An award-winning memoir and instant New York Times bestseller that goes far beyond its riveting medical mystery, Brain on Fire is the powerful account of one woman’s struggle to recapture her identity.
When twenty-four-year-old Susannah Cahalan woke up alone in a hospital room, strapped to her bed and unable to move or speak, she had no memory of how she’d gotten there. Days earlier, she had been on the threshold of a new, adult life: at the beginning of her first serious relationship and a promising career at a major New York newspaper. Now she was labeled violent, psychotic, a flight risk. What happened?
In a swift and breathtaking narrative, Susannah tells the astonishing true story of her descent into madness, her family’s inspiring faith in her, and the lifesaving diagnosis that nearly didn’t happen. “A fascinating look at the disease that...could have cost this vibrant, vital young woman her life” (People), Brain on Fire is an unforgettable exploration of memory and identity, faith and love, and a profoundly compelling tale of survival and perseverance that is destined to become a classic.
|Publisher:||Simon & Schuster|
|Product dimensions:||5.50(w) x 8.30(h) x 0.90(d)|
About the Author
Read an Excerpt
Brain on Fire
At first, there’s just darkness and silence.
“Are my eyes open? Hello?”
I can’t tell if I’m moving my mouth or if there’s even anyone to ask. It’s too dark to see. I blink once, twice, three times. There is a dull foreboding in the pit of my stomach. That, I recognize. My thoughts translate only slowly into language, as if emerging from a pot of molasses. Word by word the questions come: Where am I? Why does my scalp itch? Where is everyone? Then the world around me comes gradually into view, beginning as a pinhole, its diameter steadily expanding. Objects emerge from the murk and sharpen into focus. After a moment I recognize them: TV, curtain, bed.
I know immediately that I need to get out of here. I lurch forward, but something snaps against me. My fingers find a thick mesh vest at my waist holding me to the bed like a—what’s the word?—straitjacket. The vest connects to two cold metal side rails. I wrap my hands around the rails and pull up, but again the straps dig into my chest, yielding only a few inches. There’s an unopened window to my right that looks onto a street. Cars, yellow cars. Taxis. I am in New York. Home.
Before the relief finishes washing over me, though, I see her. The purple lady. She is staring at me.
“Help!” I shout. Her expression never changes, as if I hadn’t said a thing. I shove myself against the straps again.
“Don’t you go doing that,” she croons in a familiar Jamaican accent.
“Sybil?” But it couldn’t be. Sybil was my childhood babysitter. I haven’t seen her since I was a child. Why would she choose today to reenter my life? “Sybil? Where am I?”
“The hospital. You better calm down.” It’s not Sybil.
The purple lady moves closer, her breasts brushing against my face as she bends across me to unhook the restraints, starting on the right and moving to the left. With my arms free, I instinctually raise my right hand to scratch my head. But instead of hair and scalp, I find a cotton hat. I rip it off, suddenly angry, and raise both hands to inspect my head further. I feel rows and rows of plastic wires. I pluck one out—which makes my scalp sting—and lower it to eye level; it’s pink. On my wrist is an orange plastic band. I squint, unable to focus on the words, but after a few seconds, the block letters sharpen: FLIGHT RISK.
Brain on Fire
Maybe it all began with a bug bite, from a bedbug that didn’t exist.
One morning, I’d woken up to find two red dots on the main purplish-blue vein running down my left arm. It was early 2009, and New York City was awash in bedbug scares: they infested offices, clothing stores, movie theaters, and park benches. Though I wasn’t naturally a worrier, my dreams had been occupied for two nights straight by finger-long bedbugs. It was a reasonable concern, though after carefully scouring the apartment, I couldn’t find a single bug or any evidence of their presence. Except those two bites. I even called in an exterminator to check out my apartment, an overworked Hispanic man who combed the whole place, lifting up my sofa bed and shining a flashlight into places I had never before thought to clean. He proclaimed my studio bug free. That seemed unlikely, so I asked for a follow-up appointment for him to spray. To his credit, he urged me to wait before shelling out an astronomical sum to do battle against what he seemed to think was an imaginary infestation. But I pressed him to do it, convinced that my apartment, my bed, my body had been overrun by bugs. He agreed to return and exterminate.
Concerned as I was, I tried to conceal my growing unease from my coworkers. Understandably, no one wanted to be associated with a person with a bedbug problem. So at work the following day, I walked as nonchalantly as possible through the newsroom of the New York Post to my cubicle. I was careful to conceal my bites and tried to appear casual, normal. Not that “normal” means a lot at the Post.
Though it’s notoriously obsessed with what’s new, the Post is nearly as old as the nation itself. Established by Alexander Hamilton in 1801, it is the longest continually run newspaper in the country. In its first century alone, the paper crusaded for the abolition movement and helped promote the creation of Central Park. Today the newsroom itself is cavernous yet airless, filled with rows of open cubicles and a glut of filing cabinets packed with decades of unused, forgotten documents. The walls are freckled with clocks that don’t run, dead flowers hung upside down to dry, a picture of a monkey riding a border collie, and a big foam Six Flags finger, all memorabilia from reporters’ assignments. The PCs are ancient, the copy machines the size of small ponies. A small utility closet that once served as a smoking room now holds supplies, and is marked by a weathered sign warning that the smoking room no longer exists, as if someone might accidentally wander in for a cigarette among the monitors and video equipment. This has been my eccentric little world for the past seven years, since I started here as a seventeen-year-old intern.
