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Brain on Fire: My Month of Madness [Hardcover]

Susannah Cahalan
4.5 out of 5 stars  See all reviews (841 customer reviews)

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Book Description

November 13, 2012
One day in 2009, twenty-four-year-old Susannah Cahalan woke up alone in a strange hospital room, strapped to her bed, under guard, and unable to move or speak. A wristband marked her as a “flight risk,” and her medical records—chronicling a month-long hospital stay of which she had no memory at all—showed hallucinations, violence, and dangerous instability. Only weeks earlier, Susannah had been on the threshold of a new, adult life: a healthy, ambitious college grad a few months into her first serious relationship and a promising career as a cub reporter at a major New York newspaper. Who was the stranger who had taken over her body? What was happening to her mind?

In this swift and breathtaking narrative, Susannah tells the astonishing true story of her inexplicable descent into madness and the brilliant, lifesaving diagnosis that nearly didn’t happen. A team of doctors would spend a month—and more than a million dollars—trying desperately to pin down a medical explanation for what had gone wrong. Meanwhile, as the days passed and her family, boyfriend, and friends helplessly stood watch by her bed, she began to move inexorably through psychosis into catatonia and, ultimately, toward death. Yet even as this period nearly tore her family apart, it offered an extraordinary testament to their faith in Susannah and their refusal to let her go.

Then, at the last minute, celebrated neurologist Souhel Najjar joined her team and, with the help of a lucky, ingenious test, saved her life. He recognized the symptoms of a newly discovered autoimmune disorder in which the body attacks the brain, a disease now thought to be tied to both schizophrenia and autism, and perhaps the root of “demonic possessions” throughout history.

Far more than simply a riveting read and a crackling medical mystery, Brain on Fire is the powerful account of one woman’s struggle to recapture her identity and to rediscover herself among the fragments left behind. Using all her considerable journalistic skills, and building from hospital records and surveillance video, interviews with family and friends, and excerpts from the deeply moving journal her father kept during her illness, Susannah pieces together the story of her “lost month” to write an unforgettable memoir about memory and identity, faith and love. It is an important, profoundly compelling tale of survival and perseverance that is destined to become a classic.


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Editorial Reviews

Review

“Harrowing . . . Cahalan's tale is . . . admirably well-researched and described. . . . This story has a happy ending, but take heed: It is a powerfully scary book.” (The Washington Post)

“A dramatic and suspenseful book that draws you into her story and holds you there until the last page. . . I recommend it highly.” (The Lancet)

“The bizarre and confounding illness that beset the 24-year-old New York Post reporter in early 2009 so ravaged her mentally and physically that she became unrecognizable to coworkers, family, friends, and—most devastatingly—herself… She dedicates this miracle of a book to ‘those without a diagnosis’… [An] unforgettable memoir.” (Elle )

“Swift and haunting.” (Scientific American)

“This fascinating memoir by a young New York Post reporter…describes how she crossed the line between sanity and insanity…Cahalan expertly weaves together her own story and relevant scientific information…compelling.”

(Booklist (starred review))

“Compelling…a New York Post reporter recounts her medical nightmare.” (Mental Floss)

“For the neurologist, I highly recommend this book on several grounds…First, it is a well-told story, worth reading for the suspense and the dramatic cadence of events…Second, it is a superb case study of a rare neurologic diagnosis; even experienced neurologists will find much to learn in it…Third, and most important, it gives the neurologist insight into how a patient and her family experienced a complex illness, including the terrifying symptoms, the difficult pace of medical diagnosis, and the slow recovery. This story clearly contains lessons for all of us.”

(Cognitive and Behavioral Neurology)

“Focusing her journalistic toolbox on her story, Cahalan untangles the medical mystery surrounding her condition…A fast-paced and well-researched trek through a medical mystery to a hard-won recovery.”

(Publishers Weekly)

It's a cold March night in New York, and journalist Susannah Cahalan is watching PBS with her boyfriend, trying to relax after a difficult day at work. He falls asleep, and wakes up moments later to find her having a seizure straight out of The Exorcist. "My arms suddenly whipped straight out in front of me, like a mummy, as my eyes rolled back and my body stiffened," Cahalan writes. "I inhaled repeatedly, with no exhale. Blood and foam began to spurt out of my mouth through clenched teeth."

It's hard to imagine a scenario more nightmarish, but for Cahalan the worst was yet to come. In 2009, the New York Post reporter, then 24, was hospitalized after — there's really no other way to put it — losing her mind. In addition to the violent seizures, she was wracked by terrifying hallucinations, intense mood swings, insomnia and fierce paranoia. Cahalan spent a month in the hospital, barely recognizable to her friends and family, before doctors diagnosed her with a rare autoimmune disorder. "Her brain is on fire," one doctor tells her family. "Her brain is under attack by her own body."

