Susannah explains that it possibly all began with bedbug bites—though the bedbugs never existed. She wakes one morning to find bites on her left arm, and is concerned that her apartment is infested with bedbugs. Susannah calls an exterminator to check her apartment, and he deems it free of bugs. Regardless, Susannah insists he come back to spray. She feels as though her body is overrun by bugs.
By stating right off the bat that the bedbugs never existed, Susannah allows the reader a detached, all-knowing look into how she changes over the course of her memoir. Her fear and paranoia are symptoms of her illness, and by bringing these emotions front and center, she shows how they came to singlehandedly guide her actions.
Susannah does her best to keep her concerns from her coworkers, so she conceals her bites the next day when she walks to her cubicle at the New York Post. She describes the newsroom as eccentric, like a bar without alcohol. Today, however, the room is subdued and silent. Susannah slides into her seat beside Angela, one of her best friends, and quietly asks if she knows anything about bedbug bites.
It's important to note that Susannah begins asking for help and affirmation right away. This begins to build up the idea that she has strong, trusting relationships with friends and family before all the action takes place.
Angela scoots away from Susannah with a smile. As Susannah tries to show Angela her arm, her phone rings. It's Steve, the Sunday editor. All reporters have pitch meetings with Steve on Tuesday. Susannah realizes with horror that she has nothing to pitch to Steve; she totally forgot about the meeting. This is entirely out of character for her, but she nervously walks to Steve's office anyway and sits down next to Paul, another editor and her mentor.
Because Susannah never has the opportunity to show anyone her bug bites, it becomes one of the great mysteries of the text. Later, she questions if they were even ever there. This is an example of Susannah offering evidence that she's an unreliable narrator, and that there are parts of her story that are impossible to corroborate.
Susannah, Paul, and Steve sit in silence for a few minutes. Desperately, Susannah says she saw something on a blog. Steve cuts her off and tells her to not come into his office again with nothing prepared. Susannah feels like she's not worthy of Paul's faith and respect, and feels angry at herself for forgetting the meeting.
The fact that the outcome of this meeting is out of character for Susannah shows that prior to her illness, she was generally responsible and on top of things. When she questions this strange turn of identity, it shows that she's trying desperately to figure out how this actually fits in with what she knows of herself.
As Susannah walks home to her apartment in Hell's Kitchen later that evening, she ruminates on the day's disasters. She describes her apartment as a complete cliché of a New York writer: it's a tiny studio, and she sleeps on a pullout sofa. Despite the exterminator's insistence that the apartment doesn't have bedbugs, Susannah prepares for her extermination appointment by throwing away everything that could harbor bugs. She throws out hundreds of articles she wrote for the Post. She wonders how she's suddenly so bad at a job she loves so much.
When Susannah does things early on like wonder why she's suddenly so bad at her job, or forgets things, it begins to erode her trust in herself and in her judgment—something that will prove catastrophic as the disease progresses. This suggests that physical illness (especially involving the brain, and when it's not diagnosed or obvious) has the power to both change a person's identity and that person's trust in their identity.
Susannah pauses when she comes across the biggest story of her career: an interview with the child kidnapper Michael Devlin. She explains that she loved journalism because it gave her a life that was crazier than fiction, but she didn't know then that her life was about to become just as bizarre as some of her headlines. Throwing beloved mementos away like this was totally out of character for her, she says, and a bug obsession can be a sign of psychosis.
Throwing these mementos away is also symbolic of the fact that Susannah's illness will change her, fundamentally and forever. She'll never be the same person as the person who wrote and collected these articles, and their imminent departure alludes to Susannah's own coming departure from the person she was.
When Susannah finishes clearing out her apartment, she suddenly feels a pit in her stomach. As she stands, intense pain flashes through her head. She stumbles to the bathroom, feeling as though her body is slow to react, and wonders if she's getting the flu. She tells the reader that her illness began mysteriously, and she almost ended up in an asylum for life.
By making it very clear that this illness could have had catastrophic consequences for her, Susannah creates tension and suspense in the narrative. Describing her symptoms in such detail also works in her overall project of spreading awareness about this disease.