Susannah Cahalan - Brain on Fire - My Month of Madness

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One day in 2009, twenty-four-year-old Susannah Cahalan woke up alone in a strange hospital room, strapped to her bed, under guard, and unable to move or speak. A wristband marked her as a “flight risk,” and her medical records—chronicling a monthlong hospital stay of which she had no memory at all—showed hallucinations, violence, and dangerous instability. Only weeks earlier, Susannah had been on the threshold of a new, adult life: a healthy, ambitious college grad a few months into her first serious relationship and a promising career as a cub reporter at a major New York newspaper. Who was the stranger who had taken over her body? What was happening to her mind?
In this swift and breathtaking narrative, Susannah tells the astonishing true story of her inexplicable descent into madness and the brilliant, lifesaving diagnosis that nearly didn’t happen. A team of doctors would spend a month—and more than a million dollars—trying desperately to pin down a medical explanation for what had gone wrong. Meanwhile, as the days passed and her family, boyfriend, and friends helplessly stood watch by her bed, she began to move inexorably through psychosis into catatonia and, ultimately, toward death. Yet even as this period nearly tore her family apart, it offered an extraordinary testament to their faith in Susannah and their refusal to let her go.
Then, at the last minute, celebrated neurologist Souhel Najjar joined her team and, with the help of a lucky, ingenious test, saved her life. He recognized the symptoms of a newly discovered autoimmune disorder in which the body attacks the brain, a disease now thought to be tied to both schizophrenia and autism, and perhaps the root of “demonic possessions” throughout history.
Far more than simply a riveting read and a crackling medical mystery,
is the powerful account of one woman’s struggle to recapture her identity and to rediscover herself among the fragments left behind. Using all her considerable journalistic skills, and building from hospital records and surveillance video, interviews with family and friends, and excerpts from the deeply moving journal her father kept during her illness, Susannah pieces together the story of her “lost month” to write an unforgettable memoir about memory and identity, faith and love. It is an important, profoundly compelling tale of survival and perseverance that is destined to become a classic.

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“I thought you were hungry,” Stephen said.

“I’m not anymore.”

Mom and Allen exchanged glances in the front seat.

The traffic was light heading uptown, so we got to Dr. Bailey’s quickly. When I walked into the office, something felt different about the place, odd, alien. I felt like Gonzo walking into the casino after he had dropped mescaline in Fear and Loathing in Las Vegas. Nothing was as it seemed, and everything dripped with apocalyptic meaning. The other waiting patients were caricatures, subhuman; the glass window that separated the receptionist from us seemed utterly barbaric; the Miró was smiling down at me again with that twisted, unnatural grin. We waited. It could have been minutes or several hours, I have no idea. Time didn’t exist here. Eventually a middle-aged female technician called me into an examination room, wheeling in a cart behind her. She dug out a box full of electrodes and pasted all twenty-one of them, one by one, onto my scalp; first rubbing the dry skin, and then fixing them to my head with some kind of glue. She turned off the lights.

“Relax,” she said. “And keep your eyes closed until I tell you to open them. Breathe deeply in and out. One complete breath for every two seconds.”

She counted for me, one, two, exhale; one, two, exhale; one, two, exhale. And then faster, one, exhale; one, exhale; one, exhale. It went on forever. My face flushed, and I started to get dizzy and lightheaded. I heard her fiddling around with something across the room so I opened my eyes enough to see her handling a small flashlight.

“Open your eyes and look directly into the light,” she said. It pulsated like a strobe, but with no apparent rhythm to its pattern. When she turned on the light to remove the electrodes, she began to speak to me.

“So are you a student?”

“No.”

“What do you do?”

“I’m a reporter. I write for a newspaper.”

“Stressful, huh?”

“Sure, I guess.”

“There’s nothing wrong with you,” she said, gathering the electrodes back into the box. “I’ve seen this dozens of times, mostly with bankers and Wall Street guys who come in here all stressed out. There’s nothing wrong with them; it’s all in their heads.” It’s all in my head. When she closed the door behind her, I smiled. That smile turned into a laugh, a belly laugh dripping with bitterness and resentment. It all made sense. This was all a ruse, set up to punish me for my bad behavior and tell me that I’m suddenly cured. Why would they try to trick me? Why would they arrange something this elaborate? She wasn’t a nurse. She was a hired actor.

My mother was the only person left in the waiting room; Allen had left to get the car, and Stephen, overwhelmed by my harrowing behavior on the ride in, had called his mom for consolation and advice. I gave my mom a wide, toothy smile.

