An Exploration Of 'The Migraine Brain'

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An Exploration Of 'The Migraine Brain'

TERRY GROSS, host:

This is Fresh Air. I'm Terry Gross. If election anxiety has been giving you headaches, my guest may be of some help - not politically, neurologically. Dr. Carolyn Bernstein is an expert in the treatment of migraines. And if you think your headaches aren't migraines, you may be wrong. She says most people with migraine illness don't realize they have it. Only half of people with migraines have sought a doctor's help, and half of these get the wrong diagnoses. Dr. Bernstein's new book, "The Migraine Brain," draws on the latest research into the biochemical basis for migraine, the influence of hormones, and the newest drugs and why they work.

Bernstein has been on the Harvard Medical School faculty and a practicing neurologist for 17 years. She's treated thousands of men and women. In 2006, she founded and became director of the Women's Headache Center at the Cambridge Health Alliance, which is the teaching hospital for Harvard Medical School. Dr. Carolyn Bernstein, welcome to the Fresh Air. What separates a migraine from a plain old headache?

Dr. CAROLYN BERNSTEIN (Neurology, Harvard Medical School): I think that, if you took a group of, let's say, 100 people and lined them up and described the classic headache, just a plain old tension or muscle-contraction headache, I think a lot of people would raise their hand if you said, have you ever experienced a band of tightening and pressure around your head, some throbbing maybe? And that might just be a plain tension headache.

But I think, in terms of a migraine headache, you do have to meet the diagnostic criteria in order to make the diagnosis, and those include a variety of different factors, including unilateral pain that's throbbing, has to last a certain amount of time.

GROSS: What do you mean by unilateral? Is it on one side of your head?

Dr. BERNSTEIN: Unilateral means on one side of the head or the other. So, the pain will grip you on the right or grip you on the left. For most people, it's the same side. But every so often, it may switch sides. Pain is throbbing. It is often accompanied by nausea, vomiting, lights bother you. That's called photophobia. Sounds bother you; that's called phonophobia, stomach pain, and then other symptoms that may be less frequent.

For a number of people, not all people with migraines, sometimes they'll have what's called aura, and they'll have changes in their vision most commonly. They may have difficulty getting words out. They may have numbness and tingling on one side or the other before the headache actually starts. Really important to recognize that - to know that that's actually part of the migraine because it helps with treatment and it helps with diagnosis once you figure out that's what the explanation is.

GROSS: You say migraine isn't a type of headache. It's a complex neurological disease that affects the central nervous system. Would you explain that?

Dr. BERNSTEIN: Sure. I think the thing to remember there is that it isn't just a headache. So, people say migraine headaches, and to be honest, sometimes I slip and say migraine headache, but it really involves more than that. So, there are number of changes that are happening in the brain that are triggering off the whole migraine process.

There are changes that are going on on a real cellular basis. And by that, what I mean is, the nerve cells in the brain are becoming a little bit unstable, and they are sending out messages, which are transmitted through the brain, triggering off pain nerves, sometimes hitting what's called the nausea and vomiting center in the brain. They may create some of those other symptoms - numbness and tingling, sometimes even weakness on one side of the body or the other. So, there's a cascade of events that take place that cause all the different migraine symptoms, and they are more or less pronounced from person to person. Everybody is a little bit different.

GROSS: Your book is called "The Migraine Brain." And you make the case in the book that people who get migraines have certain characteristics in their brain chemistry that's a little different than the average brain. You say people who get migraines have basically a super-excitable brain. Would you explain what you mean by that?

Dr. BERNSTEIN: Sure. People who have migraines, who are unfortunate enough to have migraines, have cells in the brain that are hyper-excitable. And by that, what I mean is that the cells in the brain will become activated in a way that the brains of other people may not.

GROSS: So what makes the migraine brain more excitable?

Dr. BERNSTEIN: Cells in the brain usually are pretty stable, and they have to get certain kinds of messages in order to fire off the signal, let's say, to move an arm or move a leg or a thought process or whatever else may be happening. For someone with migraines, something triggers off this impulse, and it could be a certain food. It may be a glass of red wine or poor night sleep. The cells will begin to depolarize. And what that means is that they'll send off their electrical responses, releasing certain kinds of chemicals and deploying all the different nerve responses that then become the migraine.

GROSS: Now, does this super excitability of the brain pertain in other areas, too? Somebody who gets migraines because of the super-excitable brain, are they also prone to depression or anxiety or feeling more physical pain with any kind of, you know, spinal injury or nerve injury?

Dr. BERNSTEIN: So, we do know that there's an association between migraines and depression, even though I can't define for you precisely what that is. In other words, people who have migraines are more likely to suffer from depression than people who don't. There may be other associations with other sorts of pain. There may be a link with what's called irritable bowel syndrome. But again, research at this point is in the earlier stages of really understanding that.

