Published on July 29th, 2014 | by MacKenzie Warner


Brain on Fire: My Month of Madness – Susannah Cahalan

Brain on Fire: My Month of Madness is a harrowing true tale of one woman’s peek over the edge of madness through her psychological misdiagnosis.


In high school or University, you probably read Charlotte Perkins Gilman’s story, ‘The Yellow Wallpaper.’ If you have not, make use of your local library or the Internet right now. It is well worth your while to read it. Without giving away too much detail, the story portrays a woman who becomes increasingly paranoid and mentally ill while being treated by her physician husband.  Some have argued that it’s actually a ghost story, but I think that’s hogwash. Gilman herself suffered from severe depression and vehemently opposed the sexist and oppressive “bed rest” methods after her own personal experience. In fact, she’s quoted as saying, “I came so near the border line of utter mental ruin that I could see over.” The horror of knowing you’re at the edge of madness must be terrifying. But what if you did fall into it head first without warning? That’s what Susannah Cahalan answers in her memoir, Brain on Fire: My Month of Madness.

In 2009, Susannah Cahalan was a young and successful journalist at the New York Post. That all changed when she woke up strapped down in a hospital bed and labelled as a “flight risk” one spring morning. Up until this point, she had lived a normal life with no history of mental illness. Now, she was paranoid, hallucinating, and suffering massive seizures. Blood tests, MRIs, and cognitive therapy could not identify any physiological explanations for her behaviour or symptoms. She was wrongly diagnosed as possibly bipolar and schizophrenic. One physician even accused her of exhaustion from “too much partying.” Cahalan herself thought she was suffering a mental breakdown. Nothing else could explain her mood swings, paranoia, uncontrollable emotions, and loss of appetite.

However, after Cahalan suffered a series of seizures, she was admitted to the hospital for observation. There, she was monitored around the clock by cameras, nurses, and specialists. Still, her health deteriorated so badly that she lost the ability to easily speak, write, and walk. Her situation seemed hopeless until a neurologist tried a simple test on Cahalan. He asked her to draw a clock. After she was finished, her drawing revealed that the right side of her brain was not functioning properly. She had drawn all the numbers to one side of the clock. It was then that her neurologist, Dr. Najjar, was able to properly diagnose Susannah Cahalan with a rare auto-immune disease called Anti-NMDA receptor encephalitis. This disease was attacking the neurons in the right side of her brain.

Fast forward to 2012, a very lucky and recovered Cahalan releases her memoir, Brain on Fire. The combination of her journalism background and the survival of her illness is what makes Brain on Fire so good. Since the memories of her ordeal are shaky at best, Cahalan turned to video footage, diaries, interviews, and accounts from her friends, boyfriend, and family for reference. She treated her month of madness the same as she would any assignment from the New York Post: with tenacity and vigorous research. Still, her words are not devoid of emotion and reflection. She writes about her embarrassing, sometimes hurtful, thoughts and feelings. She discusses the frustration of not knowing her illness before diagnosis. She recognizes the emotional and physical toll it takes on her loved ones.

Brain on Fire is interesting because it’s a record of someone slipping into a scary world of mental and physical anguish and coming out the other end alive and well. As it turned out, Cahalan’s disease was not related to a psychological illness even though her symptoms suggested otherwise. It makes you wonder how many patients in care homes or institutions have been wrongly diagnosed in the past. Cahalan admits that without her seizures, she would have surely been diagnosed with bipolar disorder or schizophrenia. That idea alone is terrifying. Imagine knowing you’re not crazy but everyone else thinking you are nuts. It’s truly the stuff that nightmares are made of.

Brain on Fire is dedicated to those without a diagnosis. It’s clear that Cahalan’s memoir wants to be a source of encouragement for those people. More importantly, it’s a document outlining the horrible physical and mental effects of Cahalan’s illness. It nearly cost the author her life, had it not been for the talent and expertise of her neurologist, Dr. Najjar. How close she came to being lost forever is not exactly known but after reading her book, it appears that she was close. Having her account means that doctors, researchers, and patients can realize there is so much more we don’t know about the human body, so much more that needs to be explored. That’s also a scary thought but I think there’s an important lesson in there. No matter how advanced our civilization gets; no matter how many drugs we create; no matter how sophisticated we become, we are always at the mercy of our bodies.

Maybe that’s a bleak note to take away from Brain on Fire but I find it comforting in a way. We’re all connected by our basic instinct to survive and when it’s threatened, we really understand what it means to be just another organism on this planet. If we are lucky enough to pull through, like Cahalan, it makes living that much more vivid, exciting, and sacred. If you have a vague interest in psychology, medicine, or just need a good summer read, Brain on Fire might be just what the doctor ordered. Pun intended.

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About the Author

spends her time writing, drawing, or, more likely, watching movies (when she’s not asking friends and strangers inappropriate questions).

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