I have wanted to read Susannah Cahalan’s memoir Brain on Fire: My Month of Madness for such a long time, but have struggled to get my hands on a copy. Thankfully it was added to my online library app, and I was able to borrow it straight away. Unusually in this case, I actually watched the film before picking up the book, and thankfully found a memoir which has so much depth in both formats.
Brain on Fire is described as ‘the powerful account of one woman’s struggle to recapture 
her identity’. As a twenty four-year-old, Cahalan was establishing herself as a journalist in New York City, living in a studio apartment by herself, and working at the New York Post. After having a series of strange symptoms for a number of weeks – the certainty that there were bedbugs in her apartment which were biting her, a sudden out of character jealousy which causes her to check her boyfriend’s emails, migraines, numbness in various parts of her body, and paranoia – she wakes alone in a hospital room, ‘strapped to her bed and unable to speak’, and with no memory of how she came to be there. This previously astute and independent woman was labelled ‘violent, psychotic, a flight risk.’
Cahalan has vivid and terrifying hallucinations, and violent moodswings. She loses her appetite, she forgets how to read, and she loses her ability to speak. When she is first admitted to hospital, Cahalan writes: ‘This new me was physically different: skinny and pale, cheeks sunken in, and thighs whittled down to toothpicks. My eyes were glazed over… it was hard to maintain a conversation because I operated on a delay, responding to basic questions several seconds after they were posed.’
Cahalan spent weeks visiting different medical experts, with both her family and her boyfriend, in order to get to the bottom of her illness. All of her tests and vital signs came back as normal, but her family pushed for answers. Although she does eventually get an answer, many of the doctors whom she sought help from tried to convince her that her illness was all in her head, and originated only from a psychological source. Cahalan believes that her illness may have been caused by a pathogen ‘that had invaded my body, a little germ that set everything in motion.’ She comments: ‘I would learn firsthand that this kind of illness often ebbs and flows, leaving the sufferer convinced that the worst is over, even when it’s only retreating for a moment…’.
Cahalan’s experiences are harrowing, and rather troubling to read about. Her first seizure ‘marked the line between sanity and insanity. Though I would have moments of lucidity over the coming weeks, I would never again be the same person. This was the start of the dark period of my illness, as I began an existence in purgatory between the real world and a cloudy, fictitious realm made up of hallucinations and paranoia.’ She forgets huge chunks of time, and moves through various misdiagnoses, some of which are rather traumatic.
Along with her own experiences, Cahalan has woven in those of her divorced mother and father and their new partners, her boyfriend Stephen, and her brother, who was away at college and largely kept in the dark about her illness. Cahalan also includes portions of the stream-of-consciousness journal which she kept whilst in hospital, and which in retrospect she does not recognise herself within. Some of her patient notes also feature in Brain on Fire. This, alongside her narrative, demonstrate how erratic her behaviour so quickly became, and the way in which she had no control whatsoever over her body.
Throughout, Cahalan is open and honest about all of her experiences, many of which must have been highly traumatic to recount. The terror of her condition within Brain on Fire is almost tangible. Of course, with a memoir or illness narrative dealing with such a strange and debilitating disease, parts of the book are rather difficult to read. However, Cahalan charts her incredibly hard and harrowing journey, in a thoughtful and fascinating manner. There is so much depth to Cahalan’s narrative, both scientifically and emotionally, and it feels like a privilege to finally be able to read Brain on Fire.
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