GROSS: Can you see the differences in a migraine brain if you do, you know, imaging through MRI or a CAT scan?

Dr. BERNSTEIN: There's one study that we reference in the book which is really interesting when - and it's a very small study, but when MRI scans of patient suffering from migraines were compared to patients who don't have migraines, there was some thickening in what's called the somatosensory cortex. And that's the part of the brain that relays pain and sensation. And there's a lot of research now, as I mentioned, that's in preliminary stages, but it does indeed look like the brains of people who have migraines probably are different and probably function differently. And so as we continue to get information back, we'll be able to define this better.

GROSS: But that's a sign that something is different?

Dr. BERNSTEIN: Correct.

GROSS: That there's a part like physiological or neurological explanation here.

Dr. BERNSTEIN: That's correct.

GROSS: My guest is Dr. Carolyn Bernstein. We're talking about her new book, "The Migraine Brain." She is the founder and director of the Women's Headache Center at the Cambridge Health Alliance, which is a teaching hospital of Harvard University.

What about serotonin? And, you know, I think we've heard about the role that serotonin might play in depression. Does serotonin play a role in migraine as well?

Dr. BERNSTEIN: It probably does play a role. Some of the medications that we use to treat migraines actually make serotonin more available to certain receptors on cells. And what the receptors do is, they use a chemical. They receive a message from a chemical that tells them how to act in sequence. And so not having enough serotonin may be a trigger for certain people with their migraines.

GROSS: So, what does that have to say about the possible connection between migraine and depression?

Dr. BERNSTEIN: Well, it's very interesting for people who have what's called co-morbidity, where they both have migraines, and they have depression. Sometimes one kind of medication, such as an antidepressant, may treat both. And what you see is not only that the depression improved, but the migraine may improve as well.

GROSS: I think a lot of people who get migraines find that the over-the-counter medications that people typically used for headaches, whether it's like aspirin or acetaminophen or ibuprofen, just aren't going to do the trick. Migraines, I think, usually require special migraine prescription medication. Why don't the over-the-counter remedies work?

Dr. BERNSTEIN: Sometimes they do. For example, ibuprofen is one of the best migraine medications that you can buy. If you're stuck somewhere, and you really don't have anything else to take, it can be really helpful at kind of quieting down all these chemical changes that we've been talking about.

The problem with the over-the-counter medicines is, a lot of them have caffeine in them. So, I encourage people to actually - if you're taking an over-the-counter medicine for migraines, go home and look at the bottle and see if it's got caffeine. Caffeine can make a migraine stop. It can make you feel better, but it's notorious for causing what's called rebound. So when the caffeine wears off, the migraine is still there, and it comes back full force.

There are also some guidelines that are really important to think about concerning what's called medication overuse headaches. And for a lot of these medicines, it's - if you use them 10 or more days a month, which is a lot of days out of the month. You're a set up for having withdrawal kind of a syndrome. So, in other words, if every other day, you're taking some over-the-counter acetaminophen and caffeine together, and then you miss it for a couple of days, or you feel a bit better, you may get a headache that comes roaring right back. So, it's hard.

You know, I think that a lot of people who have migraine can actually do some self-education, hopefully get help from their primary care providers and understand how to treat an occasional migraine. But for people who are requiring a lot of medicine and find that they're going to the pharmacy and buying a lot of things, you're set up for the overuse syndrome. So that's where you really need to seek some help.

GROSS: So, how do the migraine medications work compared to, you know, your typical, you know, Advil or Tylenol or aspirin approach?

Dr. BERNSTEIN: So, they probably work on serotonin receptors specifically, and they stop some of this cascade of events when the migraine, the impulse that's causing the migraine has actually began to irritate the nerve that's causing the pain and causing a release of some of these, what are called neuropeptides, pain transmitters. They probably stop the impulse right at that point.

The trick with them is, you have to have them with you everywhere, and I joke with patients, I've got them in my gym bag. I have them in my brief case because you have to take them as soon as the migraine starts, and if you wait too long, they really don't help. So, if you're somebody who is already in the throes of a migraine, or something that can be really disabling for people, when they wake up in the morning with the migraine, the triptians aren't going to help with you at that point.

GROSS: My guest is Neurologist Carolyn Bernstein, author of the new book, "The Migraine Brain." We'll talk more after a break. This is Fresh Air.

(Soundbite of music)

GROSS: My guest is Dr. Carolyn Bernstein, author of "The Migraine Brain." She's the founder and director of the Women's Headache Center at Cambridge Health Alliance, which is one of Harvard's teaching hospitals.

You write that three times as many women get migraines as men. Is that because of changes in women's hormones during menstruation and pregnancy and menopause?

Dr. BERNSTEIN: Well, here's an interesting fact, Terry. Kids up until about the age of 12 - and kids do get migraines - it's probably equal boys and girls or maybe even a little more common in boys, and then after that, girls just take off. And that figure that you quoted a minute ago with the three to one ration becomes more and more apparent.

