Brain on Fire: My Month of Madness

A few days later, Dr. Najjar is finally scheduled to arrive. Susannah drools and smacks her lips, habits that are now constant. Mom is excited to meet Dr. Najjar, but Dad is much less enthusiastic. When Dr. Najjar enters Susannah's room, he warmly greets Mom and Dad and then goes through Susannah's medical history. He's the first doctor to express interest in seemingly disconnected symptoms, such as the bedbug scare and the numbness. Then, he turns to Susannah and speaks to her directly.

Susannah explains to the reader that Dr. Najjar is personal and heartfelt, and he loves to help the weak and powerless. This is because as a boy in Syria, he'd done very poorly in his private Catholic school. His father had moved him to public school, where a kind teacher took him under her wing. By the end of the year, Najjar was getting straight As. When his parents confronted the teacher about the possibility that Najjar was cheating, the teacher suggested that Najjar was actually smart. Eventually, Dr. Najjar graduated at the top of his class, immigrated to the US, and became an esteemed neurologist. He never gives up on his patients.

Dr. Najjar asks Susannah for her name, the date, and the president, which she can answer with some delay. He leads her through several movement exercises, which Susannah can perform with extreme delay and difficulty. Finally, he decides to try the "clock test," a test designed to diagnose problem areas of the brain in patients with Alzheimer's and strokes. He hands Susannah a piece of paper and asks her to draw a clock face with numbers. On her second try, Susannah manages to draw a circle. Slowly, she writes in the numbers--all on the right side of the clock. Dr. Najjar is ecstatic, and explains that this means the right side of Susannah's brain is inflamed.

Susannah tells the reader that both sides of the brain must work to see: information that the eye sees in its left field of vision is processed in the right side of the brain and vice versa. Susannah's clock is an example of "visual neglect," or evidence that the brain isn't processing things on one side. This also explains the numbness on one side of her body as well as the paranoia, seizures, and hallucinations. Dr. Najjar figures that the inflammation is likely the cause of an autoimmune reaction and remembers a rare autoimmune disease. The diagnosis requires a brain biopsy, but Dr. Najjar doesn't tell Mom and Dad that.

Dr. Najjar paces as he thinks all this through and then sits down next to Susannah. He tells Mom and Dad that Susannah's brain is on fire, takes Susannah's hands in his, and tells her that he'll do everything he can. Susannah begins to cry and throws her arms around him.