his name. One such research study, based at Yale, is now searching for genetic clues to cluster headaches. Emmanouil Dermitzakis, a renowned Swiss geneticist leading similar research in Europe, had never heard of the condition before being approached by colleagues. That level of obscurity reflects how marginalized headache disorders remain – even in elite scientific circles.
Patients with chronic headache disorders – especially cluster headaches – often feel abandoned by the medical system. Their pain doesn’t show up on scans, and standard tests can’t explain it. Many patients report being dismissed, misdiagnosed, or told their pain isn’t real – especially women, who are more likely to have their symptoms attributed to stress or emotion. In that vacuum, online support groups have become a kind of underground healthcare network – places to trade treatment tips, swap names of trusted specialists, and share frustration with a system that too often shrugs.
Oxygen is one of the only reliable treatments for cluster headaches, yet many insurers still refuse to cover it. One patient resorted to buying welding tanks to self-administer oxygen during attacks. For some, it’s the only thing that works. Meanwhile, studies show that people with chronic head pain face significantly higher suicide risk – especially women and military veterans.
One rare breakthrough in public awareness came in 1974 when a BBC film crew captured a man mid-attack in a London clinic. The footage showed him frozen in agony, unable to speak or move. When broadcast, it shocked viewers and helped reframe these episodes as neurological emergencies rather than personal weakness.
Strangely, enough progress has also come from cats. In the 1990s, researchers discovered that felines injected with nitroglycerin – a known migraine trigger – displayed classic migraine-like behavior: light sensitivity, social withdrawal, and signs of head pain. These findings helped establish migraine as a neurological disorder and paved the way for more targeted research.
Compared to other neurological disorders, headache research remains vastly underfunded. And even as pain neuroscience has advanced, headaches still sit low on the priority list. But things are changing thanks to work funded by The Will Erwin Foundation and a rekindling of interest in the biology of headaches.
Despite being one of the most burdensome medical conditions on the planet, migraine remains near the bottom of the National Institutes of Health’s priority list. For decades, advocates have pushed for better. Congress has even added formal language to budget reports urging the NIH to act. But inside the agency, those requests often go ignored or brushed aside.
The reason why, according to critics, is both structural and cultural. It works like this: NIH funding follows demand: grants go where proposals go, and proposals go where funding has historically flowed. Since headache research was never a priority, it’s stuck in a vicious loop – few researchers apply, so few grants are awarded, reinforcing the idea that the field lacks promise. And when proposals do come in, they’re measured against those from better-funded disciplines, making it harder to compete.
That’s not just frustrating – it’s costly. Some researchers estimate that effective migraine treatment could add a trillion dollars to the US economy by restoring lost productivity. Yet the funding gap persists, in part because headache has long been dismissed as a second-tier science. NIH insiders have admitted that the field still suffers from low prestige. One former institute director said the research was simply “not very good.” But patients and advocates argue the science can’t improve without meaningful investment.
Private industry has stepped in to fill part of the gap. Drug companies like Eli Lilly have developed new migraine treatments and funded conferences to help reboot the field. But their interest follows patent cycles – not public health. When the profits taper off, so does the support. That’s no substitute for sustained, public investment in basic research.
In the meantime, advocates like Robert Shapiro have spent years pushing for change. The work has taken a real toll – on careers, reputations, and relationships – but it has also laid groundwork for a new generation of researchers who might finally crack the code.
Still, the science remains fragmented. Some researchers focus on blood vessels. Others on serotonin, the trigeminal nerve, cortical waves, or immune responses. But each camp tends to operate in isolation, with little cross-talk between disciplines. That siloed approach has stalled the search for a single, unified understanding of what migraine really is.
It’s like the old story of the blind men and the elephant – everyone’s grasping a different piece, but no one sees the whole. Without integration, even the most promising leads can fade into obscurity. Until that changes, progress will remain slow, and the full nature of migraine will stay maddeningly out of reach.
In this lesson to The Headache by Tom Zeller Jr., you’ve learned that headache disorders – especially migraines and cluster headaches – are among the most disabling medical conditions worldwide, yet they’re still widely misunderstood, stigmatized, and underfunded.
The pain is invisible, the symptoms hard to prove, and many patients spend years being misdiagnosed, dismissed, or told their suffering isn’t real. Historically, medicine blamed food, emotions, or moral failings. Even today, outdated theories linger and shape how symptoms are interpreted – often through a lens of gender bias or cultural minimization. But research is slowly catching up. Scientists are now exploring genetic patterns, developing better brain models, and trialing drugs that act on targeted pain pathways. Devices that stimulate nerves noninvasively are showing modest results. AI tools may soon help detect early signs of an attack.