So, I think that hormones are part of that and certainly changing hormone levels in the body and in the brain, all these different things that go on as women begin to have monthly cycles, those things, for a brain that is irritable, that is sensitive to any kind of changes, in other words, a migraine brain, are probably migraine triggers. But more research is beginning to tell us that women's brains actually just may be different than mens', and I don't have more specifics at this point, but that's really something that I'm excited about understanding.

GROSS: People that get migraines know that there are certain things that can often trigger a migraine. For some people, it's certain foods, like wine or chocolate. For other people, it can be being very tired or stress? Is there an explanation why something like a certain food, like chocolate for some people, could actually trigger a migraine?

Dr. BERNSTEIN: The specific trigger that we really understand the best is red wine, and that's probably because it has an amino acid called tyramine that's very migrainugenic, very likely to cause a migraine. The old thinking was that, if you had migraines, you should avoid cheese. You should avoid chocolate and red wine for sure, white wine, preserved foods, all kinds of other things. And now, as our understanding gets better and better, we realize that it's different for everybody.

In other words, everyone's migraine brain is a little bit different. So, some people do fine with chocolate, and, in fact, because chocolate raises serotonin a little bit, it may actually make them feel better. But other people will find one specific trigger, and they really have to avoid it. And that's where you have to do a little bit of work to be able to understand that.

One patient, with the help of our nutritionist at the Women's Headache Center, was able to figure out that tomatoes were her trigger, and I have never seen that before. But when we talked about it and went through - there's a substance in the skin of tomatoes, what's called the lycopene, that for her was a trigger and set off her migraines. And as soon as she began to avoid tomatoes, her headache frequency really dropped substantially. So, it's where being a detective is going to pay off.

GROSS: Why is hunger or changing levels of blood sugar sometimes a trigger?

Dr. BERNSTEIN: Again, migraine brains are very, very sensitive, and they like what's called homeostasis. They like things to be the same all the time. There's a specific kind of headache called the starvation headache that's classified and coded a little differently than a migraine, but for lot of people, having a change in their blood sugar makes these cells that want things to just be the same, it can trigger off a migraine. It can be a very potent signal for them.

GROSS: A plane trip can really set off a migraine? What is different about a plane trip? Why should that trigger a migraine?

Dr. BERNSTEIN: Well, I think there's probably a lot of different reasons, and again, for an individual person, you could probably do some homework and try to figure it out one way than the other. First of all, let's face it, plane travel is stressful, especially in this day and age, and stress is a potent migraine trigger and just a plain old headache trigger, people with tension headaches. So, there's the stress piece.

Then there is the piece of changes in the air quality on the airplane, lack of food when you're flying. Nowadays, you either have to pay a lot of money, and you get a little tiny bag of chips, or you have to be proactive and bring your own food. Changes in the altitude as well are - the air is thinner when you're flying, and so that may be a trigger for people. So, try to understand all of those different things, doing whatever you can to feel relaxed before you get on the plane and kind of having your own little bag of goodies to bring with you may really decrease the migraine frequency for flyers.

GROSS: You know, you pointed out that people with migraine, their brains don't like changes. So, whether it's a change in blood sugar or a change in hormones, it's not going to make your brain happy, and it might set off a migraine. So, what does that say about, for women, oral contraceptives or using hormones during menopause?

Dr. BERNSTEIN: It's a very individual question, and I always encourage people and really feel strongly that women need to consult with their gynecologist in terms of making these decisions. But for some migraine patients, it's not safe to use oral contraceptives. It's not safe to use extra hormones. And so, yeah, need to be aware of that and think of some other solution if that's going to be an issue for you.

For example, women with aura, specifically with visual auras, there may be a slightly increased risk of stroke. And so, that is a situation where you'd want to be really careful, but for other women, stabilizing their hormones so that they don't have the fluctuation each month and maybe skipping a period every month or every couple of months can really cut down on what are called menstrual migraine, for women who suffer from them. So, again, an individual decision, but something that I asked about that we talked about in the book is understanding, if you're female, how hormones actually affect your migraines.

GROSS: So, you founded the Women's Headache Center in Cambridge. How did you set up the clinic so that just like the environment itself is sensitive to people who get migraines?

Dr. BERNSTEIN: Well, I had some great people that I was working with at the Cambridge Health Alliance tossing these ideas back and forth. And what we decided to do was really try to focus on patient-centered care, which is something that the alliance works to provide for all of its patients. So, what I did was to invite a group of women who had migraines, and it was open to anybody who I was seeing and treating at that point, to become a part of an advisory panel.

These women would meet with me. We'd serve some food so that nobody would begin to develop a starvation headache and sit around and talk about what makes up the perfect headache center? Where would you want to go and what would you want the care to be like? And the women were fabulous. It was a chance to really be a designer of something and from their own experiences of what it was like to have a headache, what it was like to have a migraine.

