Wednesday, October 24, 2012

Brain on Fire

by Susannah Cahalan, Free Press, November 2013

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! 

I read a copy of this book provided by the publisher.

1 comment:

Zibilee said...

This book just came for me a few weeks ago, and I have been fascinated by it! I love medical nonfiction, and think that this is going to be a wonderful read for me. I am glad that her research was impeccable. It makes for such better reading!!