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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“Liz, Liz!” I shouted. “I need to talk to you!”

She stopped. “Oh, hey, Susannah. How’s it going?”

There was no time for pleasantries. “Liz, did you ever feel like you’re here but you’re not here?”

“Sure, all the time,” she said.

“No, no, you don’t understand. I can see myself from above, like I’m floating above myself looking down,” I said, wringing my hands.

“That’s normal,” she said.

“No, no. Like you’re outside of yourself looking in.”

“Sure, sure.”

“Like you’re in your own world. Like you’re not in this world.”

“I know what you’re saying. It’s probably just residue from the astral travel you experienced during the reading we did yesterday. I think I may have taken you to another realm. I apologize for that. Just try to relax and embrace it.”

Meanwhile, Angela, worried about my erratic behavior, got permission from Paul to take me to the bar at a nearby Marriott hotel for a drink—and to tease some more information out of me about why I was acting so out of character. When I returned to the newsroom, Angela convinced me to gather my things and join her on a walk a few blocks north up Times Square to the hotel bar. We walked into the hotel’s main entranceway through revolving doors and stood beside a group of tourists waiting to take the transparent elevators to the eighth-floor bar, but the crowd bothered me. There were too many people around. I couldn’t breathe.

“Can we please take the escalator?” I begged Angela.

“Of course.”

The escalators, decorated on each side with dozens of glowing bulbs, only intensified my jitters. I tried to ignore the heart palpitations and the sweat forming on my brow. Angela stood a few steps above, looking concerned. I could feel the pressure of fear rise in my chest, and suddenly I was crying again.

At the third floor, I had to get off the escalator to compose myself because I was sobbing so hard. Angela put her arm on my shoulder. In total, I had to get off the escalator three times to steady myself from sobbing during that eight-floor trip.

Finally we reached the bar floor. The rugs, which looked as if they belonged in an avant-garde production of Lawrence of Arabia, swirled before me. The harder I stared, the more the abstract patterns merged. I tried to ignore it. The hundred-plus-seat bar, which looked down over Times Square, was almost completely empty, with only a few groups of businessmen dotting the chairs around the entranceway. When we walked in, I was still bawling, and one group looked up from their cocktails and gawked at me, which made me feel worse and more pathetic. The tears kept coming, though I had no clue why. We positioned ourselves in the center of the room at seats with high chairs, far away from the other patrons. I didn’t know what I wanted, so Angela ordered a sauvignon blanc for me and an Anchor Steam for herself.

“So what’s really going on?” she asked, taking a small sip of her amber-colored beer.

“So many things. The job. I’m terrible at it. Stephen, he doesn’t love me. Everything is falling apart. Nothing makes sense,” I said, holding the wineglass like a comforting habit but not drinking.

“I understand. You’re young. You have this stressful job and a new boyfriend. It’s all up in the air. That’s scary. But is it really enough to make you feel this upset?”

She was right. I had been thinking about all of that, but it was a struggle to make one detail fit well enough to solve the entire problem, like jamming together pieces from incongruent sets of puzzles. “There’s something else,” I agreed. “But I don’t know what it is.”

картинка 8

When I got home at seven that night, Stephen was already waiting for me. Instead of telling him I’d been out with Angela, I lied and told him I had been at work, convinced that I needed to hide my perplexing behavior from him, even though Angela had urged me to just tell him the truth. But I did warn him that I wasn’t acting like myself and hadn’t been sleeping well.

“Don’t worry,” he responded. “I’ll open a bottle of wine. That will put you to sleep.”

I felt guilty as I watched Stephen methodically stir the sauce for shrimp fra diavolo with a kitchen towel tucked in his pant loops. Stephen was a naturally skilled and inventive cook, but I couldn’t enjoy the pampering tonight; instead, I stood up and paced. My thoughts were running wild from guilt to love to repulsion and then back again. I couldn’t keep them straight, so I moved my body to quiet my mind. Most of all, I didn’t want him to see me in this state.

“You know, I haven’t really slept in a while,” I announced. In fact, I couldn’t remember the last time I had slept. I had gone without real sleep for at least three days, and the insomnia had been plaguing me for weeks, on and off. “I might make it hard for you to sleep.”

He looked up from the pasta and smiled. “Don’t worry. You’ll sleep better with me around.”

He handed me a plate with pasta and a healthy helping of parmesan. My stomach turned at the sight, and when I tasted the shrimp, I almost gagged. I pushed the pasta around on my plate as he devoured his. I watched him, trying to hide my disgust.

“What? You don’t like it?” he asked, hurt.

“No, it’s not that. I’m just not hungry. Great leftovers,” I said cheerfully, while having to physically restrain myself from pacing around the apartment. I couldn’t stay with one thought; my mind was flooded with different desires, but especially the urge to escape. Eventually I relaxed enough to lie down on my couch bed with Stephen. He poured me a glass of wine, but I left it on the windowsill. Maybe I knew on some primal level that it would have been bad for my state of mind. Instead, I chain-smoked cigarettes, one after another, down to their nubs.

“You’re a smoking fiend tonight,” he said, putting his own cigarette out. “Maybe that’s why you’re not hungry.”

“Yeah, I should stop,” I said. “I feel like my heart is beating out of my chest.”

I handed Stephen the remote, and he flipped the channel to PBS. As his heavy breathing turned into all-out snores, Spain… on the Road Again came on, the reality show that followed actress Gwyneth Paltrow, chef Mario Batali, and New York Times food critic Mark Bittman through Spain. God, not Gwyneth Paltrow, I thought, but was too lazy to change the channel. As Batali ate luscious eggs and meat, she toyed with a thin goat’s-milk yogurt, and when he offered her a bite of his dish, she demurred.

“That’s nice to have at seven in the morning,” she said sarcastically. 4You could just tell how disgusted she was by his belly.

As I watched her nibble on her yogurt, my stomach turned. I thought about how little I had eaten in the past week.

“Hold on,” he retorted. “I can’t see you on that high horse of yours.”

I laughed right before everything went hazy.

Gwyneth Paltrow.

Eggs and meat.

Darkness.

CHAPTER 8

OUT-OF-BODY EXPERIENCE

As Stephen later described that nightmarish scene, I had woken him up with a strange series of low moans, resonating among the sounds from the TV. At first he thought I was grinding my teeth, but when the grinding noises became a high-pitched squeak, like sandpaper rubbed against metal, and then turned into deep, Sling Blade –like grunts, he knew something was wrong. He thought maybe I was having trouble sleeping, but when he turned over to face me, I was sitting upright, my eyes wide open, dilated but unseeing.

“Hey, what’s wrong?”

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