They brought that with them and said, we need dimmers on the lights. We need soothing colors. We want background music that's relaxing. We want furniture that's women's size that we can sit in. Don't put fragranced magazines. Provide as many different kinds of care as you possibly can in that one site. If we're going to come and see you, we want to be able to do everything. We want to see you and the nutritionist and talk to the nurse at the same time. And so we had a list of different things that were important and sat down and worked through and tried to achieve as many of those as possible.

GROSS: What do you think of alternative therapy for migraine - biofeedback, acupuncture? Have you had success with those?

Dr. BERNSTEIN: I have. I, again, think that anytime you can either use, add in, incorporate into care of a person something that's not a drug, it's a good idea. So I think medications can be great for a lot of people. They can really be extraordinary helpful. But I also think that, whatever you put in your body, from an aspirin right on up, is going to have some kinds of other effects on how you are and how you function, how your body works. So people will say, does this drug have side effects? And I always say, of course. Everything has side effects.

Now, if you're learning biofeedback, which is a very specific set of relaxation techniques, mind-body techniques that you can start when you feel a migraine coming on, it also works when anxiety works and some other conditions as well. If you can start to do these relaxation exercises when you feel the start of a migraine, you may actually be able to abort the migraine right there or certainly cut down on how severe and how painful it's going to be. So maybe that lets you use less medication. Maybe that lets you stay longer in the work that you're trying to accomplish without having to stop and go lie down. So I think that that can be really helpful.

In terms of acupuncture, there are lots of non-Western ways to treat different kinds of pain, and acupuncture's one of them. I think we don't fully understand every part of the pathophysiology. And I think that we don't fully understand precisely how acupuncture works, and for some people, it may not be something that they want to consider. But for a lot of people, it can be extraordinarily helpful, and a series of 10 acupuncture treatments may decrease the frequency and intensity of their migraines, even if it doesn't get rid of them altogether.

GROSS: A lot of people have been so anxious about whether their candidate will win the presidential election. I wonder if you've seen a surge in the number of migraine patients coming into your clinic during the campaign season?

Dr. BERNSTEIN: Well, I can tell you that the Women's Headache Center is pretty much busy all the time, and I think there are a lot of women out there with migraines looking for some help. So I haven't noticed an increase in frequency. I have noticed that a lot of women come in, and they do want to talk about their political feelings and the stress that they feel, just as you mentioned, when it gets hard for people to fall asleep at night, when they're anxious about their money, losing their job, losing their house. Those are all things that can trigger off more migraines.

GROSS: Well, Dr. Bernstein, I want to thank you so much for talking with us.

Dr. BERNSTEIN: Oh. It's been my pleasure. Thank you so much.

GROSS: Dr. Carolyn Bernstein is the author of "The Migraine Brain." She's the founder and director of the Women's Headache Center at Cambridge Health Alliance, which is one of Harvard's teaching hospital. I'm Terry Gross, and this is Fresh Air.
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Dion Pays Homage To Guitar-Rock Giants

TERRY GROSS, host:

Coming up, Dion brings his guitar and performs a tribute to some of the great early rock and rollers, including Buddy Holly and Elvis Presley. His new CD is called "Heroes: Giants of Early Guitar Rock." It ends with this new version of Dion's signature song.

(Soundbite of the song "The Wanderer")

Mr. DION: (Singing) They call me the wanderer - yeah -the wanderer.
I roam around around around around.
Oh, well there's Flo on my left arm and there's Mary on my right.
And Jenny is the girl with that I'll be with tonight.
And when she asks me which one I love the best,
I tear open my shirt and show her Rosie on my chest.
'Cause I'm the wanderer, yeah the wanderer.
I roam around around around around.
Oh, well I roam from town to town.
I go through life without a care.
And I'm as happy as a clown.
And with my two fists of iron but I'm going no way on.
Oh yeah, I'm the type of guy that likes to roam around.
I'm never in one place,
I roam from town to town.
And when I find myself fallin' for some girl,
I hope right into that car of mine drive around the world.
'Cause I'm a wanderer, yeah the wanderer.

GROSS: This is Fresh Air. I'm Terry Gross. Fans who love Dion's hits from the '50s and '60s, like "The Wanderer," "Runaround Sue," and "Teenager in Love," were surprised to hear his two recent albums paying tribute to the blues musicians that influenced him. Now, Dion has a new CD called "Heroes: Giants of Early Guitar Rock." It pays tribute to some of his contemporaries, most of them are no longer with us, people like Elvis Presley, Buddy Holly, Ritchie Valens, Roy Orbison, and Gene Vincent.

