Reviewed by Muna Khan

As a genre, memoirs are no longer relegated to the lives of the rich and famous at the tail-end of their careers, reminiscing about their lives, sometimes coyly, falling just short of naming that next-door neighbour or Hollywood actor they had an affair with. Since we live with the Kardashians, we’re talking no-holds barred, dirty, gritty, come-into-the-birthing-room-with-me memoir. Or Eat Pray Love. Or I went to Vietnam and still can’t ride a motorbike and all I got was letters of rejection from publishers saying they are not interested in publishing my memoir. You get the drift.

People want to keep their stories alive — and readers serve as their enablers — for all the obvious reasons, largely cathartic, and maybe because they hope to get closure. We know how the story ends. At least, it is always of survival and hope when we’re buying it, which explains why the memoir of the (for lack of a better word) ordinary person shares bestseller space with Barack Obama’s tales of hope. Publishers went wild in their quest to buy Malala Yousufzai’s memoir with the highest bidder taking the prize for $3 million. People are inspired by other peoples’ stories. If they can make it, so can we.

So you know that Susannah Cahalan, who wrote Brain on Fire, makes it but you’re still going to want to know how. The 24-year-old New York Post journalist, who once went undercover to write a piece on butt implants and called it ‘Rear and Present Danger,’ had it all — with copy skills like that and a loving boyfriend named Stephen — she was clearly on the up. But then came what she thought was a bite from a bedbug, a problem going around in the city; the exterminator said it wasn’t. What followed was some dizziness, things that didn’t seem to add up, missing deadlines — unusual territory. A colleague suggested she see a doctor who diagnosed it as mono and everyone had a laugh. But she still didn’t ‘feel’ alright. Then she missed an interview, some paranoia began to kick in, as did loss of appetite, irritability. Another doctor said it was the result of her drinking, that it would all be okay when she stopped “partying”.

And then came the first seizure, straight out of The Exorcist, as Michael Schaub rightly noted in NPR when reviewing this book. What follows is Cahalan’s piecing together of her “month of madness” using interviews with doctors and videos and journals used by her parents and Stephen during her hospitalisation at NYU where she was treated while they searched for a diagnosis.

In that time Cahalan was placed on restraints because she was feared to be violent, had episodes of psychosis and showed “dangerous instability”. Doctors wanted her committed to a psych ward but her family fought hard against it.

“Because I am physically incapable of remembering that time, writing this book has been an exercise in my comprehending what was lost,” Cahalan writes in the preface to Brain on Fire.

Yes, Cahalan used her skills as a journalist to put her life back together but can she apply the same objectivity or distance upon herself? The honestly with which she writes is laudable. The reader truly empathises with her when, for example, she watches videos of herself, emaciated, looking lost, and desperately tries to search for something to recognise of herself in there, some piece of herself that may trigger a part of her brain. Imagining the idea of not having any recollection of one’s life for X amount of time, even when that life is being played out in front of you in Technicolor, is too daunting a task, yet Cahalan lays it out and says: “But I still made it.” It gives hope for the innumerable people who do not have a diagnosis for whom she has dedicated the book.

Although it is a memoir and we know that she comes out with a diagnosis, the story also has a hero in the form of a doctor — in this case, Syrian-born Dr Najjar who convinces her parents to let their child have a brain biopsy to confirm his suspicion that she has NMDA autoimmune encephalitis. The reader is gripped as if it is a murder mystery.

What makes it a compelling read is that we are so desperate to get to the bottom of the diagnosis. What makes a happy, healthy young woman suddenly become inexplicably mad and wake up to find herself in restraints in a psych ward? Doctors rack up a $1 million bill in MRIs, spinal taps, ECGs and experimental tests in the hopes of finding a diagnosis all the while Cahalan is at a disconnect, more concerned about the TV monitors in her hospital room (set up to ensure that she doesn’t manage to escape) talking to her, taunting her.

Is she ever going to be the same again?  Can this happen to any of us? More worryingly, why didn’t any of the earlier doctors listen to her complaints or dismiss her problems as related to alcohol?

Incidentally, Cahalan became the 217th person to receive this diagnosis and that too after much trial and tribulation at one of the best medical facilities in the world. She was also surrounded by loved ones, not least of all her parents and her boyfriend. Finally, her newspaper wanted her to return and when she was ready, it was her editor who suggested she write an article about her experience with her illness which prompted her to begin her research into her ailment. The article was published — and then came Brain on Fire. And we’re all the better for it.


Brain on Fire: My Month of Madness


By Susannah Cahalan

Penguin Books, India

ISBN 978-1-846-14739-5