Especially around deadline, the room buzzes with activity—keyboards clacking, editors yelling, reporters cackling—the perfect stereotype of a tabloid newsroom.
“Where’s the fucking picture to go with this caption?”
“How is it that he didn’t know she was a prostitute?”
“What color were the socks of the guy who jumped off the bridge?”
It’s like a bar without alcohol, filled with adrenaline-soaked news junkies. The cast of characters here is unique to the Post: the brightest headline writers in the business, the hardened newshounds hunting after exclusives, and type-A workaholics who possess the chameleon ability to either befriend or antagonize almost anyone. Still, on most days, the newsroom is subdued, as everyone silently combs through court documents, interviews sources, or reads newspapers. Often, like today, the newsroom is as quiet as a morgue.
Heading toward my desk to start the day, I wove through the rows of cubicles marked by green Manhattan street signs: Liberty Street, Nassau Street, Pine Street, and William Street, throwbacks to a time when the Post was actually flanked by those downtown streets in its previous home at the South Street Seaport. My desk is at Pine Street. Amid the silence, I slid into my seat beside Angela, my closest friend at the paper, and gave her a tense smile. Trying not to let my question echo too loudly across the noiseless room, I asked, “You know anything about bedbug bites?”
I often joked that if I ever had a daughter, I’d want her to be like Angela. In many ways, she is my newsroom hero. When I first met her, three years before, she was a soft-spoken, shy young woman from Queens, only a few years older than me. She had arrived at the Post from a small weekly paper and since then had matured under the pressure of a big-city tabloid into one of the Post’s most talented reporters, churning out reams of our best stories. Most late Friday nights, you’d find Angela writing four stories on split screens simultaneously. I couldn’t help but look up to her. Now I really needed her advice.
Hearing that dreaded word, bedbugs, Angela scooted her chair away from mine. “Don’t tell me you have them,” she said with an impish smile. I started to show her my arm, but before I could get into my tale of woe, my phone rang.
“You ready?” It was the new Sunday editor, Steve. He was just barely in his midthirties, yet he had already been named head editor of the Sunday paper, the section I worked for, and despite his friendliness, he intimidated me. Every Tuesday, each reporter had a pitch meeting to showcase some of his or her ideas for that Sunday’s paper. At the sound of his voice, I realized with panic that I was completely unprepared for this week’s meeting. Usually I had at least three coherent ideas to pitch; they weren’t always great, but I always had something. Now I had nothing, not even enough to bluff my way through the next five minutes. How had I let that happen? This meeting was impossible to forget, a weekly ritual that we all fastidiously prepared for, even during days off.
Bedbugs forgotten, I widened my eyes at Angela as I stood back up, gamely hoping it all would work out once I got to Steve’s office.
Nervously, I walked back down “Pine Street” and into Steve’s office. I sat down next to Paul, the Sunday news editor and close friend who had mentored me since I was a sophomore in college, giving him a nod but avoiding direct eye contact. I readjusted my scratched-up wide-framed Annie Hall glasses, which a publicist friend once described as my own form of birth control because “no one will sleep with you with those on.”
We sat there in silence for a moment, as I tried to let myself be comforted by Paul’s familiar, larger-than-life presence. With his shock of prematurely white hair and his propensity to toss the word fuck around like a preposition, he is the essence of a throwback newsman and a brilliant editor.
He had given me a shot as a reporter during the summer of my sophomore year of college after a family friend introduced us. After a few years in which I worked as a runner, covering breaking news and feeding information to another reporter to write the piece, Paul offered me my first big assignment: an article on the debauchery at a New York University fraternity house. When I returned with a story and pictures of me playing beer pong, he was impressed with my chutzpah; even though the exposé never ran, he assigned me more stories until I had been hired on full time in 2008. Now, as I sat in Steve’s office wholly unprepared, I couldn’t help but feel like a work in progress, not worthy of Paul’s faith and respect.
The silence deepened until I looked up. Steve and Paul were staring at me expectantly, so I just started talking, hoping something would come. “I saw this story on a blog . . . ,” I said, desperately plucking up wisps of half-formed ideas.
“That’s really just not good enough,” Steve interrupted. “You need to be bringing in better stuff than this. Okay? Please don’t come in with nothing again.” Paul nodded, his face blazing red. For the first time since I’d started working on my high school newspaper, journalism disagreed with me. I left the meeting furious at myself and bewildered by my own ineptitude.
“You okay?” Angela asked as I returned to my desk.
“Yeah, you know, I’m just bad at my job. No big deal,” I joked grimly.
She laughed, revealing a few charmingly crooked incisor teeth. “Oh, come on, Susannah. What happened? Don’t take it seriously. You’re a pro.”
“Thanks, Ang,” I said, sipping my lukewarm coffee. “Things just aren’t going my way.”
I brooded over the day’s disasters that evening as I walked west from the News Corp. building on Sixth Avenue, through the tourist clusterfuck that is Times Square, toward my apartment in Hell’s Kitchen. As if purposely living the cliché of a New York writer, I rented a cramped one-room studio, where I slept on a pullout sofa. The apartment, eerily quiet, overlooked the courtyard of several tenements, and I often awoke not to police sirens and grumbling garbage trucks but to the sound of a neighbor playing the accordion on his balcony.