(Soundbite of song "Be Bop a Lula")

DION: (Singing) Be-bop-a-lula, I don't mean maybe.
Be-bop-a-lula, she's my baby.
Be-bop-a-lula, I don't mean maybe.
Be-bop-a-lula, she's my baby doll.
My baby doll, my baby doll.
Well, she's the girl in the red blue jeans.
She's the queen of all my dreams.
She's the woman walks around the storm.
She's the one that gives me more, more, more.
Be-bop-a-lula, she's my baby.
Be-bop-a-lula, I don't mean maybe.
Be-bop-a-lula, she's my baby doll,
My baby doll, my baby doll.

GROSS: That's Dion doing Gene Vincent's "Be-bop A Lula" from Dion's new CD, "Heroes." He brought his guitar to our show to play and sing some of the songs on the new CD and tell some stories about the musicians who originally recorded them.

Dion, welcome back to Fresh Air. It's really great to have you back. When I ask you start by playing a song from a new CD, would you do "Summertime Blues"?

Mr. DION (Singer, Song Writer): Yeah, I'd like to - this is the Eddie Cochran song I did, and it goes like this.

(Soundbite of song "Summertime Blues")

Mr. DION: (Singing) Well I'm a-gonna raise a fuss,
I'm gonna raise a holler
About working all summer just to try to make a dollar.
Every time I call my baby, trying to get a date,
My boss says, no dice, son, you gotta work late.
Sometimes I wonder what I'm gonna do
'Cause there ain't no cure for the summertime blues.

Terry, this guy had a great sense of humor. I will do the last verse.

GROSS: OK.

(Soundbite of song "Summertime Blues")

Mr. DION: (Singing) I'm gonna take a week,
Gonna find me a vacation.
I'm taking my problem to the United Nation.
Well, I called my congressman and he said quote,
I'd like to help you son, but you're too young to vote.
Sometime I wonder what I'm gonna do
'Cause there ain't no cure for the summertime blues.

GROSS: I am glad you pointed that out. When I was young and listening to that song when I was growing up, that line, I'm going to take my problems to the United Nation, always made me laugh. Actually, like, you don't hear a lot of pop songs with that in it. Did you know Eddie Cochran?

Mr. DION: I did. He and I played the Palace Theater with Eddie Cochran on 46th Street and Broadway back in his heyday. It was, you know, the late '50s and great looking guy. He wore this tan suit, had this orange guitar, you know, that Chet Atkins Gretsch guitar with the whammy bar on it that Bixby invented in the '50s. And he'd come out, man, take that stance and get it on, you know? He was like, he was a little guy, was about five-foot-two.

GROSS: Really that short, wow.

Mr. DION; Yeah. And the guitar always looks gigantic on him. You know, what's he playing? A bass. You know, but he was a little guy, but man, did he cause a racket, let me tell you.

GROSS: Did Eddie Cochran show you anything on the guitar that you hadn't already thought of?

Mr. DION: Eddie Cochran, he had his own style, but no, I loved rhythm. In fact, I call myself a rhythm singer because, you know, we all develop styles from listening to certain things. I used to go down to the Apollo Theater in Harlem and listen to Red Prysock and Big Al Sears and King Curtis and Sam 'The Man' Taylor, and they'd all play like da-da-da-dop bop da-da-da-dop bop.

So I became like a rhythm singer in some sense of the word. If you give me a beat, I could sing. And Eddie Cochran had that. You know what I'm saying?

GROSS: Yeah, ahah, ahah. Now, your new CD is called "Heroes." How did you choose the song on like what holds them all together?

Mr. DION: Well, it's subtitled "Giants of Early Guitar Rock," and I was trying to, this is quite a story because I always felt like I flew under the radar as a guitar player. Gerry Wexler always told me, the guys at Rolling Stone always told me, they'd say, we didn't know you play guitar, but I played guitar on all my hit records. You know, if I did.

(Soundbite of song "The Wanderer")

Mr. DION: (Singing) Oooh, I am a type of guy that likes to roam around...

You know, I got it from Jimmy Reed. You know that...

(Soundbite of song "You Got Me Runnin'")

Mr. DION: (Singing) You got me running,
Hiding, run, hide, hide, hide, run, and away you want to let it go,
Babe, oh, oh, oh, oh, oh, yeah.
You got me girl,
What you want?
Any way you want to let it roll.

And that's where I got like.

(Soundbite of song "Ruby Baby")

Mr. DION: (Singing) I love a girl and Ruby is her name.

You know, when you use it as a springboard, all that - you know, if Jimmy Reed didn't exist, I wouldn't be here, Terry.

GROSS: Right, right. Well, because you started with Dion and the Belmonts, and because it had a a cappella sound, you know, a harmony sound, the musicianship wasn't emphasized. It was like the vocals that were emphasized. Is that why you weren't known as a guitarist?

