Migraine Nocturne

On her vaulted porch, long after dark, she feels
all five autumnal auras fire up at once.
Woodsmoke masks the smoulder of decay,
the last hard cider kindles to giddiness,
cold numbs her windward cheek,
crickets, close to flatline, blip-blip        blip-blip,
and, through the complicated earth-to-air ramifications
of her unpruned, blighted arbor vitae
a too-red blindspot scintillates
in the nextdoor neighbor's living room,
decussates from merely dextrous to frankly sinister,
and heralds the inevitable souped-up musclecar approach,
the blinding snake-eyes, hooded and halogen,
the whitewashed rictus of her picket fence,
and the throbbing, wordless subwoofer ostinato
that, merciless, vengeful, back for blood,
reclaims her temple like a deposed God.

Paula Tatarunis, MD
Waltham, Mass

Reprinted from JAMA March 14, 2001-- Vol 285, No. 10