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Brain on Fire:Novel Summary and Complete Review Analysis


She is an American journalist and author known for Brain on fire .She is young determined journalist who has everything going for her .She is making a living as a writer in New York city.

Theme : The slope of the line is positive. In her memoir, she reflects on how people are always moving forward whether or not they like what that forward movement look like .In the Susannah's case , it was her own body that turned against her .She lost memories and personality traits but she remains determined and remains focused on present and future. She uses her time in rehabilitation to learn about her disease. She became victim of rare illness. She commits to educating others about her disease . Susannah also recognizes how much her parents ,brother and boy friend love her . After her recovery ,she takes her relationship to new level.

Important people :

SUSANNAH CAHALAN : It is the main character of novel , Susannah is an independent, precocious young journalist who one day finds herself fighting a rare autoimmune disease that threatens her sanity and her life. Dr. Souhel Najjar is a talented neurologist from Syria who eventually diagnoses Susannah with an autoimmune disorder. Stephen is Susannah’s boyfriend. He stands by Susannah through her illness. Rhona Nack is Susannah’s mother, one of Susannah’s biggest advocates for better care and treatment. Tom Cahalan is Susannah’s father, with whom Susannah develops a strong bond over the course of her illness and recovery. James Cahalan is Susannah’s 19-year-old brother, with whom she is very close. Allen Goldman is Susannah’s stepfather, who is loyal and devoted to Rhona.Giselle Cahalan is Susannah’s stepmother. Paul McPolin is Susannah’s editor, mentor, and friend at the New York Post. Dr. Ian Arslan, psycho pharmacologist; Dr. Saul Bailey, neurologist; Dr. Sabrina Khan, psychiatrist, and Dr. William Siegel, neurologist, are Susannah’s other doctors.  

Summary :Everything was going well for 24-year-old Susannah. She was a reporter at the New York Post. Her relationship with her boyfriend, Stephen, was getting serious. But in early 2009, she started to experience strange symptoms. First, when Susannah found what looked like a bug bite on her arm, she became convinced that bedbugs had infested her Manhattan apartment. Not long after, she became paranoid that Stephen was cheating on her. An onslaught of new symptoms followed: headaches, nausea, and tingling and numbness in her limbs. The first doctor whom Susannah called was her gynecologist. She worried that maybe her new birth control was causing the strange symptoms. Her gynecologist referred her to a neurologist, Dr. Bailey. But when the MRI came back normal, the doctors did not know what to tell Susannah. They hypothesized that she had mono or some other virus.

 Somewhat relieved, Susannah tried to get back to life and work. But on a weekend ski trip with Stephen, she panicked at the top of the slope. And while conducting an interview for work, she couldn’t focus and laughed at an inappropriate moment. Then, a bizarre incident in Times Square in which the bright colors both exhilarated and nauseated her led Susannah to worry even more about her increasingly erratic emotions and behavior. Both at home and work, her feelings were unpredictable and volatile. One night in bed with Stephen, Susannah started making strange noises. Her eyes rolled back in her head. Blood and foam gushed from her mouth. Stephen called 911. Later, Susannah would not be able to remember this first tonic-clonic seizure, also known as a convulsive seizure. After the seizure, Susannah went to stay with her mother, Rhona, and stepfather, Allen, in their Manhattan suburb. Her next visit to Dr. Bailey didn’t bring answers. Dr. Bailey told Susannah that she was probably working and partying too hard. Then Susannah visited a psychiatrist, and insisted that she was bipolar. The psychiatrist agreed. But Susannah’s mother and 19-year-old brother, James, doubted the diagnosis. Susannah’s symptoms persisted. Her family began to notice her smacking her lips. Only later would Susannah learn that such mouth movements likely indicated a more subtle kind of seizure. She began to think that people around her were speaking, even when they weren’t. Susannah also started to think that people were imposters, or hired actors trying to trick her. While in a cab with her father, Tom, and his girlfriend, Giselle, Susannah became convinced that they were kidnapping her. When Susannah had EEG and blood tests done, the results were normal. Dr. Bailey concluded that Susannah was experiencing alcohol withdrawal. But Susannah’s mother insisted that she be admitted to a hospital. Just as Susannah was about to be admitted to New York University Langone Medical Center, she had another seizure. This moment marked the beginning of her “lost month of madness. Susannah was admitted to NYU’s epilepsy unit. In the unit, cameras monitored the beds to document seizures. Later, this video footage would be essential to Susannah as she worked to assemble a narrative of what happened to her during her lost month. Upon being admitted, Susannah continued to believe that people around her were imposters, a delusion called Capgras syndrome. She also thought that the nurses were spying on her and that people were talking about her behind her back. She even leapt out of bed and tried to escape on several occasions.

