Review by New York Times Review
IN the vast and growing literature of affliction there is essentially one story: how the writer and her loved ones made it through. From a literary point of view, everything depends on the sensibility of the narrator, her comportment both as the teller and as the main character in her own tale. The reader's resistance to these stories can be strong. Severe illness, by its nature, narrows the focus; the palette of experience both intensifies and shrinks; we crawl into the bush, figuratively speaking, and wait out our fate, fighting to survive. There is little suspense: the existence of the memoir is testament to the fact that the author has lived to tell the tale. But what hard-won nugget of wisdom has she brought back from her brief descent into a hell that most of us, for now, have been lucky enough to avoid? Can she give her ordeal meaning beyond the brute fact of the thing itself? One thing you don't want to be to your doctor is "an interesting case." Susannah Cabalan had the bad luck of being a unique and baffling one: profoundly sick, deteriorating with dangerous speed, yet her MRIs, brain scans and blood tests were normal. "My diagnosis had been discussed in almost every major medical journal," she tells us with an air of pride and exhausted wonder, "including the New England Journal of Medicine, and The New York Times." "Brain on Fire" is at its most captivating when describing the torturous process of how doctors arrived at that diagnosis - an extremely rare autoimmune disease almost undocumented in medical literature. The illness presented itself in malevolent fashion, with symptoms of bipolar disorder and schizophrenia, which are often indistinguishable from each other in their early stages: grandiosity, paranoia, bouts of irrational rage, incomprehensible utterances and flat catatonic-like affect. There were also seizures, with "blood and foam" spurting out of Cahalan's mouth, that suggested not mental illness but a neurological disorder. Cahalan has the narrative advantage of having no memory of what happened to her, except for unreliable, almost hallucinatory flashes, like being strapped to her hospital bed as a "flight risk." This temporary outage gives her an opportunity to ponder the mystery of her self, and how quickly our assumed knowledge of who we are can be radically altered. Cahalan employs her journalistic skills (she works as a reporter at The New York Post) to explain the fascinating medical intricacies of her illness and how it compromises NMDA receptors in the brain, "vital to learning, memory, and behavior." Of deeper interest is her attempt to become a historian of her lost self, piecing together the facts of her ordeal from her father's diaries, the recollections of her mother and her boyfriend, and the forensic evidence of medical and psychological records. Looking at hospital videos, she is shocked to see a young woman she can barely recognize as herself, cowering in bed and uttering repeatedly, and with difficulty, the word "please," as if begging for help. Reading her own disjointed diary entries of the time "is like peering into a stranger's stream of consciousness." SALVATION came in the form of a gifted neurologist, profoundly attuned to her symptoms, and the decisive diagnostic tool turned out to be a piece of paper and pen: Cahalan's skewed drawing of a clock revealed more about what was going on in her brain than the battery of expensive tests she underwent. Her treatment cost about a million dollars. At its best, Cahalan's prose carries a sharp, unsparing, tabloid punch in the tradition of Pete Hamill and Jimmy Breslin. But when the acute period of her illness passes and she chronicles the slow process of her recovery, the writing falls flat. Here was the chance to make good on her ambition to inquire into the "deepest part of the self - personality, memory, identity - in an attempt to pick up and understand the pieces left behind." Instead, Cahalan is locked in the dull passage of those weeks, dutifully informing us of her 15-minute walks, her decision to take spin class, her forays out to family gatherings and parties. Finally, and bravely, she crawls back to her old vivacious self. "However, when I look at photographs taken of me 'post,' versus pictures of me 'pre,' there is something altered, something lost - or gained, I can't tell - when I look into my eyes." Michael Greenberg is the author of "Hurry Down Sunshine" and "Beg, Borrow, Steal: A Writer's Life."