Still obsessed with my bites, despite the exterminator’s assurance that I had nothing to worry about, I prepared for him to spray the place and spent that night discarding things that could be harboring bedbugs. Into the garbage went my beloved Post clips, hundreds of articles reminding me of how bizarre my job is: the victims and suspects, dangerous slums, prisons and hospitals, twelve-hour shifts spent shivering inside photographers’ cars waiting to photograph—or “pop”—celebrities. I had always loved every minute of it. So why was I suddenly so terrible at it?
As I shoved these treasures into the trash bags, I paused on a few headlines, among them the biggest story of my career to date: the time I managed to land an exclusive jailhouse interview with child kidnapper Michael Devlin. The national media were hot on the story, and I was only a senior at Washington University in St. Louis, yet Devlin spoke to me twice. But the story didn’t end there. His lawyers went nuts after the article ran, launching a smear campaign against the Post and calling for a judicial gag order, while the local and national media began debating my methods on live TV and questioning the ethics of jailhouse interviews and tabloids in general. Paul fielded several tearful phone calls from me during that time, which bound us together, and in the end, both the paper and my editors stood by me. Though the experience had rattled me, it also whetted my appetite, and from then on, I became the resident “jailhouser.” Devlin was eventually sentenced to three consecutive lifetimes in prison.
Then there was the butt implant story, “Rear and Present Danger,” a headline that still makes me laugh. I had to go undercover as a stripper looking for cheap butt enhancements from a woman who was illegally dispensing them out of a midtown hotel room. As I stood there with my pants around my ankles, I tried not to be insulted when she announced that she would need “a thousand dollars per cheek,” twice the amount she charged the woman who had come forward to the Post.
Journalism was thrilling; I had always loved living a reality that was more fabulist than fiction, though little did I know that my life was about to become so bizarre as to be worthy of coverage in my own beloved tabloid.
Even though the memory made me smile, I added this clip to the growing trash pile—“where it belongs,” I scoffed, despite the fact that those crazy stories had meant the world to me. Though it felt necessary at the moment, this callous throwing away of years’ worth of work was completely out of character for me. I was a nostalgic pack rat, who held on to poems that I had written in fourth grade and twenty-some-odd diaries that dated back to junior high. Though there didn’t seem to be much of a connection among my bedbug scare, my forgetfulness at work, and my sudden instinct to purge my files, what I didn’t know then is that bug obsession can be a sign of psychosis. It’s a little-known problem, since those suffering from parasitosis, or Ekbom syndrome, as it’s called, are most likely to consult exterminators or dermatologists for their imaginary infestations instead of mental health professionals, and as a result they frequently go undiagnosed. My problem, it turns out, was far vaster than an itchy forearm and a forgotten meeting.
After hours of packing everything away to ensure a bedbug-free zone, I still didn’t feel any better. As I knelt by the black garbage bags, I was hit with a terrible ache in the pit of my stomach—that kind of free-floating dread that accompanies heartbreak or death. When I got to my feet, a sharp pain lanced my mind, like a white-hot flash of a migraine, though I had never suffered from one before. As I stumbled to the bathroom, my legs and body just wouldn’t react, and I felt as if I were slogging through quicksand. I must be getting the flu, I thought.
This might not have been the flu, though, the same way there may have been no bedbugs. But there likely was a pathogen of some sort that had invaded my body, a little germ that set everything in motion. Maybe it came from that businessman who had sneezed on me in the subway a few days before, releasing millions of virus particles onto the rest of us in that subway car? Or maybe it was in something I ate or something that slipped inside me through a tiny wound on my skin, maybe through one of those mysterious bug bites?
There my mind goes again.
The doctors don’t actually know how it began for me. What’s clear is that if that man had sneezed on you, you’d most likely just get a cold. For me, it flipped my universe upside down and very nearly sent me to an asylum for life.
Table of Contents
Author's Note ix
Part 1 Crazy
Chapter 1 Bedbug Blues 3
Chapter 2 The Girl in the Black Lace Bra 10
Chapter 3 Carota 13
Chapter 4 The Wrestler 20
Chapter 5 Cold Roses 24
Chapter 6 America's Most Wanted 27
Chapter 7 On the Road Again 31
Chapter 8 Out-of-Body Experience 40
Chapter 9 A Touch of Madness 43
Chapter 10 Mixed Episodes 51
Chapter 11 Keppra 54
Chapter 12 The Ruse 61
Chapter 13 Buddha 65
Chapter 14 Search and Seizure 70
Part 2 The Clock
Chapter 15 The Capgras Delusion 75
Chapter 16 Postictal Fury 80
Chapter 17 Multiple Personality Disorder 83
Chapter 18 Breaking News 86
Chapter 19 Big Man 91
Chapter 20 The Slope of the Line 95
Chapter 21 Death with Interruptions 100
Chapter 22 A Beautiful Mess 106
Chapter 23 Dr. Najjar 113
Chapter 24 IVIG 116
Chapter 25 Blue Devil Fit 121
Chapter 26 The Clock 127
Chapter 27 Brain Biopsy 135
Chapter 28 Shadowboxer 143
Chapter 29 Dalmau's Disease 146
Chapter 30 Rhubarb 152
Chapter 31 The Big Reveal 156
Chapter 32 90 Percent 161
Chapter 33 Homecoming 165
Chapter 34 California Dreamin' 169
Part 3 In Search of Lost Time
Chapter 35 The Videotape 175
Chapter 36 Stuffed Animals 176
Chapter 37 Wild at Heart 180
Chapter 38 Friends 184
Chapter 39 Within Normal Limits 189
Chapter 40 Umbrella 194
Chapter 41 Chronology 197
Chapter 42 Infinite Jest 202
Chapter 43 NDMA 207
Chapter 44 Partial Return 210
Chapter 45 The Five W's 214
Chapter 46 Grand Rounds 218
Chapter 47 The Exorcist 221
Chapter 48 Survivor's Guilt 229
Chapter 49 Hometown Boy Makes Good 236
Chapter 50 Ecstatic 238
Chapter 51 Flight Risk? 242
Chapter 52 Madame X 246
Chapter 53 The Purple Lady 249
What People are Saying About This
“Brain on Fire reads like a scientific thriller, but with a profound and moving philosophy at its heart.”