 Dr. Khan, a psychiatrist, thought that Susannah could have a mood or psychotic disorder. Dr. Arslan, a psycho pharmacologist, wanted to rule out postictal psychosis and schizoaffective disorder. As Susannah’s symptoms worsened and the doctors still could not figure out what was wrong, Susannah’s family stayed by her side. Her mother and father, who had just left his banking job, visited daily and kept detailed notes about her case. Stephen, too, committed to visiting Susannah every evening. Less than a week after she was hospitalized, Susannah’s symptoms had shifted from psychosis to catatonia. She lost all short-term memory, dexterity, and even language.

At this point, Dr. Souhel Najjar, a talented doctor from Damascus, Syria, who would eventually save Susannah’s life, joined the team. He suspected that Susannah had encephalitis, or brain inflammation, and started giving Susannah IVIG, or antibody, infusions. A spinal tap revealed that Susannah had a high white blood cell count, suggesting that she had encephalitis.

 Then Dr. Najjar had an idea. He decided to give Susannah the “clock test,” which can identify areas of the brain that are not functioning correctly. When Susannah tried to draw a clock, she put all the numbers on the right side. She also put the 12 where the six should have been. This meant that the right side of her brain, the side responsible for seeing the left side of the clock, was the problem. Dr. Najjar realized that Susannah’s inflamed brain was probably caused by an autoimmune reaction. Her body was attacking her own brain.

 Susannah underwent a brain biopsy, which confirmed her encephalitis. Soon after, Dr. Najjar made his diagnosis: anti-NMDA-receptor autoimmune encephalitis, a rare disease that doctors were only just beginning to understand. In the few patients who had been diagnosed, the disease course resembled Susannah’s: flu symptoms followed by anxiety, delusions, paranoia, and mania, and eventually a loss of language and memory. By that point, Susannah had arrived at the catatonic stage, which comes before coma and sometimes death. Susannah learned that more than 20 percent of people who had been diagnosed with the disease became permanently disabled and four percent died as a result of it. Half of the time the disease was triggered by an ovarian tumor called a teratoma, though Susannah did not have one.

 Dr. Najjar was optimistic, though, and predicted that Susannah could recover most of her former life and self. He began to treat her aggressively with steroids, antibodies, and plasma exchange. Not long after, Susannah was able to go home.

 The weeks and months that followed were difficult for Susannah. While she slowly recovered and rehabilitated, Susannah knew that she was not the same person as before. Her first interactions with family and friends in the outside world were challenging. They filled Susannah with self-consciousness and a feeling of powerlessness. It took time for her to regain her language and memory. Since she could not live by herself, Susannah had to give up her Manhattan apartment. Her medication caused her to gain weight, which further contributed to her insecurity. Susannah felt uncertain about who she really was.

 To regain a sense of purpose, Susannah began researching her disease. She began to learn about the connection between autoimmune diseases and mental illness. She learned that scientists and doctors were starting to think that common conditions like obsessive-compulsive disorder and depression may be caused by inflammation of the brain.

 Personal review :

Susannah Cahalan authorial style is direct, clear and readable . She provides a compelling personal account of what it was like to face and survive life threatening illness. What is perhaps more most impressive about this account is that much of it was reconstructed through research that the author conducted about experiences she could not remember. Her memoir is not only a fast-paced ,thrilling story of one's women survival but also a highly informative report on new research and finding on mental illness.

04-16-16

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