Thursday, November 27, 2014

REVIEW: Brain on Fire by Susanna Cahalan



Brain on Fire by Susanna Cahalan
Original Publication Year: 2012
Genre(s): Non-Fiction, Medical
Series: NA
Awards: None
Format: Audio (from Audible.com)
Narrated by: Heather Henderson

In 2009, Susanna Cahalan was a 20-something with a successful career as a journalist when her behavior became decidedly odd and erratic.  It signaled the beginning of a weeks long odyssey into brain dysfunction most of which Susanna does not remember.  Through the accounts of her friends, family, doctors and even some video footage, Cahalan tries to piece together the story of what happened to her brain and how by the slimmest of margins, she was able to recover.

For me, this book was a good example of the whole being greater than the sum of its parts.  While reading, I wasn’t actually that engaged even though Cahalan lays things out as they happened, like a jigsaw puzzle and a mystery to solve.  Through the first half to ¾ of the book she focuses on the personal, on how her friends and family reacted to her, how strangers and initial doctors responded to her and what she can remember of her thoughts and feelings as she got sicker and sicker.  It’s interesting but there was something about her style and approach that was off-putting for me.  Not awful but it kept me from really connecting with her and her story. 

The story got more interesting as the ultimate team of doctors were able to, finally, figure out what was going on and she focuses a bit more on the science of neurology.  Cahalan does her job as investigative reporter, following up with all the doctors that she had encountered during her illness and connecting with patients and families of patients who have gone through similar things as she.  She also does not flinch away from describing everything that happens to her, no matter how embarrassing or upsetting. 

The real strength of the book for me was when I put it down and reflected.  Cahalan’s behavior was seriously bizarre and extremely out of character but a visit to a neurologist with a good reputation, showed no abnormalities and had him suggesting, based on little evidence, that she was an alcoholic going through withdrawal.  A psychiatrist thought she may have been exhibiting the first signs of a bipolar disorder.  Even after a couple of weeks in a hospital with a team of doctors there were still no clear medical results to explain her behavior, seizures and physical tics.  In fact she may not have even gotten into the hospital as soon as she did if she hadn’t been who she was – a young woman with a strong social network and from a well to do, professional family who pushed for Susanna’s case to get the incredible amount of attention that was needed to get a diagnosis. She also lives in a big city (New York) where medical care is more sophisticated. She was extremely fortunate and a little bit lucky.  Now think of all the people that don’t have her advantages and imagine all the missed diagnoses and even possible needless deaths and institutionalizations.  Cahalan does a very good job making this point.  There is also the point that with all the advancements we have made in medical science there are still a lot of unknowns, with the brain being one of the more complicated areas to study and understand.  It is all, quite frankly, terrifying.

Final Verdict:  While I found it hard to connect with Cahalan as she struggles with a “month of madness” the book packs more of a wallop when taken as a whole and was ultimately an interesting read, particularly if you are interested in medical science. 3 out of 5 Stars. ✪✪✪

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