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Review: Susannah Cahalan's 'Brain on Fire'

Published Jan. 23, 2013

Susannah Cahalan's last thought before her body gave in to a terrifying seizure was a combination of Gwyneth Paltrow, eggs and meat.

"My arms suddenly whipped out straight in front of me, like a mummy, as my eyes rolled back and my body stiffened," she writes in her memoir Brain on Fire. "Blood and foam began to spurt out of my mouth through clenched teeth."

In 2009, Cahalan, then a 24-year-old New York Post reporter who churned out copy with all the journalistic gusto of a veteran writer, started to dismantle. Her body began to attack her brain, causing her to spiral into insanity.

In Brain on Fire, Cahalan documents the true story of her harrowing journey: a disease that took her from talented reporter to quiescent vegetative state and back, all in a few months time. She became paranoid and delusional, she slurred her words and drooled, her tongue hung out of her mouth and she lost her memory. She devolved into something like a schizophrenic paralytic.

The subtitle of the book is My Month of Madness; however, the sickness really spans seven, and parts of the book make it feel like more. Chapters at the end, mostly containing details of her recovery and her thoughts at the time, could have been shortened or even omitted, since they don't pack the same punch as the first three-quarters of the book.

That part of Cahalan's gripping story, which is reconstructed from hundreds of interviews with doctors, nurses, friends and family as well as medical records, video footage, her parents' notes and her own, is more of a medical drama than a memoir. There's suspense, tension, roadblocks, many twists and turns that move the reader along. One of the most moving scenes takes place when Cahalan's boyfriend, Stephen, shows his solidarity.

"I'm told that I would visibly relax when he arrived in the room carrying a leather briefcase that was often filled with Lost DVDs and nature documentaries for us to watch together," she writes. "The future didn't matter — he cared only about being there for me as long as I needed him. He would not miss even one day. And he didn't."

It takes nearly a dozen of the finest doctors and around $1 million in medical expenses at New York University's Langone Medical Center to diagnose and treat Cahalan's rare disease, which isn't revealed until after a plethora of tests, a series of incorrect diagnoses and a gruesome four-hour brain biopsy.

Dr. Souhel Najjar, whom her mother accurately describes as "a real-life Dr. House," is Cahalan's saving grace. Najjar is an immigrant from Syria who graduated at the top of his class in medical school and became a celebrated neurologist, epileptologist and neuropathologist — "the man to go to when nothing made sense." He concocts a complicated formula of treatment that will cure Cahalan and bring her back to at least 90 percent of the brilliant young woman she used to be.

Brain on Fire is a courageous account of an unimaginable tragedy, written with grace despite vulnerability. It's hard to believe that Cahalan could compose a book after losing everything her brain commands — motor skills and all. But in this book's strong writing and storytelling skill, it's easy to see that Cahalan has found her spark again.

Sabrina Rocco can be reached at srocco@tampabay.com or (727) 893-8862.

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