Pain Killer

Wild shag haircut and dark eyes beneath heavy black bangs. A whip-thin frame, sporting a leopard-print miniskirt.

Carolyn Bernstein looks so much like Chrissie Hynde of the Pretenders, you expect her to strap on a guitar and launch into "Precious."

Except she can't sing. And you might call her Dr. Bernstein, since she's a board-certified neurologist who teaches at Harvard Medical School and directs the medical specialties unit at the Cambridge Health Alliance, where she's on the cutting edge in treating migraines.

She prefers that you call her Carrie. "Maybe my clothes are a little unusual, but it's about having a personal approach and a little bit of fun," Bernstein says.

There are 28 million migraine sufferers in the United States, 80 percent of them women. It is a neurological condition that is often completely debilitating for up to 72 hours. Symptoms include intense headache, nausea and vomiting, and sensitivity to light. Bernstein is convinced that many migraines are triggered by female hormones, a theory supported by a study she conducted. This connection has been largely ignored by the medical establishment, she believes. And migraines, she says, continue to be misdiagnosed and inadequately treated.

Bernstein is determined to change that. Next summer, she will open the first center in New England dedicated to women and headache, where she will continue studying the role of hormones and other women's health issues including domestic violence in headache. And she is breaking new ground in the use of antimigraine drugs called triptans and of hormone regulators, including birth control pills, which can prevent migraines before they start.

Bernstein, who also recommends a smorgasbord of alternative treatments, including acupuncture, yoga, and biofeedback, lets patients decide what works for them. This collaborative style is born, in part, from her own experience. "When I can say to a migraine sufferer, `This really sucks,' that's a bonding right there," says Bernstein, who experienced her first migraine in medical school.

It was the suffering she saw in migraine patients that led Bernstein, 44, to the field after she graduated from Boston University School of Medicine. At the time, doctors offered little besides painkillers that often didn't work. "It was exciting, because there really was no treatment plan," she says. "It was a chance to be creative."

Elaine McArdle is a freelance writer. Her e-mail address is elainemca@hotmail.com