The deepest lesson may come from patients themselves. Living with headache disorders often means living with loss – of trust, energy, opportunity, or identity. Many learn, painfully, that understanding from others may never come. But the work to understand the condition itself continues. And while treatment is still hit or miss, the science – and the will to study these conditions seriously – is finally growing.
The Headache (2025) is a deep exploration of one of the most common – and most misunderstood – human ailments. It blends personal experience with scientific investigation to reveal why headache disorders are so often dismissed, and how that’s finally beginning to change.
One sunny day in Montana, high on hope and a large dose of psychedelic mushrooms, the author, Tom Zeller Jr., found himself zipping up a mountain road on an e-bike, convinced that this bold experiment might finally quiet the agony inside his skull. Cluster headaches – sometimes called “suicide headaches” – had taken over his days and nights, and nothing else seemed to work. As the drug took hold, the hills shimmered, the balsam root flowers seemed to cheer, and he imagined accepting an award for finally conquering his invisible tormentor. It would have been a triumphant scene – if the next headache hadn’t hit the very next day.
For millions of people, headaches are more than an occasional nuisance – they’re chronic, often debilitating conditions that disrupt lives and defy easy explanation. From migraines to cluster headaches and rarer disorders, these conditions remain poorly understood and frequently dismissed, in part because the word “headache” sounds too ordinary to reflect the suffering they cause. The pain is real, often extreme, but still invisible, and that invisibility can isolate those who live with it.
In this lesson, you’ll uncover the surprising gaps in headache science, and meet the researchers working to change that. You’ll also gain a new understanding of what these misunderstood disorders really are – and why they matter more than you think.
The first time it happened, Zeller thought he was having a stroke. Out of nowhere, a searing pain exploded behind one eye. It dropped him to the floor and left him gasping. When it happened again weeks later – and then again, and again – it began to feel like a haunting. The attacks always came without warning and vanished just as suddenly, leaving only exhaustion and dread in their wake. He’d later learn that these were called cluster headaches.
That’s exactly how it starts for many people. The pain is sudden, one-sided, and nearly indescribable – sharp, deep, and urgent. It can hit in the middle of the night, driving people from their beds to pace, rock, cry, or slam their heads against the wall in a frantic search for relief. Over-the-counter painkillers do nothing. Some try injections. Others, like Zeller, try psychedelics. Desperation pushes people to experiment. Nothing feels too strange when you’re in that much pain.
Headaches are so common, so ordinary in name, that even the most extreme versions are often dismissed or downplayed. You may look fine. Your scans may be clean. But inside your skull, something is tearing you apart.
And the pain doesn’t wait for privacy. Once, while traveling in India, Zeller curled into a narrow train bunk during his fourth attack in 24 hours, biting down on a towel to muffle his cries so he wouldn’t scare the children nearby. The attack passed – but the isolation lingered.
This kind of suffering is invisible – and that’s part of what makes it so isolating. You can’t show someone what it feels like. You can only describe it, often awkwardly, while hoping they believe you. For many, it’s a long time before anyone truly does.
And it’s not just cluster headaches. Migraine, which affects a much larger number of people, is also deeply disabling – and still poorly understood. Even researchers can’t fully agree on where the pain comes from, or what part of the brain is misfiring. The signals involved are complex. The treatments, often borrowed from other conditions, are hit-or-miss. And the funding for studying these disorders barely scratches the surface of their global impact.
Still, there are signs of change. New medications are being developed that target headache-specific mechanisms. Scientists are finally mapping out what might be going wrong inside the nervous system. And people who’ve lived for years in the shadow of these attacks are beginning to see a glimmer of hope.
For most of our history, headaches weren’t seen as medical conditions but as warnings from the gods, signs of sin, or symptoms of nervous weakness. People were so desperate that in ancient times, trepanation – drilling a hole right into the skull – was one desperate attempt to relieve the pressure. Later, Greek and Roman physicians linked head pain to imbalances in the body’s “humors.” By the Enlightenment, theories grew more elaborate but not necessarily more accurate. For instance, one eighteenth-century doctor blamed masturbation – and another blamed meat pies.