Mr. DION: Well, what happened was, I got a record contract down at Lori Records, and they wanted to put this group with me that was from Oklahoma. And they kind of sang like good ol' boys, like, yodi, doti, do, we're out in Oklahoma, doti, doh, doh.

And I said, no, no, guys, guys, let me go back to the Bronx and recruit some of the guys on the street. So I went back, and I recruited the best street singers that I knew. I brought them down to Lori Records, and, you know, they were naming groups after birds and cars at that time, you know, like the Flamingos, the Cadillacs, the El Dorados, you know, stuff like that. So we said, let's do streets. We are going to be called Dion and the Kretoner, which I thought was great, but two of the guys were from Belmont Avenue. And I said, that has a good ring. Let's do that.

I get with these guys, we - God, it was a very defining moment in my life. It just - to create a song like "I Wonder Why" in my little apartment where I lived, you know, with my parents in the Bronx. We were paying $36 a month rent. You know, we had very little room, but here we created "I Wonder Why," and I felt like I was in heaven.

We went down there. We - to Lori Records, recorded the song, and when it came out, they said, put the guitar down. Lead singers don't use guitars. So I kept putting the guitar down, you know, doing these Dick Clark Shows with, you know, you lip-synched the record, and I didn't have a guitar. So there's very few pictures of me with - but yet, every time we created this song, there I was with the guitar playing and working it out, you know.

GROSS: Let me ask you to do another song that you also do on the CD. You want to do "C'mon Let's Go," the Ritchie Valens song?

Mr. DION: Let me try.

(Soundbite of song "C'mon Let's Go")

Mr. DION: (Singing) Well, come on let's go, let's go, let's go little darling.
Come on tell me that you love me.
Come on, come on, let's go again.
Again and again,
Well, now, sing me, sing me, all the way down there.
Come on now you know I must love you baby.
Come on and I'll go it again.

Balalala , bamba,
Balalalala,

You know like that.

GROSS: You worked in his other big hit there.

Mr. DION: You know, he a lot of that - he had that rhythm thing, too, that Latin thing going, you know?

GROSS: You know, Ritchie Valens died in a plane crash. You were supposed to be on that plane. You were almost on that plane, the crash of 1959 that killed Valens, Buddy Holly, and the Big Bopper, and, you know, so many of the people who you paid tribute to on this CD are dead, you know, Eddie Cochran, Ritchie Valens, Buddy Holly, Ricky Nelson.

Mr. DION: They're all gone except...

GROSS: Del Shannon, Elvis Presley, Johnny Cash, Carl Perkins - do you often think about that? So many people who you came through the ranks with aren't around anymore? And some of them, it's like a plane crash, traffic accidents, suicide, and it's just a real mixe of reasons, illness, drugs, yeah.

Mr. DION: Well, you know, I don't know. I look at like it's the grace of God for me that I am still here. You know, I, you know, they say, if you remember the '60s, you really weren't there, and that was me. I was using a lot of drugs, drinking. I was kind of crazy and got pretty way out there. And in '68, my friend, Frankie Lymon, died of an overdose and just kind of shook me into my senses, and I said, what am I doing, you know. And I said a prayer, and I haven't had a drink or a drug in over 40 years, Terry. It's just amazing. I think God just touched me on the top of my head and said, it's your time.

GROSS: My guest is Dion. His new CD is called "Heroes: Giants of Early Guitar Rock." He'll perform more songs from it after a break. This is Fresh Air.

(Soundbite of music)

GROSS: My guest is Dion. His CD is called "Heroes: Giants of Early Guitar Rock." It pays tribute to some of his contemporaries. Let me ask you to do another song that you do on your new CD, "Heroes," and this is the Johnny Cash song "I Walk the Line." Why don't you do the song, then we'll talk about why you did it and how you knew Johnny Cash. Is this a hard one to do solo?

Mr. DION: Well, it - you know, I didn't know, but Johnny Cash wrote this song - it changes key like six times. I didn't know that from some reason. I don't have that musical - but when I got into it, I said, wow, it goes.

(Soundbite of song "I Walk the Line")

Mr. DION: (Singing) I keep close watch on this heart of mine.
I keep my eyes wide open all the time.
I keep the ends out for the tie that binds.
Because you're mine, I walk the line.

You know, he - take a song like that. You know, Johnny Cash was, come on, he was a bad ass. You know, he was like a rapper. He was a country singer, you know, punk rocker. You know, and here he is, he writes a song that is leaning into his relationship, you know, to me to reach higher ground. That's where you go to mine the gold and to go deeper.

GROSS: How did you meet? Did you do shows together?

Mr. DION: Well, I met him in Nashville. And I met him through Waylon Jennings, who was on that Buddy Holly tour with me. We go back again, I said, with that tour because after Buddy Holly, Ritchie Valens, and the Big Bopper died in that fatal plane crash, Waylon and I were on that bus alone. I mean, we talked. We bonded. I told him to - in fact, you know, in a way, I feel like I launched his career because I loved the ways he sang, and I always said, you should sing. I loved the way - because we had guitars, and we'd sing on the bus.

