Watson’s coffee and croissant-induced contemplative state is disturbed by his excited colleague. ‘I didn’t know that you had met with Professor Ottar Sjaastad. I understand he was a preeminent distinguished neurologist and researcher in headache and the founding editor of Cephalalgia.’
‘Yes,’ replies Watson, ‘that is why in 1995 I reached out to him.’ ‘Why did you contact him?’
The Frustration, Perseverance, and the Value of a Supportive Partner
‘I was looking for a supervisor for my PhD program, explicitly researching the role of cervical afferents in the migraine condition. Thinking that, for my research to be credible, it needed the support of a neurologist, but approaches to numerous neurologists were, let’s say, met with fervent rejections. At this stage, my frustrated partner suggested I approach Professor Sjaastad.’
‘That makes sense because he is often considered the modern father of cervicogenic headache,’ comes Watson’s colleague’s reply.
Trondheim, Here We Come!
‘Yes, why not? I had nothing to lose; given his status, I tentatively made the phone call explaining my clinical experience and desire for research and received a warm reception, which lasted the best part of an hour. Two more lengthy phone conversations followed this, leading to an invitation to meet with him and his research team in Trondheim, Norway,’ recounts Watson.
‘I bet you were excited,’ comes the energetic reply. ‘Yes, we had our bags packed that night! Within two months, we arrived in Trondheim, and Professor Sjaastad greeted us at the airport—he was holding a card with my name on it – I wasn’t expecting that!’
The Abandonment
‘Travelling from the airport to Trondheim city, we recounted our conversations, and then came a reasonable question that I hadn’t quite expected: What would you like to achieve whilst you are here? I had mentioned to Professor Sjaastad that I could reproduce familiar head pain, which resolves as the technique is sustained, which suggested to me that cervical afferents could be involved in the migraine process. Professor Sjaastad paused, and then, after what seemed like an eternity, sage advice came my way… Dean, whilst you will find fences between professions are lower here in Norway, you still need to be careful about how loudly you say that.’
‘Perhaps not surprising, given his journey; I read the obituary for Professor Sjaastad,’ interjected Watson’s colleague.
‘As I had made clear in our previous communications, I restated that I don’t expect people to accept this without question, but to demonstrate this on a patient with migraine would be invaluable. He paused again and then said that would not be possible. I was quietly devastated; this was why I had come to Trondheim. I thought we had agreed on this previously. It then appeared that an adverse experience involving a physiotherapist had occurred in the interim. So, I thought all was lost…’
Really… Is it all Lost?
‘So, what happened then,’ exclaims Watson’s disconcerted colleague.
‘My partner and I had planned a week with Professor Sjaastad. We had arrived on a Sunday. The next morning, there was, as with each morning, a meeting, over croissants and coffee, with his research team (neurophysiologist, neuroanatomist, neurology colleagues) and PhD candidates.’ ‘That sounds very civilised’, interjects Watson’s colleague.
‘I think that’s what I thought too, but I remember feeling quite anxious, out of my depth, despite Professor Sjaastad’s calming comment about lower fences. My uneasiness was not helped by the coincidental presence of a research team, around 4-5, from The Netherlands that same week!’ explains Watson. ‘The new attendees at the meeting were asked to introduce themselves and explain their reason for visiting Professor Sjaastad’s research facility. The Netherlands research team introduced themselves; then it was me… to be quite honest, I didn’t hear them. I was focused on what I was going to say.’
‘That’s understandable, ‘comes Watson’s colleague’s supportive reply.
Professor Sjaastad to the Rescue
Watson continues, ‘Something about Professor Sjaastad’s warm and genuine acceptance and a little bit mischievous, a part of his pioneering character, gave me confidence whilst simultaneously, my mind was trying to assimilate my thoughts… what have I got to lose? I’m here; I have been given an opportunity that may not come way again, so go for it! So I did!’
‘And?’ comes the anticipatory acknowledgement.
‘I stood up and said, ‘I am a physiotherapist who has been treating exclusively primary headache conditions, primarily migraine, and I have been able to reproduce and achieve resolution of typical head pain in various primary headache conditions, which suggests that cervical afferents could play a causative role in the migraine (and primary headache) conditions,‘ Watson recounts nostalgically.
‘What happened then?’ comes the obvious reply whilst Watson continues to reflect.
Is Silence Really ‘Golden’? No!
‘Silence, which seemed to last an eternity,’ Watson recalls and continues, ‘I interrupted the silence with… I don’t expect you to accept this without question, but to demonstrate this on a patient with migraine would be invaluable; there was more silence; it was getting a little uncomfortable, to say the least. Then someone said, Oh, Belinda* (a credible member of Professor Sjaastad’s research team), you get migraine, don’t you? Yes, acknowledged Belinda, but I am not having my neck examined!’
‘It sounds like there was significant resistance from Belinda’, recognises Watson’s colleague.
‘Yes,’ replies Watson.
Watson’s phone reminds him of an appointment, ‘My apologies, I have to get going…’ ‘But… but…’ comes Watson’s colleague’s stumbled reply. ‘I’ll come back to you.’ Watson hurries off.
* for the sake of anonymity, the name has been changed