—David B. Agus, M.D., Professor of Medicine and Engineering, University of Southern California, and author of The End of Illness
“Engrossing. . . . Unquestionably, an important book on both a human and a medical level. Cahalan’s elegantly-written memoir of her dramatic descent into madness opens up discussion of the cutting-edge neuroscience behind a disease that may affect thousands of people around the world, and it offers powerful insight into the subjective workings of our minds.”
—Mehmet Oz, M.D., Professor and Vice Chair, Department of Surgery, New York Presbyterian-Columbia Medical Center
Reading Group Guide
This reading group guide for Brain on Fire includes an introduction, discussion questions, and ideas for enhancing your book club. The suggested questions are intended to help your reading group find new and interesting angles and topics for your discussion. We hope that these ideas will enrich your conversation and increase your enjoyment of the book.
One day, Susannah Cahalan woke up in a strange hospital room, strapped to her bed, under guard, and unable to move or speak. Her medical records—from a month-long hospital stay of which she had no memory—showed psychosis, violence, and dangerous instability. Yet, only weeks earlier she had been a healthy, ambitious twenty-four-year old, six months into her first serious relationship and a sparkling career as a cub reporter. Susannah’s astonishing memoir chronicles the swift path of her illness and the lucky, last-minute intervention led by one of the few doctors capable of saving her life. As weeks ticked by and Susannah moved inexplicably from violence to catatonia, $1 million worth of blood tests and brain scans revealed nothing. The exhausted doctors were ready to commit her to the psychiatric ward, in effect condemning her to a lifetime of institutions, or death, until Dr. Souhel Najjar—nicknamed Dr. House—joined her team. He asked Susannah to draw one simple sketch, which became key to diagnosing her with a newly discovered autoimmune disease in which her body was attacking her brain, an illness now thought to be the cause of “demonic possessions” throughout history.
Topics & Questions for Discussion
1. A quote from the philosopher Friedrich Nietzsche appears at both the beginning and end of Cahalan’s memoir: “The existence of forgetting has never been proved: we only know that some things do not come to our mind when we want them to.” Why do you think Cahalan chooses to recall this quotation at both the story’s start and end? How does it correspond to Cahalan’s tale and its major themes? In addition to the content of the quotation, why is it particularly poignant that the author would choose a quote by Nietzsche to bookend her work?
2. Evaluate and discuss the style and genre of Brain on Fire. Cahalan describes the book as a memoir, but she also says that it reportage. She acknowledges using help from other sources since she has little to no memory of many of the happenings recounted in the book. In the author’s note she goes so far as to describe herself as an “unreliable source.” How does this detail affect our experience of and response to her story? What does this indicate about truth and bias in storytelling? What complex issues does it raise in our understanding of works designated as nonfiction?
3. In the author’s note, Cahalan says that her book is “a journalist’s inquiry into that deepest part of self—personality, memory, identity.” What does her story reveal about these three subjects? How does her account challenge our preconceptions of these three subjects? Alternatively, how does her account confirm or bolster what we already know and believe about these three subjects?
4. Brain on Fire is divided into three parts and fifty-three chapters. Why is this structure meaningful and important? How does it correspond to some of the major subjects and themes of the book? How does this structure affect our comprehension of the work or our emotional experience of it as readers?
5. Consider and discuss the various reactions to Cahalan’s illness as chronicled in her book. Are the responses uniform or varied? Are they expected or unexpected? What about Cahalan’s own responses to her illness and what she endures? Consider the response she recalls having while she was suffering versus her response after her treatment and recovery. What does consideration of these responses reveal about our responses to the mysterious and the unknown?
6. Consider and discuss your own reactions as readers to what you encounter on the page—at the opening of the story and as the story continues to its conclusion. How did your thoughts, feelings, and opinions change throughout?
7. In Chapter 22 (p. 83), Cahalan refers to a quote by William F. Allman’s book Apprentices of Wonder: Inside the Neural Network Revolution: “The brain is a monstrous beautiful mess.” What does Allman mean by this? What does it reveal about the workings of the brain? How does this correspond to what we find revealed in Cahalan’s book?
