Brain on Fire: My Month of Madness- Susannah Cahalan
Okay, I admit it: I only read this book because the doctor in it was described as ‘a real life Dr House’. I was disappointed, though. The book describes (in sometimes tedious detail) how the author, Susannah Cahalan, was afflicted by a rare and serious autoimmune disease that was wrongly diagnosed by several specialists before it was correctly identified and treated.
The book begins with Susannah describing her initial symptoms. Some seemingly harmless mood swings and nervousness were actually ominous early signs of her illness. While this in itself is enough to cause panic attacks in hypochondriacs, it gets worse…
One would expect the narration to be anecdotal, but it’s choppy and often disconnected. Not the fault of the author though- she has very few memories of incidents that occurred during her ‘month of madness’. She has used her experience as a journalist to piece together information collected from her father’s journals, CCTV footage of her while in the hospital, and doctors’ reports.
Back to the story. Initially, Susannah’s illness is attributed to schizophrenia, which commonly manifests in women during their late teens or early twenties. Enter Almost House, Dr. Souhel Najjar, who suspects that her worsening physical symptoms are due to brain swelling. However, all tests are inconclusive. He asks her to draw a clock. All the numbers are clustered in the right side of the circular face, an indication that her right hemisphere is inflamed. AH deduces that this is due to a newly identified autoimmune ailment, anti-NMDA receptor encephalitis. A brain biopsy confirms his hunch, and after a few months of treatment Susannah is well enough to return to her job.
After Susannah’s case was written about in medical journals, many more patients were diagnosed with this relatively rare disease. It is clear that a significant number of sufferers may have been misdiagnosed as schizophrenic or bipolar, which will hopefully change due to the publicity that was generated by this book. Though this is undeniably a good thing, there are many other books that deal with similar subjects in more informative and entertaining ways. The Man Who Mistook His Wife For a Hat, by Oliver Sacks, The Tell-Tale Brain, and Phantoms in the Brain (both by V S Ramachandran) all deal with strange neurological disorders and how they manifest themselves (inability to identify faces, phantom limbs, etc). Both Sacks and Ramachandran are neurologists, and manage to convey the latest ideas in their field without compromising on readability.