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January 10, 2026

Presidential Headaches

You have to keep going, even when all you want to do is lie in bed in a dark room.

By  Rachel Toor

The Sandbox

Inside Higher Ed Insider
image of a man with a headache

From Rachel Toor

And we’re back. Hello, 2026. Please try to treat us better than your predecessor did.

In the dawning of this age of AI, it’s more important than ever to pay attention to what makes good prose good. Fifteen years ago I wrote a love letter to Orwell’s “Politics and the English Language” that seems sadly more relevant now than ever.

And to the horror of English teachers everywhere, I also confessed a deep and abiding adoration for Strunk and White. I appreciate the first author’s bossiness and delight in his student’s playful wit.

To start off this new year, I offer a 1973 letter from that sprightly man called Andy by his friends.

Dear Mr. Nadeau:

As long as there is one upright man, as long as there is one compassionate woman, the contagion may spread and the scene is not desolate. Hope is the thing that is left to us, in a bad time. I shall get up Sunday morning and wind the clock, as a contribution to order and steadfastness.

Sailors have an expression about the weather: they say, the weather is a great bluffer. I guess the same is true of our human society—things can look dark, then a break shows in the clouds, and all is changed, sometimes rather suddenly. It is quite obvious that the human race has made a queer mess of life on this planet. But as a people we probably harbor seeds of goodness that have lain for a long time waiting to sprout when the conditions are right. Man’s [sic] curiosity, his relentlessness, his inventiveness, his ingenuity have led him into deep trouble. We can only hope that these same traits will enable him to claw his way out.

Hang on to your hat. Hang on to your hope. And wind the clock, for tomorrow is another day.

Sincerely, 
[Signed, E. B. White]

***

When a president confessed that if she had to sit through one more women’s leadership session to hear about self-care she might hit someone, I thought, Right there with you, sister. 

At this point, those of us who have been around a few professional blocks don’t need to be told what to do to feel better. If we haven’t learned that by now, we wouldn’t hold the positions we’ve attained.

Like many, I suffer from migraines. It’s an invisible chronic illness, though I’ve always had friends who can take one look at me and know I have a headache. Joan Didion also suffered from the “physiological error called migraines” and had, as I suspect many presidents do, a “migraine personality.”

In December I went through a particularly bad bout that landed me in urgent care a couple of times and was feeling sorry for myself. That is, until I talked to a president friend who has it even worse than me, as you’ll see below. When I was with a president suffering from a crippling (literal) pain in the neck, I marveled to watch her work the room as if she’d just come from a day at the spa. That inspired me and gave me another insight into how tough y’all need to be to do this work.

Wind the clock, friends.

The writer is a current president.

As a college president, I take full responsibility for the operation of my institution so that we serve our students and communities to the best of our abilities. I take the good, the bad, and the ugly and go with the flow. I do advocacy visits, donor visits, special events in the community, and, most importantly, student events. I am no different than any of you reading this right now.

But I do all of this with a diagnosis of severe and chronic migraine, and I keep this issue to myself most of the time.

I had my first migraine around the age of 10, and they occurred randomly until I was in my late 20s. I wasn’t diagnosed until my mid-30s. Over the past two decades, migraine has been a daily part of life as I know it, including my work life.

I have between 12 and 18 migraines a month and another 10 headaches that never develop into a migraine. I have been through six different medications that are designed to prevent migraines, and either they don’t work or the side effects are too debilitating. Some of my migraines are single days, but most are multiday events, and some can last weeks without a break.

Every day and everywhere I go, I carry a small pharmacy in a special bag. I have a prescription for nonmigraine headaches, a muscle relaxer, two different nausea prescriptions, two different prescriptions for triptans I take if I am getting a migraine, and two different pain prescriptions for days when I have reached my maximum dosage per week of a triptan. I travel three hours one way to a headache center every three months to see my neurologist. I have Botox every six months and nerve blocks to help with the intensity of my migraines; I go back in three months to get more nerve blocks to help me manage until the next round of Botox. Every six months, I get an occipital ablation in the back of my neck for pain management, and on a separate six-month cycle, I get an ablation in my forehead, also for pain management.

One of the symptoms that is difficult for me, especially as a president, is that right before or during a migraine, I forget words, bringing my speaking to an abrupt stop, or I use the wrong word in a sentence. While the latter can be humorous, it does earn you a strange look when you are meeting new people. Another difficult issue is a what’s called a headache hangover, which is what it sounds like—a malaise mimicking depression that leaves me listless and with low energy after I have had a multiday migraine.

Lots of days, I do my job with a pounding head or a headache hangover—all the events, the daily tasks, the disagreements, and the celebrations. I think that I do a good job hiding when I have a migraine, but I am only kidding myself. I have had meetings wearing sunglasses and with the lights off. I do my best not to leave work early, but occasionally that happens. I probably should leave early more often than I do, but I am stubborn. My team helps me through on bad days, and I am more grateful than words can express for them.

No leader willingly admits they have a chronic issue that impacts their ability to do the job at the level that is required. It is just one of those unwritten and time-honored rules that get passed on to people at the highest levels of leadership. We are not supposed to admit a weakness or a flaw or have anything that will show us in a less than competent light. I decided hiding wasn’t going to serve me well, so my Board of Governors, my executive team, and my cabinet all know. It was liberating, and I do not regret my decision.

I do not share this narrative to receive pity or anything close to it; I share it because I am probably not the only president who works with some type of invisible chronic issue. We all have tough jobs, and we all want to be the strong leaders that we need to be for our institutions. As much as we want to be seen as invincible, honesty with ourselves and our teams is the strongest thing we can do as a leader. We would have grace and understanding for any employee battling a chronic condition, and giving ourselves that same grace and understanding is the best gift we can give ourselves.

https://moderncampus.com/the-5g-learner

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All previous issues of The Sandbox are available here. 

Photo of three big dogs, from left, some kind of doodle, a Bernese mountain dog, and a chocolate lab.

Samosa, Wally, and Lola Chilton of the University of New Hampshire.

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The Sandbox

Not your typical weekly newsletter. This is a space where presidents and chancellors can say what they really think without fear. Everyone is welcome to read, but only those who have been in the top job can submit to us. The Sandbox, by Rachel Toor, is an exclusive benefit of our paid Insider membership program.

 

 

The Sandbox Archive

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The Worst of Times: FY 2025–26

October 3, 2026

Hiring a Leadership Team

September 26, 2026

The Real Text Messages of Lady Presidents

September 19, 2026

Retreat Rights

September 12, 2026
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