8. The characters in Brain on Fire—friends, family, medical personnel, and even Cahalan herself—frequently consider if she may be suffering from some form of mental illness. What does the book reveal, then, about our way of thinking about mental illness? For instance, what does Cahalan’s story suggest about the relationship between psychology and neurology? What preconceptions does it reveal about our understanding of mental illness as a society? How does this story help to highlight the necessity of compassionate responses to those who are ill?
9. Cahalan incorporates many epigraphs, quotes, and references to famous figures—Nietzsche, Aristotle, Virginia Wolff, and many others—in her story. What may be the primary reason or reasons for these being included and why are they important?
10. Cahalan has titled her memoir Brain on Fire. What does this title mean and where does it come from?
11. Consider the role of faith in the story—not only religious faith, but also faith defined more broadly to include support for others, faith in one’s self (think not only of Cahalan’s story but of Dr. Najjar’s story), hope and resilience. What role does faith seem to play in success and recovery both for Cahalan and those around her?
12. What are some of the reasons that Cahalan may have chosen to share her story with the public? What lessons can we ultimately learn from her unique story?
Enhance Your Book Club
1. Write about an important experience or event in your own life. Consider how this event changed you as a person. How did others react or respond to this event? What can others learn from an account of your experience? Next, rewrite this story incorporating information from interviews of one or two people who witnessed this same event. How do the two accounts differ? How accurate is each version? Which is more believable? Does your memory of the event differ substantially from that of the subjects you interviewed? Use this exercise as a platform to initiate discussion about truth, memory, perspective, and point-of-view in literature.
2. Research and discuss other medical mysteries. You might consider sources such as Lisa Sanders’s Diagnosis column in The New York Times, which inspired the hit television show House. What do these stories have in common with Cahalan’s story? Consider and discuss your own experiences awaiting diagnosis and treatment of medical conditions. How did you and others around you react to this experience? How are these experiences like or unlike Cahalan’s experience? What can we learn by considering these experiences collectively?
3. Have a film night. You might screen episodes of the Discovery channel’s Mystery Diagnosis or the fictional drama House. What connections can you draw between these mysteries and Cahalan’s real-life medical mystery?
4. Read and discuss other works that challenge the mind-body connection. For instance, Malcolm’s Gladwell’s Blink: The Power of Thinking Without Thinking (Little, Brown, & Company, 2005) examines the brain’s ability to instantaneously interpret information. How do such works lead us to a better understanding of ourselves and our potential? What misconceptions do these works correct? What do you find reassuring about these works? Alternatively, how are these works challenging?
5. Consider Brain on Fire alongside other memoirs, comparing style, narration, structure, and other formal elements. How do the works compare and how do they differ? What issues related to truth and bias in memoir surface within these stories? What do we find most compelling about these memoirs? What do these works reveal about identity, experience, and self-reflection? In addition to what we learn about the subject of each memoir, what do these books allow us to realize about others and ourselves? What, then, does this reveal about memoir as a genre and about literature as a didactic tool?
Most Helpful Customer Reviews
This is a profoundly moving, true story of a young woman who, over the course of a few weeks, spirals into almost total madness. Her loved ones stay by her side throughout her month long hospitalization watching doctor after doctor doing test after test handing down diagnosis after diagnosis. When a doctor mentions a rare disease that may be the cause of the young woman’s illness, her parents are left to decide whether or not to allow a test that may cause permanent brain damage. Susannah Cahalan’s account of her life before, during and after her battle with mental illness is very well written and surprisingly readable. As she delves into the working of the human brain the reading becomes a little dry but by the next paragraph, the reader is once again swept up into a story that is consuming and compelling. I was extremely moved by this book and strongly recommend it.
This is a remarkable book. Author Susannah Cahalan is courageous as she shares her personal experience of “madness”. She brilliantly writes about her bizarre and confounding illness that stumped many neurologists and takes us through her and her family’s journey as they searched for answers to restore her health. This book is inspiring for people/families who have ever experienced a loved one who has been misdiagnosed or has experienced loss in brain functionality. I feel more informed and empowered by reading Cahalan’s true story. As a person who has had a loved one experience rapid loss of brain function, I highly recommend reading this book. I also recommend any books written by Ariel and Shya Kane. I found great comfort reading their book “Being Here: Modern Day Tales of Enlightenment” when my father had a stroke. I found answers how to best support him and my family during this period of our lives. I highly recommend reading Cahalan’s book and seeking out the Kanes to support well-being in your life.
