Brain on Fire: My Month of Madness

by

Susannah Cahalan

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Brain on Fire: My Month of Madness: Chapter 31 Summary & Analysis

Summary
Analysis
Later in the afternoon, Dr. Russo arrives and tells Dad that they've officially diagnosed Susannah with anti-NMDA receptor autoimmune encephalitis. She describes the usual progression of the disease, which follows Susannah's progression perfectly. Dad is relieved to hear that there are treatments, but Dr. Russo cautions him that some patients remain disabled, and 4% die anyway. She also mentions that the disease is often instigated by a tumor called a teratoma, which often grows on the ovaries. Susannah notes that this kind of tumor can contain bone, hair, and eyes. Dr. Russo explains that they'll perform a transvaginal ultrasound and checks for melanoma.
Finally, Dad can experience the true relief and sense of control that comes from being able to name and describe what's been happening to Susannah. Having the name is comforting also because it means that there are others like her who have had this disease—Susannah is now a part of a (very small) community who understands this experience. This then demonstrates the true power of being able to name and describe something.
Themes
Storytelling, Memory, and Emotion Theme Icon
Love and Family Theme Icon
Responsibility and the Medical System Theme Icon
Susannah stares off for much of this, but reacts when she hears Dr. Russo mention the possibility of chemotherapy. She begins crying, and Dad rushes to comfort her. Susannah cries that she's dying, and Dad promises to get her out of the hospital. Dr. Russo says that this diagnosis is good news, and they might be able to get Susannah mostly back to her old self.
Susannah's reaction to this part of Dr. Russo's description in particular suggests that she's beginning to come back to “herself” and isn't so delusional.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Susannah explains that over her three weeks in the hospital, she'd gone from being a difficult patient to a favorite and a curiosity. The morning after her diagnosis, a young doctor leads a group of medical students into Susannah's room while Dad feeds her breakfast. The doctor speaks as though Susannah isn't there, and shares her diagnosis. He then mentions the possibility of a teratoma and says that if they find one, they may remove Susannah's ovaries. Susannah begins to cry. Dad rushes the doctor and yells for him to get out of the room.
This doctor illustrates how the medical community often dehumanizes the very people it aims to help—particularly in some varieties of the practice described here, called “grand rounds,” in which a doctor might use a patient as a teaching example for medical students or fellows. To this doctor, Susannah is little more than an interesting test subject now available at NYU, and his speech to the med students demonstrates a shocking lack of compassion and empathy.
Themes
Identity and Illness Theme Icon
Responsibility and the Medical System Theme Icon