Memoir Review: “Brain on Fire”

Cahalan, Susannah. Brain on Fire: My Month of Madness
Free Press, 2012
ISBN 978–1–4516–2137–2

Highly Recommended

One day in 2009 Susannah Cahalan woke up in a hospital room, strapped to her bed, unable to speak, move, or remember how she got there. As she stared at an orange band around her wrist, the words FLIGHT RISK came into focus.

Cahalan’s journey to that hospital room had begun weeks earlier. Out of nowhere she began having paranoid thoughts; for example, with no evidence she suddenly believed that her boyfriend was cheating on her, and the voice in her head nearly overpowered her: Read his e-mails. The paranoia was rapidly followed by other symptoms: slurred speech, over-reaction to colors and sounds, nausea, insomnia, wild mood swings, uncontrollable crying, lack of focus, inability to write, facial tics, drooling, involuntary muscle movements, and seizures.

Physical examinations and extensive medical tests revealed no discernible cause for her symptoms. Various doctors prescribed anti-anxiety and anti-seizure medications and used phrases ranging from all in her head to psychotic break as Calahan’s family and friends watched her condition continue to worsen. Finally, a new neurologist, Dr. Souhel Najjar, joined the medical team and did one more medical test that saved her life. Dr. Najjar tested Cahalan for a newly discovered, rare autoimmune disease that causes the body to react against the brain. The disease causes inflammation that Dr. Nijjar explained this way: “Her brain is on fire.”

This book differs from most memoirs in that Cahalan has almost no memories of what happened to her during the period she writes about. Her father, who spent most days in her hospital room, kept a personal diary of the ordeal (hers and his own). In addition, her father and mother left a notebook in her room in which both documented what had gone on during their visits; the purpose of this notebook was to keep both parents informed about their daughter’s condition. Cahalan used these two documents, her medical records, and interviews with family, friends, work colleagues, and medical personnel as the basis for the book. Her journalism background enabled her to do the extensive research necessary to supplement those sources.

Despite the absence of her own memories, Cahalan maintains the focus on personal experience that’s necessary in memoir. When she can’t focus on her own experiences, she frames the story with the experiences of the people close to her: her parents, her boyfriend, her friends, and her colleagues at the New York Post.

Cahalan excels at describing complex, arcane medical material for a general reader. Here, for example, is her description of how memory works:

My short-term memory had been obliterated, a problem usually rooted in the hippocampus, which is like a way station for new memories. The hippocampus briefly “stores” the patterns of neurons that make up a memory before passing them along to the parts of the brain responsible for preserving them long term. Memories are maintained by the areas of the brain responsible for the initial perception: a visual memory is saved by the visual cortex in the occipital lobe, an auditory memory by the auditory cortex of the temporal love, and so forth. (p. 101)

After Cahalan was successfully treated for her brain inflammation, there remained questions about how much of her former self, particularly her mental faculties, would return. This book, with its extensive research and clear writing, demonstrates that her brain is now back to functioning quite well.

Brain on Fire has been made into a movie that will come out on February 22, 2017. You can find information about the film, including a link to the official trailer, here.

© 2017 by Mary Daniels Brown

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