Susannah Cahalan, a bright young reporter for the New York Post, a talented writer with a career full of promise, suddenly began losing her mind. One day she was doing brilliant research, and the next day she was too obsessive-compulsive about bed bugs to complete her assignment. Then she couldn’t concentrate, couldn’t track conversations, couldn’t compose a simple paragraph. All for no apparent reason. Day by day, hour by hour, reality slipped away as terror took over. Susannah doesn’t remember the trip to the hospital or being admitted, but what she knew for sure was that she didn’t belong there. The morning after a failed attempt to escape, she told the attending neurologist: “You need to let me out of here. I don’t belong here. They’re all saying bad things about me.” “Who’s talking to you?” “The people on the TV.” She also heard people’s thoughts, frightening thoughts about herself. Then she discerned that her parents set up the whole scene: the doctors, the nurses, all of it, in order to trick her into being forced into the medical center. It was all one giant conspiracy. In this candid and brave memoir, Brain on Fire: My Month of Madness, Susannah Cahalan reveals how it feels to be trapped inside a mind that’s playing tricks and in a body that won’t cooperate. It’s all here: the madness, the details about the team of medical experts who tried every possibility to help her, her family’s and boyfriend’s responses, and the reaction of lifelong friends and strangers. Her story is fascinating, horrifying, and most importantly, educational. We learn about the medical tests, the logic of the diagnostic hypotheses, and how the human brain works. We learn the questions the doctors struggled over, including the bet between two doctors as to what the correct diagnosis might be. It even includes original notes and drawings from her hospital stay. What was destroying Susannah’s mind? Was it bipolar disorder? Schizophrenia? Alcohol poisoning? Allergic reactions? Epilepsy? Demonic possession? No one knew and nothing they tried was working. In the meantime, she lost the ability to read and most of her speech. The one thing everyone agreed on is that something needed to be done fast in order to save Susannah’s life. This is more than a medical memoir; it is also a story of true and enduring love. Her mother and father, divorced and estranged, put aside their personal feelings to stay by their daughter’s side through it all. Her boyfriend, the one her father thought of as a “temporary place holder” showed his true heart and strength by his actions. This part of the story is also important, because it shows the tenacity of love and loyalty. My favorite part of the book is when her father gets down on his knees and prays for his daughter; and her mother, a Jewish skeptic, meets with a Baptist co-worker to join hands in prayer. Right after this, the family is led to a gifted specialist from Pennsylvania. A corner is turned, and in the end, Susannah Cahalan writes this amazing book. Near the conclusion, she writes that she makes a list of people to thank. I have to say, I hope God is on that list. Fantastic book. Highly recommended.
This book made me terrified of my own body. This can actually happen? Your brain can turn against itself and make you appear, for all intents and purposes, as completely off your rocker? It can happen. While reading Susannah's story you can easily imagine how this must have happened to others. And not to the lucky ones with access to healthcare and tenacious doctors. You have to wonder how many people were shut away, given up on, relegated to the attic. Brain on Fire is well written, thought provoking, educational and compelling. Read it. Jennifer @ The Relentless Reader
Im going to be short and sweet here. I loved this book, couldnt put it down, found it fascinating, well written, and engrossing. Highly recommended.
When I purchased this book I wasn't sure what I was going to find. I grew up with schizophrenia, bipolar and depression from within my family. I encounter stereotypes of these illnesses all too often. I have to admit that early on in the book as Susannah begins to exhibit schizophrenia-like symptoms I wasn't sure if I could continue reading it as I care for a loved one who suffers from schizophrenia, and dealing with the paranoia and delusions are very painful for family members. You can only watch them suffer and there's not much you can say that will change it, although you never stop trying. ~ Once Susannah's illness begins to evolve I became very interested in how this was going to turn out. This couldn't be easy for Susannah to write, but I applaud the fact that she did. Stigmas come from ignorance. And even though her illness was only schizophrenia-like in the beginning, it reminded me of the shame our family suffered every day trying to appear as if we didn't experience such a thing. I feel I was meant to share my experiences with others who are hurting and who also struggle. Painful experiences only hurt when we hold onto them and try to cover them up. Life begins when you can break free from the stereotypes and come to accept yourself/family member and experiences for what they are/were, limitations and all. ~ Thank you Susannah for not allowing embarrassment or shame to keep you from writing your very important and educational story. ~Kris
A well written book on a very interesting premise. Insightful, succinct and educative account of a crippling disease of the mind and the patience's odyssey back to normalcy. True to life and helpful stories like Susannah Cahalan's Brain on Fire: My Month of Madness, and other Janvier Chando's educative story The Grandmothers, help give us strength and hope in life.
This book has been a great help for me in a situation regarding a family member. My brother's behavior changed overnight and he was hospitalized with dizziness, confusion, and memory loss. Asking him how he was feeling was impossible, and the doctors were puzzled since his tests did not show any immediate problems (tumors, stroke, etc). The doctors began moving towards autoimmune encephalitis as the problem and suggested this book as an easy to read explanation of the syndrone. As I said, it has been a great help. I'd also recommend this book for anyone who wants to better understand how the brain works, how diagnoses are (aren't) made, and how, in some cases, encephalitis better fits the definition that we have given to autism.
Twenty four year old Susannah Cahalan is a reporter in New York city when she becomes convinced her apartment is invested with bed bugs. Then she is sure her boyfriend is cheating on her. Soon she's having seizures and descending into full blown psychosis. It's harder to say what's scarier -- Susannah's illness or the endless parade of clueless medical professionals. MDs are quick to provide a variety of diagnoses from DTs to Schizophrenia but no one has any real answers. It takes a real life Dr. House to classify Susannah's illness as anti-NMDA receptor encephalitis, a condition that could possibly be used to explain cases of demonic possession. People with this disease go THAT crazy. "Brain on Fire" is a riveting account of one woman's descent into madness and her long climb out of the pit. Highly recommended.
