Brain on Fire: My Month of Madness


Susannah Cahalan

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Brain on Fire: My Month of Madness Study Guide

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Brief Biography of Susannah Cahalan

Cahalan was born in Summit, New Jersey. Her parents divorced when she was a teenager, and both remarried. Cahalan attended Washington University in St. Louis, where she studied journalism. She began interning at the New York Post as a teenager and was hired full-time as a reporter in 2008. In 2009, she became suddenly ill with a rare autoimmune disease, anti-NMDA receptor autoimmune encephalitis. She was only the 217th person in the world to be diagnosed with the disease. Cahalan made a full recovery and, after writing a first-person account of her experience for the New York Post, she turned her article into her memoir Brain on Fire: My Month of Madness. Cahalan's illness and luck obtaining a diagnosis instilled in her the desire to spread her story as far as possible. To this end, she worked with two other families whose children developed the disease to create a nonprofit organization called the Autoimmune Encephalitis Alliance in December of 2012. The alliance seeks to educate both patients and medical practitioners about the disease, as well as connect current patients to survivors. Cahalan married Stephen Grywalski in 2015, and the two live in Jersey City, New Jersey.
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Historical Context of Brain on Fire: My Month of Madness

As Cahalan explains in the book, anti-NMDA receptor autoimmune encephalitis was first discovered by Dr. Josep Dalmau in 2007, though many doctors and researchers believe that it's been around as long as humans have. Several doctors described the disease in children in papers in the 1970s and 1980s, but most patients were diagnosed with either unexplained psychosis or encephalitis. Because of Dalmau's research and the success of Cahalan's memoir, the disease is now more heavily studied and is included on many standard autoimmune testing panels. Cahalan mentions in the memoir that she was lucky to have good insurance through her job and well-off parents when she became ill, as her treatments cost upwards of one million dollars. When Cahalan became ill, the Affordable Care Act had not yet been put in place. When President Obama signed "Obamacare" into law in 2010, it eliminated some of the struggles that Cahalan and other patients likely faced during and after their treatment. It mandated that insurance companies cannot refuse coverage to individuals for any reason, and also insisted that insurance companies pay for many services that anti-NMDA receptor autoimmune encephalitis patients require, including hospitalization, prescription medications, and rehab and laboratory services.

Other Books Related to Brain on Fire: My Month of Madness

Cahalan's memoir is one of many memoirs that explore either one's own or one's family member's struggles with the medical system and illness. January First tells the story of a man's six-year-old daughter who is diagnosed with a severe case of early-onset schizophrenia, and her parents' struggles to get her the help she needs from a system that makes that exceptionally difficult. Paul Kalanithi's memoir When Breath Becomes Air chronicles his sudden diagnosis with stage IV lung cancer at the age of 36, and his quest to discover what makes a meaningful life in the face of his own impending death. The Anti-NMDA Receptor Encephalitis Foundation includes a list of articles, essays, and books on their website that tackle the subject of the disease. The book list includes Cahalan's memoir as well as The Girl on the 6th Floor by Brian Nichols and Life After Encephalitis—A Narrative Approach by Dr. Ava Easton.
Key Facts about Brain on Fire: My Month of Madness
  • Full Title: Brain on Fire: My Month of Madness
  • When Written: 2009-2012
  • Where Written: New Jersey and New York
  • When Published: 2012
  • Literary Period: Contemporary non-fiction
  • Genre: Memoir
  • Setting: New York City, New Jersey, and the NYU hospital, 2009
  • Climax: Dr. Najjar diagnoses Susannah with anti-NMDA receptor autoimmune encephalitis
  • Antagonist: Anti-NMDA receptor autoimmune encephalitis
  • Point of View: First Person

Extra Credit for Brain on Fire: My Month of Madness

Florence Forth. In 2012, a young girl named Florence died from anti-NMDA receptor autoimmune encephalitis. In her honor, her parents organize the Florence Forth race, a yearly 5K and 10K road race in North Carolina to support the Autoimmune Encephalitis Alliance.