INTERVIEW: Rachel Weaver, Author of Dizzy: A Memoir

Interviewed by J. Michael Lennon

Midway through Dizzy: A Memoir (West Virginia University Press; 2025), an alternately excruciating and lyrical memoir of being lost for 18 years in the complexities of a hard to diagnose medical condition, Rachel Weaver runs into a fellow patient at one of the innumerable clinics where she seeks succor. The woman, who has also run the gamut of diagnoses and treatments, passes on her conclusions about the medical system: “Doctors are like ants. They all do the same thing, but they don’t talk to each other.” But this is not always the case, as Weaver learned..

Eight years into the medical journey, she was diagnosed by her physician, Dr. David Tanner, as having vestibular migraine, a condition that does not have usual migraine symptoms. Her condition, however, was just as serious and painful. She was regularly visually disoriented, confused, and dizzy.

Still struggling a decade later, she entered a clinical study in Utah. Dr. Kyle Bills, along with several other collaborating researchers, after years of work, identified postprandial reactive hypoglycemia as a key component of the migraine. Treatment varies by patient and is complex, but regulation of the intake of glucose appears to provide significant relief.

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J Michael Lennon:  It seems abundantly clear that a good deal of medical research and treatment is siloed, unknown, unavailable, or ignored by the profession. Can you say something about this?

Rachel Weaver: I think being a clinician is a tough job. The medical educational system encourages specialization with rigid boundaries between houses of knowledge. Clinicians are expected (by themselves, by society, by patients) to come up with an answer to the problem quickly. When they can’t, it’s frustrating for everyone involved. When you have a complicated, long-term, seemingly undiagnosable problem, you need a team of people brainstorming from different specialties, you need a long conversation, you need wide thinking, you need collaboration. The system is not set up for this. The Mayo Clinic is this. But it was cost prohibitive for a person in an average socio-economic situation like myself. Even with health insurance there would be additional clinical costs, there would be time without pay from work, there would be a hotel to cover for up to a couple weeks. It was economically out of reach.

JML: The most common symptoms associated with migraines are fierce headaches and an aura. You didn’t have either of these, did you?

RW: No. Vestibular migraine patients are a small percentage of the migraine population. As our understanding of migraine broadens, the medical community has come to understand that it can present differently in different folks. Most commonly, as you mentioned, are the fierce headaches with or without aura, but a migraine can also be abdominal, vestibular, retinal, menstrual, or hemiplegic (stroke-like weakness).

JML: What memoirs or novels or other literary forms influenced  you, or gave you insights on your narrative form and/or technique?

RW: The Codeine Diary by Tom Andrews helped me with tone; How To Be Sick by Toni Bernhard helped me bring some grace to the page; and I Am I Am I Am by Maggie O’Farrell helped me understand that an adventure story can be much more than just entertainment.

JML: One of the things that kept you going during your medical ordeal was writing. Even when you were seeing double and feeling terrible, you managed to keep at it. Can you say something about how writing your 2014 novel, Point of Direction, which also has an Alaska setting, sustained you?

RW: The world I created in Point of Direction was a refuge for me. It was a way to stay in the midst of wild natural beauty, to live in the body of the main character who was physically capable, neither of which were accessible to me once I woke up dizzy. Writing a book is hard, don’t get me wrong, it wasn’t all joy and happiness, but it was a way to keep living surrounded by the natural beauty of Alaska in a body that worked when I no longer actually had access to either.

JML: Detailed autobiographical stories of long-term debilitating medical and psychological ordeals can turn readers off. Please explain how you dealt with this issue in Dizzy.

RW: I wrote the whole medical narrative first and it was brutal. As a way to entertain myself and remember that my whole life had not been brutal, I started writing the fun Alaska adventure stories. My dad was a fantastic storyteller, usually fueled by a campfire and a couple beers, so I channeled him and stayed in that world for a while. I started to see how one thread might mirror the other, how the adventure stories might bring stronger context and more depth to the medical story. I began to braid the two narratives together and it turned into a huge knot and I thought I should just go back to fiction. But I kept coming back to it, thinking through each individual strand.

I was fascinated by the power dynamics between bears and humans in the natural world and how much of those power dynamics were repeated in the clinical setting between the doctor and the patient. I kept thinking about what the natural world teaches us about power and relationships and resilience and resourcefulness and I began to see all these elements at play in three distinct phases of my life: the time I had with my dad before he died, the years I spent in Alaska in the backcountry, and the years I spent as a chronically ill patient. I scraped everything I wrote about the medical journey and rewrote it through the lens of the natural world and it became much less about being sick and much more about being human.

JML: When reading your memoir, Tara Westover’s Educated came to mind because of the similarly long struggle she experienced figuring out what was wrong with her. Did you read it?

RW: I did read Educated and liked it very much. Her control of craft struck me as much as the story she was telling. It’s hard to say if it influenced me directly. My husband Mike likes to refer to himself as an Audible Widow because of how much time I spend listening to books.  Staying immersed in storytelling certainly has shaped me as a person and as a writer. I love to enjoy books as a reader and then study them for craft to learn everything I can as a writer. Which is what I did with Educated.