What an amazing story. This would be a great fiction story, but the fact that it’s true makes it all the more incredible. Susannah takes us on the journey she took as she fell ill to the mysterious illness. The book starts at the first sign that something is wrong and takes us through her time in the hospital, her diagnosis, treatment and the follow-up care and research. Even though she can’t remember anything from that time, she has pulled together doctor’s notes, videos and interviews to create a thorough timeline that makes the reader fell like they’re living through it with her. And it was scary. One minute she was an outgoing, confident young woman and the next she was a paranoid, delusional mess. It came on so suddenly and there were only a few signs that something was wrong before she ended up in the hospital. The tests and incorrect diagnoses she went through before they ever discovered her problem were immense and I’m impressed that her family didn’t give up on her. Their persistence is a testament of their love. Also? I think she might have the best real-life boyfriend ever. You know it’s going to end well (she did write the book, after all) but the writing is so immersive and intense, that you wonder how it will all work out. This could have had a very different outcome, and Susannah is very lucky that the right doctor found the right test at the right time. The last section of the book deals with the aftermath – how Susannah continues to be affected and the research and development that have gone into the disease since her diagnosis. That section wasn’t as intense as the earlier parts, but it was interesting. In fact, there are interesting facts and tidbits throughout the book, which were especially useful so we would know exactly how Susannah’s brain was misfiring. The narrator did a great job, she had the moods and affectations down perfectly. When combined with the fabulous writing, I really felt like I was there in Susannah’s head while she was going through this. The sum up: An intriguing story made even better by the tight writing. Susannah is a gifted writer and I’m amazed this is her first book. Don’t miss it.
Gripping story highlighting the breaking boundary between psychiatry and physical medicine. I read this in two days. I recommend this for those who liked My Stroke of Insight or even Girl Interrupted.
I found the chapters leading up to and during her hospital stay to be extremely interesting. The later chapters when she details her recovery period felt redundant. Overall an OK read.
The topic was interesting. The substance fizzled out. Good quick read and it was enlightening.
Cannot put this one down. Cruising through it in a few days and getting short on sleep. What a riveting story and thanks Sussanah for sharing it with us. Very intereresting condition and I just love when peopel are so open and sharing of their most personal feelings, fear and ove through adversity. Absolutely Inspiring. Please keep writing you have a gift.
What a wonderful read! I was very intrigued when reading about the book and was not let down at all! Susannah Cahalan did a wonderful job of telling her story and keeping me interested throughout the book!
Brain on Fire is simultaneously a book of mystery and discovery. Susannah’s casual hints towards the later reassembling of the details of her “lost month”, as well as the subtitle: My Month Of Madness, give the book an undertone of hope even as one reads about the confusion of doctors and the deterioration of her body and sanity. Cahalan’s deeply personal narrative is accessible to all readers, and I was surprised to find that her target audience seemed to be normal people who reside outside of the world of science. People like me. The appeal to regular individuals is because Susannah was just a normal girl until she started having seizures and psychotic episodes leading up to her hospital admission. The people surrounding her played a key role in her recovery alongside the doctors. Her father was a anchor of strength, constantly reminding her of the slope of the line. Likewise, her mom provided hope through enthusiasm for doctors and persistent pursuit of knowledge. I also have nothing but respect for Stephen, who remained committed to Susannah even at her worst. As her mind was crumbling and she was torn between breaking up with him or saying “I love you”, I silently cheered when she chose to cling to him outside that local pub in New Jersey. When she was rude to nurses and waitresses, drooling, or unable to speak, he was still there every night until she fell asleep. This inclusion of emotional details about her mother, father and Stephen, prevent the book from becoming a medical narrative, although I admire her ability explain medical terminology. She has a real talent for putting complicated rhetoric into comprehensible events that were happening to a young, normal girl. Being a young, normal girl myself, I was able to understand the concept of mental illness generated by a brain disease much better through Calahan’s writing. As a student of abnormal psychology, while I still believe mental illness can be caused by a combination of things (namely genetics, biological responses, and social experiences), this book is an affirmation of mental illness as a brain disease or biological response. Her unique point of view conveys gratitude. Her story is reflective of faith. Her father and mother both spend a great deal of time praying that there might be some higher power who would help their daughter recover and maybe use her situation to make a difference. I think they were right. Their prayers were answered by Dr. Najaar, the lifeblood of Susannah’s revival. Not only is he compassionate and kind, making every patient feel safe, but he’s a creative genius. He was able to piece together the mysterious symptoms of Susannah’s perceived craziness to discover via the clock test the inflammation of her brain’s right hemisphere. This book is unlike any I have read before. While a real story of someone’s life, it is wildly entertaining and unnerving as it unfolds its message: insanity as a outcome of happenstance in the brains of normal people. Susannah Calahan’s brain was attacked by her own immune system because she has anti-NMDA-receptor encephalitis. She was only the 217th person to be diagnosed with this disease. Though the author received a happy ending, the goal of her writing is to consider the many others who might’ve had this rare disease but instead lived out their days in a psychiatric ward. Like Dr. Najaar’s philosophy to never give up on people, Susannah’s return from her lost month serves as an example to continue to fight f
This book kept me emotionally drained.
This is a courageous book by a courageous author writing from her firsthand experiences. It reminds me of a similar book I have read recently, Enlightened or Mad?, by David Y. F. Ho, a psychologist and no less a courageous author, who bears his soul about his encounters with "madness". Both authors have a lot to teach the world by sharing their personal experiences with others.
