Brain on Fire: My Month of Madness

by

Susannah Cahalan

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Brain on Fire: My Month of Madness: Chapter 41 Summary & Analysis

Summary
Analysis
Susannah tells the reader about neuroplasticity, or the brain's ability to form new neural connections and alter the strength of existing neurons. During her third hospital stay, Susannah finally becomes truly aware that her brain is healing. She begins keeping a diary and expresses that she wants to understand what happened. She explains that this diary has helped her actually remember what it was like to be this budding version of Susannah. Despite this, however, the Susannah that comes through in this diary is childlike. The passages read very much like a preteen wrote them, as they're focused entirely on her changing body and petty day-to-day issues.
As Susannah continues to heal, Cahalan's tone changes when she talks about the brain—now, she seems to have a sense of awe, which in turn offers hope that Susannah's brain will soon begin cooperating with her, not just fighting her and making life difficult. Discussing neuroplasticity suggests that Susannah will indeed be capable of creating these connections that will allow her to again perform the identity she wants.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Responsibility and the Medical System Theme Icon
Related Quotes
Susannah begins her journal on June 3. Dad sits with her and suggests that she begin to write down what she remembers about what happened. Dad is alarmed to see that Susannah remembers nothing after her third seizure on the day she was first admitted to the hospital. However, her handwriting and sentence structure have improved dramatically. Dad helps Susannah fill in events from the hospital stay, though he purposefully leaves out particularly painful events.
Though her memory isn't there, it's a major step to now have the skills to be able to tell her own story—even if she needs help filling in the events. This is an early indicator that being able to write this all down is one of the primary ways in which Susannah takes control of what happened and begins to construct some sort of memory for herself.
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Love and Family Theme Icon
Susannah explains that Dad helped her for her benefit only, as he overwhelmingly refuses to talk about her time in the hospital. Later, Giselle would tell Susannah privately how hard it had all been on Dad. He'd refused to talk to relatives on the phone, afraid he'd break down. Rather than talk to Susannah directly about her time in the hospital when she began writing this book, he gave her his personal journal.
The fact that Dad is willing to both revisit the experiences in the hospital and trust Susannah with his personal journal is indicative of the deep bond they’ve formed. He's willing to undergo pain in order to help her make sense of her experience and find some closure.
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Love and Family Theme Icon
By summer, Susannah and Dad regularly have dinner together. She tells the reader that even now, she and Dad sometimes lock eyes and begin speaking in a way that excludes everyone else at the dinner table. She explains that their bond was strengthened after looking her death in the face.
This result of Susannah's illness is a clear indicator that it’s effects weren't all bad: a new close relationship with her once-distant father is inarguably a positive outcome. Illness has the power to both strain and strengthen relationships.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Love and Family Theme Icon
Related Quotes
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Brain on Fire: My Month of Madness PDF
Susannah's relationship with Mom suffers greatly after her release from the hospital. They'd been close before, but Susannah's dependence on Mom to dispense medications took a toll on their relationship. To cope with this, Mom insists that Susannah wasn't that bad, and she knew that Susannah would recover. Mom doesn't accept that Susannah isn't fully recovered yet until midsummer. She and Susannah go out for lunch and Susannah begins to ask about the period before her hospitalization. Susannah has begun to realize that most of what she "remembers" are actually just hallucinations, so she's excited to learn more of the truth. Mom asks Susannah if she remembers her EEG. After some discussion, Susannah remembers the nurse's strobe light.
Notice here how Susannah draws a very firm line that her hallucinations aren't actually truth. Insisting that her lived experience of her time in the hospital isn't real mirrors the split between internal identity and performed identity, as hallucinations happen entirely in the brain, while actual "truth" is something that others can verify—yet both can be memories. Mom also tries to take control of her memories and rewrite her own story of what happened in order to make herself feel better.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Love and Family Theme Icon
As Mom watches Susannah try to remember, Mom puts her face in her hands and starts crying. Susannah tries to comfort Mom. Mom laughs and recounts Susannah demanding food at the diner. Susannah remembers a brief image of the man behind the counter, but nothing else. Susannah explains that this was the turning point for her relationship with Mom. Mom finally admitted how afraid she was that Susannah would die, and from that point, they're able to move forward.
The fact that the early events can now be considered somewhat funny illustrates how time changes a person’s perception of their memories, and this can be a good thing. Now, the stop at the diner doesn't have quite the sinister undertones that it did in the past.
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Storytelling, Memory, and Emotion Theme Icon