Brain on Fire: My Month of Madness by Susannah Cahalan
This is an autobiography of a young woman who had a psychotic episode that was caused by an extremely rare disorder of the brain. Susannah Cahalan was a young, dynamic, outgoing and talkative journalist for the New York Post who suddenly started experiencing hallucinations, seizures and disordered movements. She deteriorated to the point of catatonia, and was then fortunate enough to have been referred to a neurologist who was essentially her savior.
What is fascinating about this autobiography is that since the author was unable to think in any logical or functional way during the acute period of her illness, she pieced together her experience through interviews with and journals by her family, boyfriend and physicians. She creates a smooth story from this research and tells the story as if she did remember it herself, always reminding the reader that this is what she was told occurred. Some of her hallucinations are told first hand, however, because in her mind, these images were what was real.
Of course being a physician, this case is extremely interesting, but I think anyone could appreciate how interesting her course was. In addition, it gives the reader an insight into how rare medical conditions can masquerade as usual ones and that diagnosis and treatment of medical problems can sometimes be extremely challenging. While physicians are trained to recognize and treat the more common medical conditions, they are also trained to recognize that when symptoms and signs don’t add up, one has to delve deeper into the medical literature and look for what we refer to as the “zebras” of medicine. (The saying is that when you hear hooves you should think horses not zebras. Unfortunately, there are zebras out there as well.)
As Cahalan says, also, she was uniquely fortunate to have both the emotional support of her family and boyfriend (who stayed true to her through the whole ordeal and after) as well as financial support. This enabled her to not only get through this very difficult time but also to access the medical treatment she required. It is touching to read about how each of the family members dealt with her illness and stood by her side even while she was unrecognizable, both physically and emotionally.
It’s a tough book to read but very interesting…