The book “Brain on Fire” was a very marvelous read for me because it gives a somewhat of a mystery going on with the diagnosis she has and it shows her relationship with her parents coping with it. Also this book was very interesting to me because I want to become a doctor for the human brain in the near future and the book is practically all about the compilations of Susannah's brian. I strongly recommend everyone to read this book and it is worth every second that you read it. “Brain of Fire” gives a image of what is happening at this point of her life. Like how no one knew what was happening with her and how her family is coping with it. Susannah, she is the main character throughout the book she was perfectly fine going on with her life and then suddenly small symptomes started to come out of nowhere and she thought she had bed bug bites and would get really dizzy. After her symptomes would get such a bigger deal then that she started going to different doctors to see what is wrong with her. The big mystery about Susannah’s brain is throughout the whole book and it shows that doctors don’t know everything and even them can still learn new things even if they aren’t in medical school. She just thought she was really stressed until it got to the point she had to go to the doctor. When she finally went to the doctor they prescribed her with so many diagnosis and they were wrong. For example, in the beginning of the book page 83 it states “The mind is like a circuit of Christmas tree lights. When the brain works well, all of the lights twinkle brilliantly, and it's adaptable enough that, often, even if one bulb goes out, the rest will shine on.” * the diagnosis is a mystery and they don't know what to relate it to so they told them in a way they would understand it so they said “christmas tree lights” but this was false and you learn that when you finish the book. Now with the coping, the family dealt with it pretty well and she shares it within the book. For example on page 95 she says “..my dad had been spending much more time with me than usual. He was determined to support me as much as possible, but it was taking a toll on him; He had withdrawn from the rest of his life,....” This quote shows that Susannah’s dad wants to be with her throughout this whole craziness in her life, but that meant he wasn’t really involved with the world anymore because he was with her trying to understand what is wrong with Susannah all of a sudden. For the mom she states on 188 “”It’s so sad. She's so different. She's just completely lost her spark.”” and this means it shows that she's hurt that Susannah has changed her normal behavior and her mom wasn’t used to her acting like this. This quote also shows that before this Susannah had a spark so its showing her character if you really think about it and now she has completely changed. Finally towards the end of the book in the book she states “When Dr.Russo began to explain that there are treatments that have been proven to reverse the course of the disease, my father nearly sank to his knees and thanked God right there in the hospital room.” this quote really stood out to me because her dad was so grateful that her daughter is finally going to get treated and back to normal. If you really pay attention she doesn’t say things out in the clear throughout the book for example the quote i just provided she doesn't say “ we are religious” but after reading that you know they are because he thanks god and
This book is riveting. I gobbled it up in an evening. The author's undeniable journalistic talent makes it impossible to put down - the danger seems always around the corner and you can't contain your need to know why, why?? It's truly scary considering your integrity and your ability to make rational decisions could just degrade, with a snap of a finger - and the worst thing, you wouldn't quite know that it's even happening, because the functions that help you draw conclusions are not there anymore. This book puts it right out there - the fragility of our minds - of our selves. This is a rare condition, thankfully, but the fragility of self is a deeply existential question that will stir any of us inside. Susannah Cahalan was lucky to have been diagnosed right and not ended up in a ward as a vegetable, or worse. But how many people aren't? It's a wonderful thing that she did so much work in order to illuminate this condition and make it known, and of course, the same, and more can be said about the medical professionals who worked and continue working on this issue, its resolution and finding out more about why it comes up in the first place. This book explores the limits of what we know about where the biology stops and the mental realm begins - and how many of our mental problems might actually lie in the biology, in physicality? How much of us as personalities, as what we understand as soul, lies there? So many questions, most of them unanswered as of yet - but hopefully one day they will be.
A fascinating look into the intersection of neurology and psychology, and the difficulty of diagnostics. The first half of the book is compelling and insightful, told by an author who truly bares her soul in the interest of that story, and in order to help others. But I found that the second half became self indulgent and, at times, insulting, albeit unintentionally. The anger displayed by the author and her family when people assumed she was "slow" was odd and insulting, as if not being smart, witty, and clever is somehow shameful.
Fascinating true story about a woman with a rare disease. Seriously could not stop reading. Well written and keeps you wondering what happened next at each turn of the page. Highly recommend reading!
A very harrowing view into such a horrible disease
“The doctors don’t actually know how it began for me. What’s clear is that if that man sneezed on you, you’d most likely just get a cold. For me, it flipped my universe upside down and very nearly sent me to an asylum for life.” This book was so intense and shocking. It is so scary to me to think about how easy it is for a real medical diagnosis to be overlooked, to the degree that it could ruin a person’s life or lead to their death. The book itself is a very quick consumable read and tells the true story about a woman who suffers from a rare medical issue that presented itself much like a psychiatric disorder and her journey to getting help. I loved her reporters presentation to what happened to her, how she got other’s perspectives and presented information about the brain, and the histories of the various issues she faced. I give this book 4 stars.
I absolutely could not put this book down or shake it from my mind even when I wasn't reading... it was terrifying, fascinating and incredibly brave of Susannah to share her story in such excruciating detail. The only thing that kept me hopeful throughout was knowing the author had penned this herself, so she must have come out okay in the end. Gripping and inspiring read!