GROSS: Was he there just a guitarist?

Mr. DION: It was his first gig. He was playing bass. He never played bass before. He was playing bass for Buddy Holly. He was one of the Crickets on that tour.

GROSS: Oh, so he introduced you to Johnny Cash?

Mr. DION: Yes he did, and I just wanted to...

GROSS: And did Johnny Cash know your records?

Mr. DION: Johnny Cash loved the song that I did called "Born To Cry." It goes ..

(Soundbite of song "Born To Cry")

Mr. DION: (Singing) I'd like to tell something all about the good and the bad.
I wish today the world, my friends would stop being sad.
There is so much evil around us,
I feel that I could die,
And I know, that I was born to cry.
I know some day, and maybe soon, the master will call.
I'd tell you, I won't cry at all.
I know some day, maybe soon,
But I know that I was born to cry.
I said, cry, cry, cry.

You know, I've got to tell you. Let me tell you one thing about this song and one of the reasons why I wrote it. You have minute?

GROSS: Yeah.

Mr. DION: I was 16 years old. I was walking in Pelham Bay area, and there was a synagogue, and I heard the cantor of the church singing. So I walked in. I was 16. I probably had a tank-top on, and they was wondering what I was doing there. And his name was Henry Rosenblatt. And I asked him, I said what is that? He saw I was interested, and he took me in the back, and he played me some of his father's records, Cantor Rosenblatt, who was in the original Jazz Singer.

And I went home after hearing all that stuff, and I wrote "Born to Cry." And it's kind of like I was cantoring, you know, imitating this rabbi. And it was - it's kind of like fusion, Jewish rock and roll.

GROSS: That's really funny considering, you know, you grew up Catholic and weren't often in a synagogue.

Mr. DION: Yeah, but it's all about the music.

GROSS: Yeah. Yeah, yeah, yeah. So Johnny Cash really liked that song "Born to Cry?" It's too bad he didn't record it.

Mr. DION: Yeah. But, you know, the song's like - I recorded a song called "Ruby Baby." You know, like I said, sometimes, you meet people.

(Soundbite of song "Ruby Baby")

Mr. DION: (Singing) I love a girl and Ruby is her name.
Hear me talking, now.
The little girl don't love me but I love her just the same.
What I say?
Whoa, oh, oh, oh, oh. I've got love, I've got kisses, too.
I'm gonna give them all to you.
Now, listen up, Ruby, Ruby, when will you be mine?
I'm gonna get you some time, Ruby.

You know, that song, when I met John Lennon, when I met Bob Dylan, and there was somebody else, I know who it was. It was Little Richard's mother, Leva Mae. I want to tell you something, Terry. This is the greatest compliment I ever got in my life. It's number one. She said, are you the boy who sings that song "Ruby Baby?" And I said, yes, ma'am. She said, son, you got soul. And I want to tell you, Terry, I never forgot it.

GROSS: Nice compliment from Little Richard's mother. You know...

Mr. DION: If it came from Little Richard, I probably would've forgot it. But it came from Little Richard's mother.

GROSS: You do a Ricky Nelson song on your new CD, "Heroes," that I'm not really familiar with. It's called "Believe What You Say." How do you know the song, and how did you know Ricky Nelson? And then I'll ask you to do the song.

Mr. DION: Well, I met Ricky Nelson at his birthday party out on the west coast in the late '50s. And, you know, back then, another reason for doing this album - I mean, a lot of guys, we would just watch "Ozzy and Harriet" just to see the last four minutes of it, to see Ricky Nelson holding one of those Martin guitars or Gibson guitars. And James Burton, the great James Burton played behind. So there's a lot of history to a lot of these songs. And this one goes like...

(Soundbite of song "Believe What You Say")

Mr. DION: (Singing) Well, I believe what you say when you say you're going steady with nobody else but me.
Well, I believe what you say when you say you don't kiss nobody else but me.
Well, I believe, do believe, I believe.
I believe, pretty baby, believe you're going steady with nobody else but me.
Well, there's one thing, baby, that I want you to know.
When you're rocking with me, you don't rock too slow.
A-move on in, get toe-to-toe.
We're gonna rock till we can't rock no more.
I believe, I do believe, I believe, believe, pretty baby, believe you're going steady with nobody else but me.

You know, like that.

GROSS: How well did you know Ricky Nelson?

Mr. DION: I knew him pretty well. I mean, we were like - it was like a little bit of a mutual admiration society because he loved "The Wanderer," "Run Around Sue," again "Ruby Baby." Man, I tell you, Terry. That guy was good-looking. He had them light-blue eyes. Man, I tell you, man. When I first met him, I got so - I must've combed my hair about five times that day. I was like...

