We don’t appreciate what we can do until we can’t do it anymore. We don’t value what we have until it disappears. In BRAIN ON FIRE, Susannah Cahalan tells us her story, which will guarantee that she never takes anything for granted again. It’s the story of her descent into a terrifying abyss of what looked and felt like madness: seizures, outbursts, erratic behavior, hospitalization, misdiagnoses and, ultimately, a memory-free month that she can never get back.
"The brain being what it is, it’s a challenge to present enough neurological information to understand how this disease attacks without overwhelming the reader, and Susannah succeeds. It seems clear that, with BRAIN ON FIRE, she truly wants to educate as well as entertain. Her gratitude at surviving and journalistic skills combine to create a fascinating read."
It started with a bedbug bite in her midtown New York City apartment. Susannah was living her dream: working as a journalist for the New York Post and dating a promising guy named Stephen. She had a couple of bites on her arm and became convinced she had bedbugs --- not an unreasonable fear in the city. But when the exterminator came and found no evidence, she insisted he exterminate anyway. At work, her normally punctual habits slipped, and she worried that her co-workers were talking about her. She stopped sleeping, and food she normally liked disgusted her.
Susannah went to a doctor, who diagnosed her with mono, and another doctor, who told her she drank too much. She missed deadlines and interviews. She started hearing her co-workers talking about her. When her father came to her apartment and saw the bags of trash piling up, he began to worry. Then came her first seizure. “My arms suddenly whipped straight out in front of me, like a mummy, as my eyes rolled back and my body stiffened. I was gasping for air. My body continued to stiffen as I inhaled repeatedly, with no exhale. Blood and foam began to spurt out of my mouth through clenched teeth.”
At this point, Susannah was hospitalized at NYU, and thus began a more serious quest for an accurate diagnosis. Because she was a flight risk and subject to seizures, she was under video surveillance. These videos and the accounts of her parents and boyfriend are the only sort of memory she has of this period. We meet the doctors who take on the challenge of helping her, and finally a Dr. Najjar, who made the connection with a newly discovered disease called NMDA autoimmune encephalitis. A brain biopsy confirmed his suspicions, making Susannah the 217th person worldwide to receive this diagnosis. “It just begged the question. If it took so long for one of the best hospitals in the world to get to this step, how many other people were going untreated, diagnosed with a mental illness or condemned to a life in a nursing home or psychiatric ward?”
A long period of treatment and recovery followed, and as Susannah returned to her normal outgoing, positive self, she became more curious about the disease that had plagued her. Finally able to return to work, the Post asked her to write an article about her experience. Now, with this well-organized, compelling book, she has taken us along on her journey to understand her past. The brain being what it is, it’s a challenge to present enough neurological information to understand how this disease attacks without overwhelming the reader, and Susannah succeeds. It seems clear that, with BRAIN ON FIRE, she truly wants to educate as well as entertain. Her gratitude at surviving and journalistic skills combine to create a fascinating read.
Reviewed by Eileen Zimmerman Nicol on November 16, 2012