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Patient's gripping medical mystery about sanity

Hey there, time traveller!
This article was published 1/2/2013 (1661 days ago), so information in it may no longer be current.

IN the space of a few weeks, Susannah Cahalan went from being a sharp, funny, outgoing young reporter at the New York Post to a paranoid, delusional patient strapped to a hospital bed.

Spoiler alert: Cahalan recovers and writes the memoir Brain on Fire.

But it isn't whether or not she gets better that keeps you reading, it's how she gets better. Brain on Fire is a gripping medical mystery Cahalan is piecing together along with the reader.

Cahalan was 24 when she first started to lose her mind. She was convinced she had bed bugs, her boyfriend was cheating on her, and her dad was an imposter who killed her stepmom. The last thing she remembers was the moment before a seizure got her admitted to the hospital.

She does not remember the next month. So she uses her reporter skills to weed through frightening hospital-room surveillance video of a skinny, catatonic version of herself with rigid arms locked straight, journal entries from her terrified parents and hospital records detailing endless tests and treatments.

Cahalan weaves those emotional and medical pieces into a simple but powerful examination of how quickly our sense of who we are can vanish.

Cahalan has done her research. She breaks down the science in plain language and readers will learn a lot about how the brain works -- and what happens when it stops working.

A doctor who becomes a hero to Cahalan eventually has a "eureka" moment that is one of the highlights of the book. He cracks the mystery with a laughably low-tech test. He eventually diagnosis the author with a particular autoimmune disease.

Cahalan is only the 217th person in the world diagnosed with this disease. She is very clear in the book that she knows she is lucky. Not only was she in the right hospital at the right time, she also had the insurance to cover the $1 million it took to cure her.

Cahalan is haunted by the thousands of others she worries may have this disease, but are misdiagnosed as having a range of conditions from autism to schizophrenia. For some, the symptoms are straight out of The Exorcist. Children with the disease have been documented speaking in garbled voices with strange accents, contorting their bodies in violent convulsions, even crab-walking backwards across the floor.

She is also haunted by what she lost in her month of madness. After her diagnosis and treatment, the book shifts to her recovery, both physical and mental.

"I had enough distance from my own madness to view it as a hypothetical. But watching myself on screen, up close and personal, obliterated that journalistic distance. The girl in the (hospital surveillance) video is a reminder how fragile our hold on sanity and health is and how much we are at the utter whim of our Brutus bodies, which will inevitably, one day, turn on us for good. I am a prisoner, as we all are. And with that realization comes an aching sense of vulnerability."

Her focus on the weight she gained, the bald spot where doctors cut open her skull, her embarrassment at running into an ex-boyfriend while swollen from steroids and still incapable of stringing together a coherent sentence may be shallow, but it is heartbreakingly real.

Cahalan has not written a truly profound or philosophical look at what it means to lose -- and recover -- your sanity. Instead she offers a very real and intimate look at her own personal journey.


Joanne Kelly teaches journalism at Red River College. To find out more about her book club at McNally Robinson, email her at


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Updated on Saturday, February 2, 2013 at 3:50 PM CST: adds fact box

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