Cahalan, who has since recovered, remembers almost nothing about her monthlong hospitalization — it's a merciful kind of amnesia that most people, faced with the same illness, would embrace. But the best reporters never stop asking questions, and Cahalan is no exception. In Brain on Fire, the journalist reconstructs — through hospital security videotapes and interviews with her friends, family and the doctors who finally managed to save her life — her hellish experience as a victim of anti-NMDA receptor encephalitis. The result is a kind of anti-memoir, an out-of-body personal account of a young woman's fight to survive one of the cruelest diseases imaginable. And on every level, it's remarkable.

The best journalists prize distance and objectivity, so it's not surprising that the most difficult subject for a news writer is probably herself. And although she's young, Cahalan belongs firmly to the old school of reporters — she writes with an incredible sense of toughness and a dogged refusal to stop digging into her past, even when it profoundly hurts. One of the most moving moments in Brain on Fire comes when Cahalan, preparing a New York Post article about her illness, watches videos of herself in the hospital. She's horrified, but finds that she can't look away. "I was outrageously skinny. Crazed. Angry," she writes. "I had the intense urge to grab the videos and burn them or at least hide them away, safe from view."

But she doesn't, and she barely flinches when her loved ones tell her about the paranoid delusions that held her firmly in their grasp for several weeks. There's no vanity in Brain on Fire — Cahalan recounts obsessively searching her boyfriend's email for signs that he was cheating on her (he wasn't) and loudly insisting to hospital workers that her father had killed his wife (she was alive). Cahalan is nothing if not tenacious, and she perfectly tempers her brutal honesty with compassion and something like vulnerability.

It's indisputable that Cahalan is a gifted reporter, and Brain on Fire is a stunningly brave book. But even more than that, she's a naturally talented prose stylist — whip-smart but always unpretentious — and it's nearly impossible to stop reading her, even in the book's most painful passages. Reflecting on finding a piece of jewelry she'd lost during her illness, she writes, "Sometimes, just when we need them, life wraps metaphors up in little bows for us. When you think all is lost, the things you need the most return unexpectedly."

Brain on Fire comes from a place of intense pain and unthinkable isolation, but finds redemption in Cahalan's unflagging, defiant toughness. It's an unexpected gift of a book from one of America's most courageous young journalists. (NPR.org)

Review

“Engrossing. . . . Unquestionably, an important book on both a human and a medical level. Cahalan’s elegantly-written memoir of her dramatic descent into madness opens up discussion of the cutting-edge neuroscience behind a disease that may affect thousands of people around the world, and it offers powerful insight into the subjective workings of our minds.”
       —Mehmet Oz, M.D., Professor and Vice Chair, Department of Surgery, New York Presbyterian-Columbia Medical Center (Mehmet Oz, M.D. ) --This text refers to the Audio CD edition.

Product Details

  • Hardcover: 288 pages
  • Publisher: Free Press; 1 edition (November 13, 2012)
  • Language: English
  • ISBN-10: 9781451621372
  • ISBN-13: 978-1451621372
  • ASIN: 145162137X
  • Product Dimensions: 9.1 x 6.3 x 1.1 inches
  • Shipping Weight: 1.1 pounds (View shipping rates and policies)
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (841 customer reviews)
  • Amazon Best Sellers Rank: #3,272 in Books (See Top 100 in Books)

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Customer Reviews

The author is a journalist so the book is very well written. Avih Dreeder  |  197 reviewers made a similar statement
I could hardly put this book down until I finished reading it. Gerald Brusewitz  |  107 reviewers made a similar statement
Most Helpful Customer Reviews
87 of 93 people found the following review helpful
5.0 out of 5 stars Freaky Good November 13, 2012
Format:Hardcover
What makes this book so terrifying is its reality. Witnessing Susannah's decent into her bizarre illness is effing frightening, but what's even more disconcerting is that people throughout history have probably suffered from her condition but have been misdiagnosed as autistic, schizophrenic, or even possessed. This type of autoimmune disorder is becoming more identifiable, but much about it still remains a mystery, especially since the broad range of symptoms so resemble mental illness.

Cahalan's background as a journalist enables her to reconstruct her ordeal despite not forming memories for a month-long period. She interviewed her family members, doctors, nurses - anyone who witnessed her seizures, her slurred speech, her neurotic, paranoid delusions, and her awkward, uncontrolled movements. She deftly narrates a period of her life that changed her forever, as her body attacked her brain and she completely lost all control of herself. But she also successfully brings awareness to her readers. So if I start exhibiting strange behavior in the next few weeks, it's probably psychosomatic sympathy symptoms.