As science evolved, so did ideas about what actually caused a migraine. For centuries, a lot of people believed the gut was to blame. The term “sick headache” reflected how often nausea and digestive issues accompanied the pain. There’s actually still some truth to that – modern research has explored a possible “gut-brain axis” – but early treatments ranged from food avoidance to vomiting, bleeding, and plasters made with animal parts. Even food triggers like butter or black pepper were treated as character flaws rather than medical facts.
The real shift in thinking began with the idea that the brain, not the stomach or the soul, might be responsible. Elizabeth Garrett Anderson, the first woman to qualify as a physician and surgeon in Britain, used her exclusion from dissection rooms as motivation to study headaches. In her 1870 thesis, she argued that migraine stems from disordered nerve activity – not simply from what a person eats. She believed the condition was hereditary, hard to cure, and rooted in the brain’s processing systems, not just its inputs.
Her work sparked a long-running debate: Was migraine a disorder of blood vessels or of brain cells? On one side, Peter Latham championed the vascular theory, claiming that constricted blood flow caused the aura, and the rebound dilation led to pain. On the other, Edward Liveing countered with a neurological theory, suggesting migraines were more like seizures or “nerve storms” starting deep in the brain.
Both of these theories shaped the field for decades. But even as newer drugs like ergotamine seemed to support the vascular model, neurologists like William Gowers continued to argue that the problem lay with misfiring nerve cells, not swelling arteries. These competing ideas shaped which treatments got funded, which patients got believed, and which symptoms were misunderstood.
Today, some researchers look back on this long detour as a case study in scientific groupthink. Old paradigms can crowd out better ideas. And with a problem as complex as headache, clinging to the wrong theory both stalls research and prolongs suffering.
For years, Zeller held on to a doctor who couldn’t cure him but tried. This man misdiagnosed him, prescribed dubious treatments, and ultimately left medicine in disgrace – but he did one important thing: he listened. And for someone lost in the world of headache disorders, that mattered. The medical journey for headache patients is rarely linear. People bounce from physician to physician, often for years, before finding someone who validates their pain.
Stories like Kathy O’Shea’s are unfortunately all too common. Her first neurologist, during a brutal onset at 14, assumed her headaches were psychological. He asked if she wanted her mother to leave the room so she could “talk about what’s really going on at home.” Later, another specialist even implied she might be an addict. It’s a familiar loop: pain, dismissal, overmedication, and isolation.
One of the more colorful data points came in 1947 when a trapeze artist told researcher Harold Wolff her migraines eased while performing upside down. Intrigued, Wolff visited the circus to observe her in action, then sent colleagues to question other performers. Another headache sufferer confirmed a similar effect. Back in the lab, Wolff had instructed his team and patients to stand on their heads using a tilt table. Blood flow changed. Pain eased. His experiments helped usher in the vascular theory of migraine, which dominated for decades.
The downside? Wolff also described migraine personalities as overachieving, controlling, and emotionally repressed – especially women, whom he often pathologized through sexist, pseudoscientific stereotypes. That framing stuck, influencing treatment and stigma for generations.
Then came a seismic shift with the discovery of serotonin’s role in migraine. Patrick Humphrey at Glaxo developed sumatriptan – a drug that targeted a specific serotonin receptor. Approved in 1992, it offered fast, effective relief for many migraine patients, revolutionizing treatment. But it didn’t work for everyone, and access was limited by cost, insurance hurdles, and contraindications for those with heart issues.
Despite these breakthroughs, migraine remains misunderstood, often minimized, and stubbornly hard to treat. The history of headache medicine is a story of slow progress, frequent detours, and the human toll of being disbelieved. Today’s treatments – including promising CGRP inhibitors – rest on both brilliant science and the cumulative suffering of those who endured misdiagnosis, medical sexism, and silence. Even now, no one fully understands how triptans work. But at last, the voices of patients – and their pain – are beginning to shape the field they were once excluded from.
In 2020, 24-year-old Will Erwin took his own life after one last final, fruitless search for relief from cluster headaches. His parents, devastated by how little medical science seemed to know or care about the disorder, founded a research initiative in his name. One such research study, based at Yale, is now searching for genetic clues to cluster headaches. Emmanouil Dermitzakis, a renowned Swiss geneticist leading similar research in Europe, had never heard of the condition before being approached by colleagues. That level of obscurity reflects how marginalized headache disorders remain – even in elite scientific circles.
