Brain on Fire: My Month of Madness

by

Susannah Cahalan

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Brain on Fire: My Month of Madness: Chapter 39 Summary & Analysis

Summary
Analysis
Susannah's life revolves around taking her medications six times per day. For her, they symbolize that she cannot be independent, as divvying out the pills is too difficult of a task for her. Mom makes sure Susannah takes them, which leads to fights. Susannah admits that during these months, she was often cruel to Mom, as Mom was forced to parent her like a much younger child. Susannah explains that she was holding an unfair grudge against Mom for not spending enough time at the hospital, something that wasn't true. Though Mom and Susannah used to be inseparable, they now find themselves at odds.
As she recovers, Susannah's very identity is tied closely to her illness by her pills—she's forced to remember, six times per day, that she's very sick. The fights with Mom at this point mirror common teen-parent arguments and suggest again that this process is a sort of coming-of-age for Susannah. Taking her pain out on Mom shows that Susannah is still unwilling to be introspective about herself, and instead is critical of others.
Themes
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Responsibility and the Medical System Theme Icon
Related Quotes
Every two weeks, Mom, Dad, and Susannah have an appointment with Dr. Najjar. He and Dr. Arslan slowly reduce Susannah's doses of medication and ask Susannah how much she feels like herself. Susannah always answers with either 90 or 95 percent, and Dad agrees. Mom insists that Susannah is at 80 percent, though she tells Susannah later that that was a stretch.
The different reactions from Mom and Dad regarding Susannah's answers suggest another reason why Susannah resents Mom during this time: Mom isn't willing to play into Susannah's desire to see herself as fully well, while Dad is.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Love and Family Theme Icon
Responsibility and the Medical System Theme Icon
Mom is adamant that Susannah attend two evaluation sessions at a rehabilitation center. Susannah doesn't want to, as she doesn't want proof that she's unable to accomplish simple tasks. Though she's too exhausted to be tested on her first trip, Dr. Bertisch does test her on the second. Susannah scores abysmally on tests that measure her concentration, working, and visual memory, though her scores are better than they were in the hospital. However, on tests to measure her verbal processing, reasoning, and analytical thinking, Susannah scores very well. Even Susannah can verbalize that there's a major disconnect between what's in her mind and what her body can help her express.
Again, though these testing sessions are certainly valuable (at least in terms of later writing this memoir), when Mom forces Susannah to take part, it shows her forcing Susannah to accept that she's not well. Mom knows that Susannah still isn't fully herself—if she were willing to believe Susannah, such testing wouldn't be necessary. Mom is engaging in tough love, and the cruelty that Susannah shows in response indicates that tough love is tough for everyone.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Love and Family Theme Icon
Responsibility and the Medical System Theme Icon
Dr. Bertisch suggests cognitive rehabilitation and individual therapy to address Susannah's feelings of anxiety and depression when she's unable to communicate, though Susannah does none of it. She doesn't want to have to face up to the fact that she's struggling because her inner self is doing well, while her body is still failing.
Susannah’s mental health problems reinforce the connection between the body and physical illness and the mind, as Susannah's body is directly to blame.
Themes
Identity and Illness Theme Icon
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