Friday, June 7, 2013

Nonfiction: Brain on Fire by Susannah Cahalan

I'm fairly certain this book caught my attention thanks to Goodreads and Pinterest. Plus, the title was just too good to pass up. No way I could read the title Brain on Fire: My Month of Madness and not want to at least read the scenario. Add to it the fact that Susannah Cahalan actually went through this ordeal in 2009, just four short years ago, and my curiosity continued to grow.

The Situation: Cahalan is a young reporter for the New York Post, living in a studio apartment in Hell's Kitchen, just trying to make her own way through life just like any other recent college graduate. She likes her job and has actually been working at The Post since high school when she had an internship there. She has a serious boyfriend, Stephen, who has even met her parents, and all of her friends and family would describe Susannah as outgoing and talkative. The story opens during a bedbug scare in New York City, and despite the exterminators assurances that it isn't necessary, Cahalan insists that her apartment be fumigated just in case.

The Problem: Cahalan has absolutely no idea that her sudden preoccupation with bedbugs and her belief that she has bedbug bites on her left arm, is the first in a string of symptoms that will quickly magnify in intensity and lead to her hospitalization for an unknown disease. Other symptoms will soon include erratic and psychotic behavior, seizures, "zombie-like" movements, paranoia, being convinced that the TV is speaking to her, and other behaviors that are often linked to both schizophrenia and bipolar disorder. But perhaps the real problem is that Cahalan doesn't seem to be either bipolar or schizophrenic, and if doctors don't find out what is wrong with her soon, she may never return to her normal self, or even worse, she may die. As the mysterious disease progresses, it slowly takes over Cahalan's body, limiting her strength, movements, and ability to speak. It is a true medical mystery as expert after expert conducts various tests in the desperate attempt to save her life. The "month of madness" refers to a 28-day period that Cahalan spent at the hospital. She remembers being admitted, but everything after that is blank, and the little bits that do manage to come through are short and confusing.

Genre, Themes, History: This is a nonfiction book that reads like an episode of House. The disease takes over quickly as frustrated doctors and specialist try to figure out what is happening, while grief-stricken family and friends can do little more than watch and pray. Things would almost be easier if Cahalan did have a mental illness, but the physical symptoms point to something much more serious. When Cahalan is finally successfully diagnosed, the disease she is said to have isn't that well-known, and not much research has been done on it because not that many cases have been pinned down. Now, largely due to Cahalan's story, many cases have been identified and it is possible that there have been, and still are, quite a few that were misdiagnosed as a mental illness. Cahalan was surrounded by people - doctors, family, friends, and colleagues at work - that refused to give up on her, even when things were at their most desperate. And while telling her story, Cahalan also explains the science behind what is happening to her in a way that informs and even holds the attention of even the most science-challenged person. A major theme throughout the entire account is that of memory, since Cahalan had to piece together a good amount of her story from accounts she got from her family, friends, and doctors. She also relied on videotapes from her stay at the hospital, and a few notes that she was able to take herself. In other words, she had to investigate a significant part of her own life.

My Verdict: This is a fascinating and well-written story. What makes it even more impressive is that it is a true story, and the author actually lived these events. Add to that the fact that Cahalan doesn't even remember probably the most significant part of the story due to the damage to her brain, and the whole account is, quite literally, mind blowing. As I said before, Cahalan had to investigate her own life, since she couldn't rely on her own memories. Cahalan begins the story at a point she believes everything started, but she is only able to continue up until the moment she is admitted to the hospital at NYU, as she hasn't been able to clearly remember the 28 days that followed. She is able to use her journalism skills to dig into her own past and write up an account of what happened, even though her true self was pretty absent through a good chunk of it. Cahalan includes notes she wrote herself, notes from doctors, picture, diagrams, and even descriptions of some of the video footage from her time at the hospital. Even as someone who isn't all that interested in neurobiology, I found the entire account incredibly fascinating, even after she is successfully diagnosed and we know what it will take to make her better.

Favorite Moment: "Favorite" is not really the word I would use for this moment, but it is definitely the part that struck me the most. As the disease progresses, Cahalan loses the ability to do certain things that everyone mostly takes for granted. There is a moment when she admits to no longer being able to read due to the amount of concentration it takes, and that is something I just cannot even imagine.

Recommended Reading: It was difficult for me to come up with a book to recommend since I don't think I have ever read a book quite like this before, so I will go with Coming of Age on Zoloft by Katherine Sharpe. This book also deals with the issue of misdiagnosis of mental diseases and the problems that can arise from that. However, I don't believe Sharpe was ever in the same kind of danger Cahalan was, and her discussion has more to do with antidepressants than mysterious illnesses.

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