Living With Madness

A book review of Brain on Fire: My Month of Madness by Susannah Cahalan

The book tells the story of Susannah Cahalan, who suddenly seems to have a personality change. She later starts to have paranoia, hallucinations, and eventually seizures. The beginning of the book starts with the quest of her and her family to try to figure out what is wrong with her. In the meantime, while looking for a diagnosis, she keeps getting worse, and she’s eventually hospitalized.

This part is quite honestly scary. She tells her journey through madness, although most of it from video cameras of the hospital and testimonies from friends and family since she remembers little of that psychotic period. At some point, she doesn’t even remember where she is and becomes violent.

Doctors can’t figure out what is wrong with her, as every conceivable test comes back negative. It’s a race against time. On one hand, because she might get worse, and on the other, because if nothing is discovered, a psychiatric diagnosis is inevitable, which previous doctors have suggested, but the family refused. A psychiatric diagnosis would mean that they would stop looking for anything wrong with her.

After several doctors and negative tests, Dr. Souhel Najjar is put in charge of the case. After some hints of one of her psychological assessments, she gets a brain biopsy, revealing that her brain is inflamed. After some tests, she finally gets a diagnosis: anti-NMDA receptor encephalitis. A rare type of brain inflammation due to antibodies. Despite the diagnosis, nevertheless, many people never have a full recovery, and 4% die despite receiving the proper treatment.

The rest of the book follows her slow recovery, and in many ways the existential problems that came with both the illness itself and the return to a normal life. It goes deep into her personal life and her struggles, giving it a very human feel. I was expecting the book to be more medically oriented, but this went well beyond it, in a very good way. The book ends by touching on the disease itself, how her case impacted the research and awareness of it, other cases that she has encountered, and even how the medical system is prone to misdiagnosis. Overall, a fantastic book that was very pleasurable to read.

Thanks for reading. If you like non-fiction book reviews, feel free to follow me on Medium or subscribe to my Substack.

I also have a philosophy podcast. If you want to check it out look for Anagoge Podcast.

Tiago V.F.