Brain on Fire: My Month of Madness
By Susannah Cahalan
Reviewed by Judy Garrison
One day the 24-year-old New York Post reporter is an accomplished, hard working, witty and attractive journalist with a great boyfriend. She calls an exterminator when she attributes the red dots on her arm to bedbugs, a citywide scare at the time. But there are no bugs in her Jersey City apartment. In the seeming blink of an eye she becomes – to all appearances – jumpy, mean, paranoid, full of grandiose pronouncements. She recounts her migraine headaches, sleeplessness, loss of normal appetite and feelings of existential dread to a prominent neurosurgeon. He pronounces the cause of her symptoms as too much partying.
Then weird facial and body tics manifest; she develops “blood and foam” seizures, becomes spacey, inarticulate, mentally slow, disheveled, not her former self at all. Still the provisional diagnosis is too much alcohol.
Once hospitalized, all her tests are normal, though she clearly isn’t. The wonderful Dr.Najja arrives at a diagnosis after a surprisingly simple test, more or less at the 11th hour, a diagnosis which explains how this newly documented autoimmune disorder causes the receptors in the brain vital to learning, memory and behavior to shut down. He institutes a 3-pronged approach to tamping down the inflammation in her brain, and her condition, which was heading toward death, begins to improve. Still, she has to deal with a slow return to her former self. Forays into her old social milieu, where she is perceived as clearly not mentally or physically quite “normal,” and now overweight to boot, demand a different kind of courage. Her loyal boyfriend keeps the faith that the old Susannah is “in there” somewhere. Her divorced parents have rallied round her throughout.
Susannah Cahalan tells a very personal story with deep feeling and honesty. We may have wanted a little more probing into what, indeed, constitutes the personality amidst all this dramatic alteration of behavior and perception, but she isn’t one prone to philosophizing. What she does extremely well is to use her journalistic writing skills to tell a mesmerizing story and her journalistic research skills to amass, consolidate and weave together multiple resources in order to fill in what happened during her “lost month” from which she can retrieve only flashes of memory. She investigates the contents of medical and psychological records, surveillance videos, her father’s poignant journal, her own spotty notes, and interviews with the people in her life, a loyal boyfriend, devoted family, friends, and colleagues, to reconstruct that time lost to her. In addition, she provides the reader with a well-researched account of the neurology of the brain, her brain in the throes of this meningitis-like autoimmune condition, in particular. What a stunning revelation it is to discover that this condition bears a strong resemblance to the symptom cluster that through the centuries was labeled demonic possession and treated with exorcism! ~