I received a complimentary copy of this book from the publisher.
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173 of 196 people found the following review helpful
5.0 out of 5 stars Scary story, extremely well told November 14, 2012
Format:Hardcover
Brain on Fire is Susannah Cahalan's reconstruction of her harrowing year with a brain inflammation. Calahan was a 24 year old reporter with the New York Post in 2008 when she began to exhibit signs of mental illness. She was living on her own in NYC and had recently begun a serious relationship with Stephen. Cahalan's symptoms were a mixture of the physical (weakness on her left side, difficulty speaking) and the mental (paranoia, violence and psychosis). Her condition was undiagnosed for an agonizing period of time. Some of her physicians thought she was suffering from alcohol withdrawal despite the fact that she told them she was only an occasional drinker. She came very close to being diagnosed as a schizophrenic. Both of her parents but especially her father insisted that her illness had a physical cause and only with this advocacy was she admitted to NYU. There she was diagnosed as having an autoimmune inflammation in the one hemisphere of her brain. In a marvelous nod to medicine as an art not a science she is finally diagnosed by a physician who administers a simple straight forward test - she is asked to fill in numbers on a drawing of a clock. Because she writes all of the numbers on one side of the drawing the physicians now have proof that the half of her brain is inflamed. So after over one million dollars worth of laboratory tests, she is diagnosed by a savvy MD with pencil and paper! Once the diagnosis of autoimmune disease is confirmed by researchers at Penn, Cahalan has a slow but steady recovery. There are two back stories going on that deserve a mention. One, her new boyfriend Stephen sticks around even when her strange behavior appears to have a mental origin not a physical one. Surely a guy worth knowing! Secondly, Cahalan renews her strained relationship with her father as he is tirelessly at her bedside throughout her illness. As they say - it is an ill wind that blows no good.
The strength in this story is Cahalan's meticulous research. In reviewing her medical records, reading a journal her parents kept through the illness, interviewing friends and family for their perspectives, and piecing together the little that she remembers she has told a story that reads like a suspense novel. She is very good at synthesizing complicated medical issues into readable prose. For me this was a quick read not the medical tour de force that was Henrietta Lacks but good nonetheless. The one lesson I take from all of these nonfiction stories that deal with our health care system is don't enter it on your own. You must get an advocate (and not a timid one) who will fight for you and insist that you get top notch attention. It is easy to be shunted off to the easiest diagnosis. Cahalan makes the point that there are more than a few people with her syndrome who have been misdiagnosed and either did not recover or sit in psychiatric institutions today. Scary for sure!
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77 of 86 people found the following review helpful
5.0 out of 5 stars I am speechless. Excellent. November 14, 2012
Format:Kindle Edition|Amazon Verified Purchase
I didn't put this book down after I started it. I couldn't. I finished it in all one sitting. This book will stick with me for a long time. Most disturbing is had I been her, I know that my parents would have called it possession. What would have become of me?

I have just finished reading it and haven't reflected on what I've read yet but felt compelled to leave this five star review with a thank you to the author for writing this book and making herself so vulnerable for us.
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Most Recent Customer Reviews
3.0 out of 5 stars Interesting, but not intriguing
I found myself learning a lot about the brain, but not overly excited to finish the book. It was a good read, but a little slow.
Published 1 hour ago by J. Robinson
4.0 out of 5 stars fast-paced non-fiction
I love non-fiction and this book didn't disappoint. Susannah Cahalan is a writer-reporter by trade, so her book was well researched and well written. Read more
Published 4 hours ago by Diane Leonard
1.0 out of 5 stars did not like
This was not interesting to me at all. Seemed like trash was the only topics. I would not recommend this to any one.
Published 10 hours ago by R. E. Viewer
5.0 out of 5 stars Great read - an attention getter.
I really liked this book and read through it rather rapidly (not my norm). It was like a mystery novel - you really wanted to know why she was ill and what was going to happen... Read more
Published 11 hours ago by Subby
5.0 out of 5 stars Engaging Read
I loved this book and was gripped from the first pages. I really enjoyed the blend of personal experience and scientific dialogue. Read more
Published 14 hours ago by Mallory
5.0 out of 5 stars Must read
She allows you to step in her shoes, while sympathizing with the family.
Very well written and researched
Must read
Published 15 hours ago by Julia pizzoferrato
5.0 out of 5 stars Amazing and inspiring story
Susannah's story is at times heart wrenching, but also inspiring as she and her family persevered to get her the medical care she needed. Read more
Published 16 hours ago by Susan Gustafson
3.0 out of 5 stars Disappointing read
While I read the entire book it was a struggle. I don't know why I felt obligated to finish it. Perhaps I expected some startling revelation at the end. It wasn't there. Read more
Published 16 hours ago by R. Mirisch
4.0 out of 5 stars Well written and reported
An interesting personal story told in a clear and honest way. Strong writing and reporting. A medical mystery memoir that balances scientific writing with emotional personal... Read more
Published 16 hours ago by Kristen Peterson
5.0 out of 5 stars Couldn't imagine this can occur.
This story is really intriguing. This woman gets sick and can't recall what she went through. But is a needed story to tell and she went out of her way to interview everyone to... Read more
Published 1 day ago by E. Dettrey
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