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Brain on Fire: My Month of Madness Hardcover – November 13, 2012

2,449 customer reviews

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Editorial Reviews

From Booklist

*Starred Review* In this fascinating memoir by a young New York Post reporter previously known for going undercover as a stripper and writing a butt-implant story headlined Rear and Present Danger, Cahalan describes how she crossed the line between sanity and insanity after an unknown pathogen invaded her body and caused an autoimmune reaction that jump-started brain inflammation, paranoia, and seizures. Her divorced parents put aside their differences and rose to the occasion, sitting by her during the month she was confined to the hospital, about which she remembers nothing. Her boyfriend stayed with her, and one wonderful doctor, noticing that she walked and talked like a late-stage Alzheimer’s patient, was determined to get to the bottom of her medical mystery. Luckily, she was insured, because her treatment cost $1 million. Cahalan expertly weaves together her own story and relevant scientific and medical information about autoimmune diseases, which are about two-thirds environmental and one-third genetic in origin. So, she writes, an external trigger, such as a sneeze or a toxic apartment, probably combined with a genetic predisposition toward developing aggressive antibodies to create her problem. A compelling health story. --Karen Springen


“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. (

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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: 6 x 1 x 9 inches
  • Shipping Weight: 1.1 pounds
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (2,449 customer reviews)
  • Amazon Best Sellers Rank: #101,346 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

172 of 187 people found the following review helpful By Julie Merilatt VINE VOICE on 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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264 of 300 people found the following review helpful By Philly gal VINE VOICE on 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!Read more ›
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142 of 161 people found the following review helpful By Cindylou on November 14, 2012
Format: Kindle Edition 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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59 of 66 people found the following review helpful By E. Bukowsky HALL OF FAMETOP 500 REVIEWERVINE VOICE on November 17, 2012
Format: Hardcover
"Brain on Fire" is the true story of Susannah Cahalan's "lost month of madness," most of which she remembers imperfectly or not at all. Since she is a reporter, however, she has been able to piece together much of what happened by speaking to doctors, nurses, friends, and family; reading "thousands of pages of medical records"; consulting her dad's journal and her parents' "hospital notebook"; watching video footage of herself; and trying to reconstruct any impressions that she still retains.

In the preface, Susannah is in NYU Medical Center, restrained by "a thick mesh vest" to prevent her from pulling out her EEG wires or trying to escape from her "captors." The precise origin of Cahalan's illness is unknown, but one day in 2009, this pretty, carefree, vivacious, and confident New York Post reporter began to exhibit strange symptoms. She became obsessed with bedbugs, developed migraines as well as tingling and numbness in her left hand, cried uncontrollably, had persistent insomnia, could no longer cope with her professional responsibilities, felt as if she was "slogging through quicksand," and experienced seizures, hallucinations, and paranoia. Fortunately, her parents and boyfriend, Stephen, stood by her, refusing to believe that she was psychotic and needed to be institutionalized.

After a variety of physicians examined her and ran batteries of tests--but failed to pinpoint the exact cause of her physical and mental deterioration--Susannah found her savior in Dr. Souhel Najjar, "the man to go to when nothing made sense." He suspected that she might be suffering from autoimmune encephalitis and a neuro-oncologist named Dr. Josep Dalmau confirmed the diagnosis. Soon, Dr.
Read more ›
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