Brain on Fire is brilliant; a book that I now consider a ‘must-read’. Although Brain on Fire is a memoir, it is so much more than that. This book is also a public service announcement that should become required reading across the US until the disease discussed in the book becomes more widely known. Although technically a memoir, this book could more accurately be considered a case study written in the first person, a case study about a little known disease that needs more public awareness.

Susannah Cahalan is a journalist for a New York publication. She is a young professional woman with a stable job and a promising future. Cahalan, however, for unknown reasons begins to experience symptoms – sensitivity to light, mood swings, slight hallucinations, speech impediments among others that she can’t explain. After seeing a doctor about this initially, she is told it is due to excessive partying; alcohol withdrawals. One of her doctors speculates that what Cahalan is experiencing are caused by her birth control, still another believes these symptoms are the result of too much stress.

brain on fireInitially, Cahalan is skeptical of all of these possible diagnoses and attempts to diagnose herself with having, what she believes, is bipolar disorder. This self diagnosis, Cahalan reasoned, provided an explanation for a majority  of the symptoms that she was experiencing. Initially she was content with this, however her condition worsened. Her mood swings began to get more and more extreme to the point that she was taken to a hospital to be examined. Numerous tests were run on her, and they all came back displaying that Cahalan’s health was normal, despite the severity of her symptoms.

Through a series of events, she is eventually hospitalized. Her initial doctor is so perplexed with her, that he eventually hand’s off her case to a different doctor. This new doctor, Dr. Souhel Najjar was able to discover what really was going on with Cahalan and provide her with a diagnosis, a rare auto-immune disease, then provide a treatment that ultimately saved her life and returned her to a version of normal of her previous self.

This book helped to demonstrate the continued weaknesses of modern medicine – that despite our best abilities, there are still illnesses out there that, despite being prevalent, we know little to nothing about. What appears to be one thing – a mental illness, could very well be something much different. Even Cahalan’s initial doctor was perplexed by her ailments, and since he was unaware of the existence of the disease that effected Cahalan, he had no frame of reference to use in order to diagnose her.

“In the spring of 2009, I was the 217th person ever to be diagnosed with anti-NMDA-receptor autoimmune encephalitis. Just a year later, that figure had doubled. Now the number is in the thousands. Yet Dr. Bailey, considered one of the best neurologists in the country, had never heard of it. When we live in a time when the rate of misdiagnoses has shown no improvement since the 1930s, the lesson here is that it’s important to always get a second opinion.

While he may be an excellent doctor in many respects, Dr. Bailey is also, in some ways, a perfect example of what is wrong with medicine. I was just a number to him (and if he saw thirty-five patients a day, as he told me, that means I was one of a very large number). He is a by-product of a defective system that forces neurologists to spend five minutes with X number of patients a day to maintain their bottom line. It’s a bad system. Dr. Bailey is not the exception to the rule. He is the rule.”

This is why I believe this book should be required reading, because until more are aware of this disease, it will continue to be misdiagnosed until awareness grows.

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