What happens when a normal 24-year-old girl suddenly, inexplicably, changes? Devolves from music-loving writer to manic paranoid to seizure-prone patient to one who's catatonic, bed-ridden and barely functioning… and then makes a full recovery?
Well, if she's a newspaper reporter, she writes about it.
The New York Post's Susannah Cahalan recounts the mysterious illness that unraveled into a medical nightmare in Brain on Fire, an extension of her 2009 first-person Post article, "My Mysterious Lost Month of Madness."
In this harrowing tale, Cahalan uses journals, videos, medical documents and basic reporting to piece together what happened while she was suffering from the rare disease anti-NDMA-receptor autoimmune encephalitis. She herself can remember very little of the ordeal.
Cahalan swiftly sets up her life as a young, ambitious journalist with a nice boyfriend and healthy relationships with her friends and parents. Suddenly she becomes obsessed with bed bugs and begins experiencing numbness. As her health worsens, symptoms including violent, Exorcist-like seizures lead to false diagnoses such as alcohol withdrawal and mono. One thing is clear: Something is horribly wrong.
The book is separated into three parts: "Crazy," "The Clock" and "In Search of Lost Time." "Crazy" is the quickest, most compelling read, a fast-paced medical mystery that's hard to put down, as if watching a slow-motion car crash in which you know the driver somehow escapes.
Cahalan's time in the hospital is difficult but satisfying, with gritty scenes describing her as an emaciated mental patient attempting to escape. More heart-wrenching, though, is her rich description of emotional helplessness and feelings of lost identity. And Cahalan's reporting is solid: the science behind the madness is thorough and digestible.
The final act, however, lacks the universal takeaways it aims for. Clearly a personal journey – and a riveting one at that – Cahalan shares the outpouring of support and solidarity she received after her Post article ran, and reflects on how lucky she was to have insurance for the $1 million treatment she received as only the 217th person to ever be diagnosed with her rare disease.
But her story does not need this kind of clean, sterile wrap-up. A focus on Cahalan's recovery, emotional and physical, would have been more than enough.