Brain on Fire: My Month of Madness

by

Susannah Cahalan

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Brain on Fire: My Month of Madness: Chapter 33 Summary & Analysis

Summary
Analysis
The first thing that Susannah wants to do when she gets home is shower. She insists on showering by herself. When Lindsey checks on Susannah after a half an hour, she sees Susannah sitting on her bed, trying unsuccessfully to connect a zipper on her hoodie. When Susannah drops the zipper and starts crying in frustration, Lindsey rushes in and zips the hoodie for her.
Parts of Susannah’s old identity are clearly there, but they're still struggling against her illness to get out. Lindsey's hesitation to help encapsulates Susannah's family's new dilemma: how much should they help her, when she needs help but doesn't always want it?
Themes
Identity and Illness Theme Icon
Love and Family Theme Icon
That evening, Stephen cooks pasta and Mom and Allen leave Stephen, Susannah, and Lindsey home alone. After dinner they sit outside. Lindsey and Stephen talk and when they light cigarettes, Susannah gets up and goes inside. Susannah, paranoid, calls Mom's phone and leaves a voicemail saying that Stephen is going to leave her to date Lindsey. After calling Mom, Susannah looks out the window and wonders why Stephen would want to be with her.
The paranoia about Stephen's feelings for Susannah is another common delusion in patients exhibiting psychosis; this again situates Susannah within a long history of medical knowledge and demonstrates that her case isn't necessarily unique.
Themes
Identity and Illness Theme Icon
Love and Family Theme Icon
Responsibility and the Medical System Theme Icon
When Mom gets the voicemail she's worried that Susannah is regressing. She calls Dr. Arslan, who instructs Mom to give Susannah an extra dose of her anti-psychotic medication. Susannah tells the reader that it wasn't until years later that Dr. Dalmau discovered that patients recovering from anti-NMDA receptor autoimmune encephalitis go through the same stages of the disease in reverse order.
When Cahalan explains that Dr. Dalmau made this discovery years after she was ill, it impresses upon the reader that the medical community is always advancing. Also, her story isn't timeless, as it relies heavily on the medical knowledge available at the time.
Themes
Responsibility and the Medical System Theme Icon
At the end of the weekend, Lindsey prepares to drive back to St. Louis with Jeff, another friend from college. When Jeff expresses interest in seeing Susannah, Lindsey warns him that Susannah isn't how they remember her. Susannah's speech patterns and difficulty moving scares him, but he embraces her anyway and tells her that everyone is thinking of her. Before she leaves, Lindsey bursts into tears and hugs Susannah, and Susannah also cries.
Lindsey's warning to Jeff illustrates perfectly how people use memory to formulate the identities of other people: she recognizes that Jeff's memory of the person Susannah was will make this new Susannah even harder to accept, just because she's so very different.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Love and Family Theme Icon
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