Brain on Fire: My Month of Madness by Susannah Cahalan

It began - or at least it seemed to begin - with two small bug bites. Bedbugs? Perhaps. The young Manhattan reporter, just months out of college, searched her apartment for any sign of the pest. Despite finding no trace, she searched again, eventually calling in an exterminator, who also found nothing. Unknown her, this seemingly innocuous event would mark the beginning of an illness that would eventually steal her sanity, mind and nearly her life.

Susannah Cahalan's Brain of Fire: My Month of Madness is her recollection (as much as she is able to remember) of her journey through what initially appeared to be a bad cold, to extreme personality changes, paranoia, mania and vivid auditory and visual hallucinations and seizures. It is also a harrowing journey through the health care system, as she and her parents desperately searched for a diagnosis as Cahalan slipped further and further into catatonia.

Brain on Fire is based on Cahalan's recollections during the first stages of her illness. However, as she admits, the very nature of the disease makes her memory of that time unreliable, and later, simply missing. Cahalan also relies on the recollections of her parents - who kept a shared journal to keep each other updated on their daughter's progress between visits - her boyfriend's memories and stories from her family, friends and coworkers. Cahalan also draws on her extensive medical records and interviews with the doctors and nurses who treated her, including, as Cahalan's mother remarks, "a real-life Dr. House." She also reviews recordings of her time in New York University Hospital's Advanced Monitoring Unit, offering a haunting glimpses of her deteriorating sanity, none of which Cahalan remembers.

Some of the book's most moving passages (of which there are many) are the recollections of her parents and loved ones. Cahalan's parents had divorced and remarried and her relationship with her father - a somewhat reserved and emotionally distant man - had suffered. Her parents, who had not maintained a relationship, vowed early on that their daughter would not be placed in a psychiatric ward. Her father kept a near-constant vigil at her bedside and her mother researched every possible cause of her daughter illness, searching out the best doctors with increasing desperation. The effect of Cahalan's illness - of watching their only daughter fall apart and being powerless to help - was profound. But, as Cahalan acknowledges, she would not have survived without them.

The science behind the disease Cahalan is eventually diagnosed with is highly complex and not entirely understood. Therein lies the crux of the book - the disease is so rare and difficult to diagnose, its cause so mysterious - that it baffles even the best doctors in the field. Perhaps the most sobering message of this book is, as Cahalan says, how lucky she was. To have been admitted to the right hospital at the right time and referred to the right doctors; the sheer odds against her were astronomical. How many others, she wonders, were not so lucky? How many have been confined to psychiatric wards, long-term care facilities, or have died because they were not as fortunate?

At the close of the book, nearly two years had passed since her admission to NYU Hospital. While she had returned to her job at the New York Post and had, again, moved out of her mother's home, she admits that she isn't entirely sure if her recovery is complete. After such a harrowing journey, after the insults suffered by her brain and body, was is even possible to return to the same person she had been before? Cahalan seems to accept the idea that she might never return to exactly the same person she was before, nor will her parents and boyfriend.

Brain on Fire is both a memoir and a medical thriller, an exposé of the health care system and a tribute to the men and women who work within in,  it is a warning of how fragile our minds and bodies are, and an affirmation of the strength of love and family.

~ Allison , Adult Services