GROSS: Put more Brylcreem on it.

Mr. DION: I'm telling you, I said, wow.

GROSS: Was he self-conscious about how much his family and the "Ozzy and Harriet" show had come to kind of symbolize, like, suburban middle-class life in the 1950s?

Mr. DION: You know, I didn't - I wasn't thinking on that level at that time. We were just thinking of, like, songs. And Ricky Nelson and I loved Carl Perkins and Fats Domino, you know. We just - you know. And so we would talk a lot about that and guitars and playing, you know. But he was a very, very shy guy. And I was shy at the time. I just kind of got more verbal as I went along because I got comfortable, I don't know. But he was very shy and remained that way. He didn't talk a lot at all.

Same with the Everly Brothers. I've known the Everly Brothers for years. I think I've heard them say two things. I think Don once said, yup. And Phil said, right. You know, and that was it. They were like, you know, Gary Cooper and, you know - I don't know. It was kind of embarrassing.

GROSS: My guest is Dion. His new CD is called "Heroes: Giants of Early Guitar Rock." He'll perform more songs from it after a break. This is Fresh Air.

(Soundbite of music)

GROSS: My guest is Dion. His new CD is called "Heroes: Giants of Early Guitar Rock." It pays tribute to some of his contemporaries. Your new CD is all covers of great songs from the '50s and early '60s. If I asked you to do one more from the new album, is there one that you'd want to do since I've been doing most of the choosing from there?

Mr. DION: Well, I did want to just say that what I was trying to do with the new album was champion the cause of a lot of these great guitar players that flew under the radar. And this is - this album, I just wanted to capture the original intent and essence and passion of these first generation rockers and - let me give you an - this is a Buddy Holly tune that I chose.

(Soundbite of song "Rave On")

Mr. DION: (Singing) Well, baby, baby, now, the little things that you say and do makes me be want to be with you.
Rave on, it's a crazy feeling
And I know it's got me reeling
When you say I love you, rave on.
Well, the way you dance and you hold me tight,
The way you kiss and say goodnight.
Rave on, it's a crazy feeling,
And I know it's got me reeling,
When you say I love you, rave on.
Rave on, it's a crazy feeling,
And I know it's got me reeling,
When you say I'm revealing your love for me.
Rave on, rave on and tell me.
Tell me I'm not to be lonely.
Tell me you love me only.
Rave on to me.

GROSS: Thanks for doing that.

Mr. DION: I just - you know, I must've heard that song like five times a day when I was with Buddy Holly.

GROSS: One of the guitarists you paid tribute to on your new CD is Scotty Moore, who played with Elvis Presley. So I'm going to ask you to do a little bit of "Jailhouse Rock," which I realize is probably hard to do solo, but I'm sure you're the man for the job.

Mr. DION: I had a great band doing this with me, but I'll try to go.

(Soundbite of song "Jailhouse Rock")

Mr. DION: (Singing) We're going to a party in the county jail.
The prison band there and they began to wail.
The band was jumping and the joint began to swing.
You should've heard those knocked out jailbirds sing.
Let's rock, everybody, lets rock.
Everybody in the whole cell block,
They were dancing to the Jailhouse Rock.

GROSS: That's great. I want to thank you so much for performing for us and talking with us again. I really appreciate it. Thank you. And let me just ask you before you go, how have you managed to keep your voice in such good shape?

Mr. DION: Well, I don't - you know. I don't know. I guess it's because, like, many years ago, like I said, 40 years ago, no smoke and no drinking and no drugging, and I think that's part of it, you know, and a lot of love from my friends and my family. It's good to be here, Terry. And thank you again.

GROSS: Dion's new CD is called "Heroes: Giants ff Early Guitar Rock." You can download podcast of our show on our website freshair.npr.org.

(Soundbite of acknowledgment)

GROSS: I'm Terry Gross.

(Soundbite of song "Jailhouse Rock")

Mr. DION: (Singing) Number forty-seven said to number three.
You're the cutest jailbird I ever did see.
I sure would be delighted with your company,
Come on and do the jailhouse rock with me.
Let's rock, everybody, let's rock.
Everybody in the whole cell block,
They were dancing to the jailhouse rock.
The sad sack was a sitting on a block of stone,
Way over in the corner weeping all alone.
The warden said, hey, buddy, don't you be no square,
If you can't find a partner use a wooden chair.
Let's rock, everybody, let's rock.
Everybody in the whole cell block,
They were dancing to the jailhouse rock.
Shifty Henry said to bugs, for heaven's sake,
No one's looking, now's our chance to make a break.
Bugsy turned to shifty and he said, nix, nix,
I want to stick around a while and get my kicks.
Let's rock, everybody, let's rock.
Everybody in the whole cell block,
They were dancing to the Jailhouse Rock.
Then they'll do the Jailhouse Rock.
And they'll do the Jailhouse Rock.
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