Brain on Fire- Susannah Cahalan

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A month of being somebody else. A month of confusion. A month of paranoia.

It might sound like the premise for a murder mystery involving stolen identity, however when renowned journalist, Cahalan, was overtaken with a mysterious illness, that is precisely what ensued. It started with seizures, rapidly, suddenly, then strange fleeting moments of outer-body experiences, thrilling highs and bursts of tears. Nobody understood what was going on. For the rest of her life, Cahalan was an ordinary person. Throughout the onset of her symptoms, she was diagnosed with everything from excessive alcohol consumption to bipolar disorder. The severity of these symptoms soon rose though, and she was confined to a hospital for a month, leaver her with only the vaguest of memories from that time: videos revealed her psychotic nature, doctors reports highlighting her inadequacy at even speaking. This breathtaking book takes  us through Cahalan’s shocking journey, revealing every aspect from her family’s grit and support, to the doctor who saved her life when many had abandoned her.

The style and fluency of this is outstanding. The way Cahalan illustrates the finer details is truly absorbing, with the balance between detail and factuality struck ideally. Of course, this shouldn’t be too much of a surprise as she is a journalist, but still you shouldn’t take eloquence for granted.

I am avid fan of neurology books, as frequent readers may have ascertained, and this book pleased me thoroughly. Due to the nature of Cahalan’s illness, it was unusually troublesome to pinpoint, so to read about all the various tests she had to take, such as memory recall (and how that deteriorated to an overwhelming extent) and the extract of spinal fluid both interested me. Can you believe, for example, that when Cahalan was asked to draw an ordinary clock, she drew this:

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People should read this book. Not because they might care about the science or even the tale of survival of a bright young woman. After all, in my opinion there was a distinctive lack of in-depth scientific knowledge- it would have been more interesting if there could have been a little more knowledge relating to her condition. No, people should read it because it will crush their complacency. Today we live in a push button society- you already know this. Change your appearance? Trip to the plastic surgeons and you’ll be fine. Change country, climate, job, life. All possible. What cannot be manipulated to such an extent is your health: there are still a lot of things that scientists and doctors simply do not know. There a thousands of illnesses with no cure. Some people claim bizarre diets work for them, others religion. But the truth of the matter is that for most people, once that disease is contracted there is nothing to be done; as a species we have much further to go before we can be satisfied with ourselves medically. We must never forget it might be us next- nobody grew up expecting to be that person falling ill.

This concept is conveyed expertly: multiple doctors gave her wildly inaccurate diagnoses. Many refused to treat her or gave up. One such thrilling element in the book are the red herrings, the missed clues and painstaking search to find a name for her condition, to identify it.

One notable issue is that there is no baseline character, so that when Cahalan does descend into a psychotic state, although things are clearly not as they ought to be, we don’t have a clear cut idea of the behavioural changes that been undertaken. Also, Cahalan has quite a forceful character, with this showing prominently in her writing and the episodes she describes. If you don’t enjoy people with that behavioural trait, it will make reading this slightly tougher as you lose a large proportion of the sympathy you would have had for her.

Generally, a great insight into a rare illness (Dalmau’s disease), that reveals that our brains are much more complex than anyone can fully comprehend.

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