Book Review: Brain on Fire: My Month of Madness by Susannah Cahalan
When twenty-four-year-old Susannah Cahalan woke up alone in a hospital room, strapped to her bed and unable to move or speak, she had no memory of how she’d gotten there. Days earlier, she had been on the threshold of a new, adult life: at the beginning of her first serious relationship and a promising career at a major New York newspaper. Now she was labeled violent, psychotic, a flight risk. What happened?
Written by a journalist, the reader soon discovers this memoir is a survivor’s tale of brain encephalitis. Divided into three parts, the first establishes Susannah’s life when she came down with the illness and the first appearance of symptoms. The second covers the time period of her illness that she actually can’t remember, and features her own investigative journalism into what happened during that time. The third part covers the first part of her recovery time in the first year or so after she recovers her memory.
The first two thirds of the book are quite strong for different reasons. In the first third, Susannah recalls with such clarity the feeling of is this really happening or am I losing my mind? Specifically, the first thing that happens is she’s sure she has bed bugs but other people (including the exterminator) see no evidence of them. To this day, no one knows if Susannah really had bed bugs or if hallucinating them was a first symptom of her illness.
The second third of the book highlights her skills as an investigative journalist. Since she herself doesn’t remember the worst of her sickness immediately prior to or during her hospitalization, she is able to take an impartial distance to the whole situation and report on how her divorced parents put aside their differences to care for her together, as well as look at how the medical system both cared for her but also almost missed her critical diagnosis. Susannah recognizes how lucky she was to have people on her side advocating with the hospital for her, as well as to be in a city with such high-quality and cutting edge medical care.
The last third where she talks about her years of recovery and her life now was the weakest. The level of insight and analysis found in the first two parts was absent. While Susannah clearly empathizes with those with mental illness, there’s a clear sense that she thinks that all mental illness is just an illness making you look mental and not actually maybe a different way of interacting with the world. A different kind of normal you’re just born with. I think Susannah fails to take into consideration what if she was just born seeing colors more brightly and seeing the walls breathe? What if that was just always her normal? That’s the reality for many with a mental illness, and she kind of just glosses over that and comes down on the it’s all just a physical illness side. I’m more of a believer that it’s ok for there to be different ways to be “normal” and maybe society should stop shoving us all into the same shaped peghole. While it’s true that situations like Susannah’s where your whole personality changes overnight are devastating, that’s not how all mental illness presents, and I think she misses that in her quest to find and diagnose those with a brain inflammation misdiagnosed.
Overall, this is an intensely readable book that leaves you questioning what is truly madness and what is just abnormality? And what makes us who we are? If a person is unable to remember what they are doing, does that mean they’re behaving as themselves authentically or as quite the opposite?
4 out of 5 stars
Source: ARC from publisher in exchange for my honest review