Why was Susannah Cahalan, a promising, articulate reporter for the New York Post, suddenly rendered afraid, confused, awkward, lethargic, regressive, suspicious, and forgetful in 2009? Why did she sometimes explode in anger? Why did she lose her appetite and interest in almost everything? With test after test showing her to be normal and healthy, why was she losing control? One of her family's doctors assumed she was partying too much. Others thought she exhibited various psychotic diseases, but for weeks the condition could not be identified and worsened. Having read her book Brain on Fire: My Month of Madness, I can now tell you what was wrong, but you may not want to know quite yet. Cahalan reveals the solution late in her book, so I'll wait, too.
If you enjoy puzzles, stop reading this review now and get the book.
Brain on Fire may just seem to be a well-written true medical thriller and not much more, but there is much to ponder. The recently identified infection that debilitated Cahalan may have infected many people throughout history. They may have been unjustly branded shameful and locked away in mental institutions for life. Other just died suddenly without explanation. Our current thinking of some historical figures could change if we knew something like this infection was behind their behavior.
Cahalan is very fortunate to have been diagnoses and treated.
Another thing to consider is our health care system. Because Cahalan was covered by a generous insurance policy from her employer and because her family kept insisting on further tests, she was cured. She could have been written off easily when her condition was at its worst.
I am assuming if you have read this far, you do not mind a spoiler. The culprit in the story was anti-NMDA-receptor autoimmune encephalitis. Cahalan reports on the research being conducted on this assumed to be rare disease. No one knows how she contracted it. When interviewed by Cahalan after her recovery, some doctors involved in the early parts of the story claimed to have never heard of it.
Cahalan, Susannah. Brain on Fire: My Month of Madness. Free Press, 2012. 264p. ISBN 9781451621372.