Copyright (c) The New York Times Company [December 23, 2012]
Review by Booklist Review
*Starred Review* In this fascinating memoir by a young New York Post reporter previously known for going undercover as a stripper and writing a butt-implant story headlined Rear and Present Danger, Cahalan describes how she crossed the line between sanity and insanity after an unknown pathogen invaded her body and caused an autoimmune reaction that jump-started brain inflammation, paranoia, and seizures. Her divorced parents put aside their differences and rose to the occasion, sitting by her during the month she was confined to the hospital, about which she remembers nothing. Her boyfriend stayed with her, and one wonderful doctor, noticing that she walked and talked like a late-stage Alzheimer's patient, was determined to get to the bottom of her medical mystery. Luckily, she was insured, because her treatment cost $1 million. Cahalan expertly weaves together her own story and relevant scientific and medical information about autoimmune diseases, which are about two-thirds environmental and one-third genetic in origin. So, she writes, an external trigger, such as a sneeze or a toxic apartment, probably combined with a genetic predisposition toward developing aggressive antibodies to create her problem. A compelling health story.--Springen, Karen Copyright 2010 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
In 2009, Cahalan was in a serious relationship and her career as a reporter at the New York Post was taking off. But suddenly, as she tells it in this engaging memoir, she began suffering from a bizarre amalgam of debilitating symptoms including memory loss, paranoia, and severe psychosis that left her in a catatonic state that moved her close to death. Physicians remained baffled until one extraordinary doctor determined that Cahalan was "in the grip of some kind of autoimmune disease." Released from the hospital after 28 days, she had no memory of her stay there. DVDs recorded in the hospital were the only link she had to her startling condition. "Without this electronic evidence, I could never have imagined myself capable of such madness and misery," she writes. Focusing her journalistic toolbox on her story, Cahalan untangles the medical mystery surrounding her condition. She is dogged by one question: "How many other people throughout history suffered from my disease and others like it but went untreated? The question is made more pressing by the knowledge that even though the disease was discovered in 2007, some doctors I spoke to believe that it's been around at least as long as humanity has." A fast-paced and well-researched trek through a medical mystery to a hard-won recovery. (Nov.) (c) Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
A New York Post reporter whose work has also has been featured in the New York Times, Cahalan, at age 24, seemed launched into life; she was building a successful career as a journalist, had met a man with whom she shared common interests, and seemed perfectly healthy. Until, that is, she woke up in a hospital with no memory of going there or of the previous month. She created this memoir using her father's journal, her medical records, and interviews with family and friends. The book is interesting as a work of reconstructive journalism and as a record of methods the doctors tried and failed to use on her behalf. The author's own reading adds authenticity and poignancy. VERDICT For those interested in medical memoirs. ["Cahalan's hip writing style, sympathetic characters, and suspenseful story will appeal to fans of medical thrillers and the television show House," read the review of the New York Times best-selling Free Pr: S. & S. hc, LJ 11/1/12.-Ed.]-Pam Kingsbury, Univ. of North Alabama, Florence (c) Copyright 2013. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
A young journalist's descent into her own baffling medical mystery. In her debut memoir, New York Post reporter Cahalan recounts her struggle to understand an unremembered month lost to illness. Cobbled together from interviews, medical records, notebooks, journals and video footage, the author conjures the traumatic memories of her harrowing ordeal. What began as numbness in her hands and feet soon grew into something more serious, climaxing in a terrifying seizure witnessed by her boyfriend. "My arms suddenly whipped straight out in front of me, like a mummy," she writes, "as my eyes rolled back and my body stiffened.Blood and foam began to spurt out of my mouth through clenched teeth." The mystery thickened as doctors struggled to agree on a diagnosis. While the uncertainty proved maddening for her family members, however, it was also what bonded them together. Cahalan's estranged parents, in particular, found a common purpose as a result of their daughter's plight, putting her health before old hardships. After numerous tests revealed nothing, an observed increase of white blood cells in her cerebrospinal fluid eventually clued in medical professionals. Diagnosed with anti-NMDA-receptor encephalitis--a rare autoimmune disease with a cure--Cahalan and her family embarked on the long, hard road to recovery. Through the lonesomeness of her illness, a community emerged, the members of which were dedicated to returning the author to her former life as a beloved daughter, sister, lover and friend. A valiant attempt to recount a mostly forgotten experience, though the many questions that remain may prove frustrating to some readers.]] Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
