Brain on Fire: My Month of Madness


Susannah Cahalan

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Brain on Fire: My Month of Madness: Chapter 45 Summary & Analysis

Susannah returns to work in September. Though the HR department suggests that she ease back into work, Susannah dives in as though she'd never left. She tackles every article with enthusiasm, though she works slowly and must record interviews because she can't write as fast as she once could. Both Angela and Paul discreetly help her.
The need for Paul and Angela's help suggests that Susannah is in a liminal place in her recovery, where she can once again function, but she's not quite all there.
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The week before her return to work, Susannah and her parents attend her final appointment with Dr. Arslan. Susannah tells him that she feels totally back to normal, and both Mom and Dad agree. Dr. Arslan releases Susannah from his care with a smile. However, Susannah tells the reader that she was actually far from a full recovery. She was in a stage of recovery in which patients are mostly back to normal by others' assessments, but still struggle with tasks that were once easy. This stage can last several years.
As Cahalan admits that this particular liminal state is part of the natural progression of the disease, she situates her recovery once again in terms of a greater cultural and medical narrative. With this, others can know what to expect and can understand that this is normal and not necessarily indicative of a regression.
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Right after her return to work, Dr. Najjar finally gives Susannah permission to color her hair. The stylist dyes Susannah's hair blond and cuts bangs to cover up her biopsy scar. When Susannah shares some of her story with the stylist, she puts Susannah's hair in rollers to mitigate some of the strange texture changes caused by her medication. Susannah feels amazing as she walks to the subway, but is quickly brought down to earth when she hears an ex-boyfriend calling her name. He apologizes for not calling and they exchange pleasantries, but Susannah feels off balance when she sees the pity in his eyes. She catches sight of herself in a window and notices how chubby she still is, and hates how much she's changed.
Even if Susannah can perform tasks and move through society with relative ease by this point, reminders that she's not all there still have the power to plunge her back down into agonizing about her identity going forward. This is heightened by the intimacy she shared with the boyfriend while they were together—he would've seen her in ways that other people don't, which means he has more "before" memories and more information to compare to this new version of Susannah.
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