Brain on Fire by Susannah Cahalan

'My first serious blackout marked the line between sanity and insanity. Though I would have moments of lucidity over the coming days and weeks, I would never again be the same person ...'

Susannah Cahalan was a happy, clever, healthy twenty-four-year old. Then one day she woke up in hospital, with no memory of what had happened or how she had got there. Within weeks, she would be transformed into someone unrecognisable, descending into a state of acute psychosis, undergoing rages and convulsions, hallucinating that her father had murdered his wife; that she could control time with her mind. Everything she had taken for granted about her life and who she was, was wiped out.

This is Susannah's story of her terrifying descent into madness and the desperate hunt for a diagnosis, as, after dozens of tests and scans, baffled doctors concluded she should be confined in a psychiatric ward.

A gripping medical mystery with a unique personal voice, Brain on Fire is also the story of how one brilliant man, Syria-born Dr Najar, finally proved – using a simple pen and paper - that Susannah's psychotic behaviour was caused by a rare autoimmune disease attacking her brain. His diagnosis of this little-known condition, anti-NMDA-receptor autoimmune encephalitis, saved her life and possibly the lives of many others.

Susannah Cahalan is  a reporter on the New York Post and the recipient of the 2010 Silurian Award of Excellence in Journalism for Feature Writing. Brain on Fire is a searingly personal yet universal book, which asks what happens when your identity is suddenly destroyed, and how you get it back.

"This is a remarkable book about a relatively newly identified type of encephalitis called NMDA-receptor encephalitis. Susannah survives not only this devastating condition but also not uncommon mid-diagnoses, and their potential for admission to psychiatric institutions. Susannah recovers well thanks to the astute observations and ongoing professional development of a doctor, one of many in a team trying to diagnose and manage this young woman spiralling into a world of madness and mayhem.

Susannah’s book is the first account (to my knowledge) of this type of encephalitis. She successfully interweaves her own narrative with the observations of others and the expert and clinical explanations of her condition as would be expected of a journalist and writer of her calibre. This results in a book that makes us empathise with her experiences but also leaves us with an evidence-based education in relation to this condition.

The book is an absolute must-read for anyone affected, their families and friends but also for professionals working in, or with an interest in neurology. Reading this book will undoubtedly save lives and prevent inappropriate admissions to psychiatric units of people whose condition is neurological and not psychiatric. The book does of course leave us wondering how many un-diagnosed NMDA-receptor encephalitis patients remain in psychiatric institutions? Are you really sure that patient protesting their innocence or pleading sanity really is suffering a Psychiatric disorder or is that glimmer of sanity you’ve occasionally glimpsed another Susannah Cahalan?"

                                       Review By Ava Easton, CEO of the Encephalitis Society

 

“Susannah’s poignant story of her illness and eventual recovery is very readable and will appeal to the general reader. More importantly for professionals in the medical field, the book also offers valuable insights into a rare and sometimes fatal condition, which will alert them to the dangers of misinterpretation of patients’ behaviour. This book is written by an exceptionally good journalist and will appeal to all those who want to gain a better understanding of what is required to obtain a proper diagnosis and appropriate treatment for a terrifying illness.”

Barbara A Wilson, OBE, Neuropsychologist and President of the Encephalitis Society

“It seems perhaps wrong somehow to say that this is the most thrilling book I've read in ages, an actual page turner that I literally sat and read until I'd finished. A writer that gives it to you straight from the heart and soul of her nightmare. No punches are pulled and no horror un-named. It's terrifying, heart breaking and inspiring in equal parts.” 

Mathew Bose, Actor, Artist and Ambassador of the Encephalitis Society