Patients with chronic headache disorders – especially cluster headaches – often feel abandoned by the medical system. Their pain doesn’t show up on scans, and standard tests can’t explain it. Many patients report being dismissed, misdiagnosed, or told their pain isn’t real – especially women, who are more likely to have their symptoms attributed to stress or emotion. In that vacuum, online support groups have become a kind of underground healthcare network – places to trade treatment tips, swap names of trusted specialists, and share frustration with a system that too often shrugs.
Oxygen is one of the only reliable treatments for cluster headaches, yet many insurers still refuse to cover it. One patient resorted to buying welding tanks to self-administer oxygen during attacks. For some, it’s the only thing that works. Meanwhile, studies show that people with chronic head pain face significantly higher suicide risk – especially women and military veterans.
One rare breakthrough in public awareness came in 1974 when a BBC film crew captured a man mid-attack in a London clinic. The footage showed him frozen in agony, unable to speak or move. When broadcast, it shocked viewers and helped reframe these episodes as neurological emergencies rather than personal weakness.
Strangely, enough progress has also come from cats. In the 1990s, researchers discovered that felines injected with nitroglycerin – a known migraine trigger – displayed classic migraine-like behavior: light sensitivity, social withdrawal, and signs of head pain. These findings helped establish migraine as a neurological disorder and paved the way for more targeted research.
Compared to other neurological disorders, headache research remains vastly underfunded. And even as pain neuroscience has advanced, headaches still sit low on the priority list. But things are changing thanks to work funded by The Will Erwin Foundation and a rekindling of interest in the biology of headaches.
Despite being one of the most burdensome medical conditions on the planet, migraine remains near the bottom of the National Institutes of Health’s priority list. For decades, advocates have pushed for better. Congress has even added formal language to budget reports urging the NIH to act. But inside the agency, those requests often go ignored or brushed aside.
The reason why, according to critics, is both structural and cultural. It works like this: NIH funding follows demand: grants go where proposals go, and proposals go where funding has historically flowed. Since headache research was never a priority, it’s stuck in a vicious loop – few researchers apply, so few grants are awarded, reinforcing the idea that the field lacks promise. And when proposals do come in, they’re measured against those from better-funded disciplines, making it harder to compete.
That’s not just frustrating – it’s costly. Some researchers estimate that effective migraine treatment could add a trillion dollars to the US economy by restoring lost productivity. Yet the funding gap persists, in part because headache has long been dismissed as a second-tier science. NIH insiders have admitted that the field still suffers from low prestige. One former institute director said the research was simply “not very good.” But patients and advocates argue the science can’t improve without meaningful investment.
Private industry has stepped in to fill part of the gap. Drug companies like Eli Lilly have developed new migraine treatments and funded conferences to help reboot the field. But their interest follows patent cycles – not public health. When the profits taper off, so does the support. That’s no substitute for sustained, public investment in basic research.
In the meantime, advocates like Robert Shapiro have spent years pushing for change. The work has taken a real toll – on careers, reputations, and relationships – but it has also laid groundwork for a new generation of researchers who might finally crack the code.
Still, the science remains fragmented. Some researchers focus on blood vessels. Others on serotonin, the trigeminal nerve, cortical waves, or immune responses. But each camp tends to operate in isolation, with little cross-talk between disciplines. That siloed approach has stalled the search for a single, unified understanding of what migraine really is.
It’s like the old story of the blind men and the elephant – everyone’s grasping a different piece, but no one sees the whole. Without integration, even the most promising leads can fade into obscurity. Until that changes, progress will remain slow, and the full nature of migraine will stay maddeningly out of reach.
In this lesson to The Headache by Tom Zeller Jr., you’ve learned that headache disorders – especially migraines and cluster headaches – are among the most disabling medical conditions worldwide, yet they’re still widely misunderstood, stigmatized, and underfunded.
The pain is invisible, the symptoms hard to prove, and many patients spend years being misdiagnosed, dismissed, or told their suffering isn’t real. Historically, medicine blamed food, emotions, or moral failings. Even today, outdated theories linger and shape how symptoms are interpreted – often through a lens of gender bias or cultural minimization. But research is slowly catching up. Scientists are now exploring genetic patterns, developing better brain models, and trialing drugs that act on targeted pain pathways. Devices that stimulate nerves noninvasively are showing modest results. AI tools may soon help detect early signs of an attack.
The deepest lesson may come from patients themselves. Living with headache disorders often means living with loss – of trust, energy, opportunity, or identity. Many learn, painfully, that understanding from others may never come. But the work to understand the condition itself continues. And while treatment is still hit or miss, the science – and the will to study these conditions seriously – is finally growing.
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