“What’s so funny?”

“Oh! You thought I wouldn’t figure it out. Where’s the mastermind?”

“What are you talking about?”

“You and Allen set this all up. You hired that woman. You hired everyone here. You told her what to say. You wanted to punish me. Well, it didn’t work. I’m too smart for your tricks.”

My mom’s mouth fell open in horror, but my paranoia read it as nothing more than mock-surprise.

CHAPTER 13

BUDDHA

The whole time I’d been in Summit, I had been begging to return to my Manhattan apartment. I felt constantly under surveillance by my family. So on Sunday, the day after my EEG, my mom, exhausted by the week of sleepless nights and constant monitoring, agreed, against her better judgment, to let me revisit my apartment under one condition: I spend the night at my father’s house. Though my behavior was worsening day by day, it was still difficult for her to reconcile the old image that she had of her daughter as trustworthy, hard working, and independent with the new, unpredictable, and dangerous one.

I quickly consented to spend the night with my father—I would have said anything to get back to my own studio. I felt calmer as soon as we arrived in Hell’s Kitchen, being so close to freedom again. As soon as we saw my father and Giselle waiting outside on the front stoop of my building, I bounded out of the car. My mom and Allen didn’t follow, but they did wait until the three of us were safely inside before driving away.

I was delighted to be back in my safe haven. Here was my cat, Dusty, a blue-haired stray who’d been tended by my friend Zach during my weeklong absence. I was even glad to see the unwashed clothes and black plastic bags filled with books and debris and the garbage overflowing with stale food. Home sweet home.

“What’s that smell?” my father asked. I hadn’t cleaned my apartment since the last time he came, and it had only gotten worse. Some of the leftover shrimp from the meal Stephen had cooked had spoiled in the garbage. Without hesitating, my father and Giselle began cleaning. They scrubbed the floors and disinfected every inch of that small apartment, but I didn’t even offer to help. I just walked around them, watching them clean and pretending to gather my things.

“I’m so messy!” I said, stroking my cat triumphantly. “Messy, messy, messy!”

After they finished, my father motioned for me to follow him out of the apartment.

“Nah,” I said, nonchalantly. “I think I’m just going to stay here.”

“Absolutely not.”

“How about I meet you in Brooklyn after I get a few things together?”

“Absolutely not.”

“I will not leave!”

Dad and Giselle exchanged knowing glances, like they had prepared for such an outburst. Presumably Mom had warned them about me. Giselle rounded up the cleaning supplies and headed downstairs to get away from the unfolding unpleasantness.

“Come on, Susannah, we’ll grab some coffee. I’ll cook you dinner. It will be nice and calm. Just come over.”

“No.”

“Please. Will you do this for me?” he asked. It took a half hour but finally I agreed, grabbing a handful of underwear and a few other clean clothes. The illness seemed to wane momentarily, allowing the old, reasonable Susannah to return briefly. The three of us chatted a little as we walked toward the subway on Forty-Second Street. But the calm didn’t last long. Paranoia took hold as I was crossing Ninth Avenue. My father has taken my keys. I have no way to get back to my apartment. I am his prisoner.

“No. No. No!” I shouted in the middle of the street, stopping just as the lights turned green. “I’m not going. I want to go home!” I felt my dad’s tight grip on my shoulders as he pushed me out of the way of the oncoming traffic. I continued to scream as he hailed a cab. When the cab pulled up, he pushed me inside, and Giselle entered on the other side so I was wedged between them. They were determined to prevent another escape attempt.

“They’re kidnapping me. Call the police! Call the police! They’re taking me against my will!” I screamed at the Middle Eastern cab driver. He looked back in his rearview mirror but did not drive. “Let me go. I’m calling the cops!”

“Get out. Leave car. Now,” the driver said.

My father gripped the bulletproof partition and said, through gritted teeth, “You better fucking drive. Don’t you dare stop.”

I can’t imagine what the driver thought, because it must have looked tremendously suspicious, but he obliged. Soon he started to speed, darting in and out of traffic on the Brooklyn Bridge.

“I’m calling the police when I get out. You’ll see. You’ll be arrested for kidnapping!” I shouted at my dad. The driver glanced at us warily in the mirror.

“You do that,” my dad said nastily. Giselle remained quiet and looked out the window, as if trying to block out the scene. Then my father softened his voice: “Why are you doing this? Why are you doing this to me?” Honestly, I had no idea. But I was convinced I wasn’t safe in his care.

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