JML: What other memoirs or novels influenced you?

RW: Right out of college I got a job at the Teton Science School outside Jackson, Wyoming. My job was to help the instructors guide kids on hikes and canoe trips. My other job was to live in the girl’s dorm with all the high school girls and make sure no one snuck out which was easy because there was an angry bison that rattled around campus at night. Not to mention the porcupines and the bears. Two weeks into my summer job, the boy’s dorm flooded and all the high school boys moved into the high school girl’s dorm. The boys were in one huge room with 15 bunk beds, and the girls were in the other room with 15 more bunk beds. My room was in the middle off the short hallway that connected the bunk rooms. My boss said, “Just make sure no one goes home pregnant.”

There was a Western Library on campus that had about 100 books by western authors – Ed Abby, Terry Tempest Williams, BK Loren, Pam Houston, Annie Proulx, Rick Bass, Margaret Murie, Gretel Erlich. I sat in the hallway until three in the morning every night and read every book in the library. It shaped the way I think and write about the natural world. And no one went home pregnant.

JML: Near the end of the book, you bring your father back in—he’s been kind of a model or a kind of guardian angel for you as you’ve traversed what you call “that slippery sloped kingdom of the sick” throughout the narrative. What would he think of your memoir?

RW: I don’t know! He’d appreciate all the ridiculous situations I got myself into over the years. He’d be proud of my resilience. And he’d probably shake his head at the fact that I no longer change the oil in my own cars.

JML: The research on glucose levels and migraines, conducted over many years by Dr. Kyle Bills and several other researchers, has led to a new understanding of the causes and treatments for migraines. Can you summarize in lay terms what they have discovered?

RW: This group of researchers discovered a link between glucose dysregulation and chronic migraine. 247 chronic migraineurs were given a three-hour glucose tolerance blood test and a continuous glucose monitor to wear for ten days. When compared to the control group of non-migraineurs, the migraineurs showed greater glycemic variability. This is not the kind of data that will not show up in fasting blood work. The variability happens with eating, and it is particularly pronounced when eating sugar or carbs. The current solution, until further studies are conducted, is a three-month strict ketogenic diet to decrease the swings in blood sugar. From there, each of us in the study increased our carb intake (transitioning out of ketosis into a low carb diet) until we found the carb ceiling where our symptoms returned.

Since the paper’s publication, the researchers report clinical data show 80% moved from chronic migraine (15+ migraine days per month) to 1-8 migraine days per month by continuing to stay under their individual carb ceiling. The research can be found in the online journal Frontiers in Neurology. The clinic Dr. Bills runs to help migraineurs identify whether or not they have a glucose dysregulation, along with support through the ketogenic three month protocol if appropriate is called The Migraine and Neuro Rehab Center. I offer this as a resource for anyone interested, not as some sort of cure-all. We all know that what works for one migraineur doesn’t always work for another.

JML: Can you talk about your relationship with Dr. Bills? Also Dr. Tanner at the Dizziness Clinic. Are you still in regular contact with these gents?

RW: I’m not going to lie; I love both of them a little bit. I still see Dr. Tanner every so often as a patient. I still have migraine, although only mild symptoms 1-3 days per month at this point. But he helps me manage that.  I chat with Dr. Bills every so often and keep up with his ongoing research. The publication of his research and my book within a month of each other have put us in contact more often here recently. I will be forever grateful to them both.

JML: I found the narrative structure of your memoir to be exquisite; it put me in mind with the way Don DeLillo deals with time in his 1997 novel, Underworld. The segmentation and handling of time in the two books are similar. Your book has 20 chapters, plus a short preface and a much longer coda. But before each numbered chapter there is a page that tells readers what year of your experience you are in. It’s wonderful pacing. Also, the chapters grow successively shorter, as we progress. All this is quite unusual, unique, really, and quite impressive. How far along were you into the writing when you found your structure?

RW: I struggled with fine tuning the structure all the way to the moment I had to hand off the final draft. Time turns itself inside out during sustained illness. It becomes irrelevant, it stretches out of reach. It didn’t want to be wrangled into something recognizable for this narrative. I struggled to reconstruct the actual timeline. So many years lived in a haze, and then the sharp ax of fear cutting through it all, cleaving it into pieces that have nothing to do with time. From the beginning, I set out to write a book that made the reader feel the experience as much as possible. In the end, I kept working toward that elusive edge we all aim for as writers where the reader can feel the chaos fully but not lose their footing in the narrative.

JML: You began as a writer of fiction, and you have a new novel coming out later this year. And now you have also written a marvelous memoir. Will you write more creative nonfiction in the future?

RW: I’m working on shorter creative nonfiction pieces currently. I’m enjoying trying to figure out the short form after spending the last couple years writing the memoir. And I have another novel underway, but that one is still pretty early stages.