Brain on Fire: My Month of Madness

by

Susannah Cahalan

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Brain on Fire: My Month of Madness: Chapter 48 Summary & Analysis

Summary
Analysis
As she researches her disease, Susannah realizes that she's not the only person who suffered from this disease and others like it. She explains that though her disease is rare, it's very common for women to contract autoimmune diseases because their immune systems are more complicated. Dr. Dalmau has also identified other autoimmune diseases that attack different receptors in the brain, which will hopefully allow medical mysteries to be solved.
When Susannah mentions that women are more prone to diseases like this, it vaguely calls out a medical system that doesn't take women seriously: women, more often than men, are prescribed medications to help with "mental health" issues and are less likely to have their pain or problems taken as the serious physiological conditions they might be.
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Identity and Illness Theme Icon
Responsibility and the Medical System Theme Icon
After the article runs, Susannah's inbox fills with emails from people who either believe they're suffering from the same disease or suspect that their family members are. Susannah speaks with many fellow sufferers who experienced delusions and hallucinations, not all of whom returned fully to normal. Some individuals diagnosed with schizophrenia begin calling Susannah, desperate for another answer. These calls scare her, and she refers them to her doctors at NYU.
These early calls and emails show Susannah that there's absolutely a need for her voice in the discourse about disease. In turn, this is one of the reasons she eventually writes this book, to allow people a concise look at the disease without the confusing medical jargon. Further, she didn't change the names of some of her doctors, which means that they're easily searchable on the internet.
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Responsibility and the Medical System Theme Icon
Susannah feels guilty that she survived and recovered when so many others do neither. One man calls Susannah and in an accusing, aggressive voice asks her why she got better when his wife died. Susannah tells the reader that even with treatment, there's still a 25% chance that a patient will die or be permanently disabled. Some of the people Susannah meets make her illness seem like a gift. One woman whose daughter developed the disease spends hours spreading awareness on Facebook and other sites to connect sufferers to survivors.
These endeavors to connect patients and survivors seek to mitigate some of the pain and suffering that Susannah experienced when it seemed like she was the only one with the illness. This means that families will have more support and might not suffer as much or in the same way that Mom and Dad did with Susannah.
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Love and Family Theme Icon
Responsibility and the Medical System Theme Icon
Susannah tells the reader that the most affirming moment of her life was when a man called her to share the story of his daughter, Emily. Emily, a college student, became paranoid, spent time in the ER and in a psychiatric ward, and was diagnosed with "psychosis, not otherwise specified." A family member saw Susannah on the Today Show and passed the video on to the man. When he brought it to Emily's doctor, the doctor was offended. Emily appeared to recover and returned to school, but over spring break, her condition deteriorated. She stopped speaking and couldn't eat. When her parents took her to the hospital, they learned that an MRI from the year before indicated that her brain was inflamed. Emily developed a blood clot and began having seizures.
Emily's story is proof that Cahalan's project of spreading awareness and giving others the language to talk about the disease was successful in at least one crucial instance—Emily almost certainly would've died if her dad hadn't had access to Susannah's article. The doctor who was offended shows again how broken the medical system can be, and how the prestige afforded to doctors causes them to sometimes doubt their own ability to make mistakes or miss things.
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Love and Family Theme Icon
Responsibility and the Medical System Theme Icon
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Brain on Fire: My Month of Madness PDF
Emily's dad shoved Susannah's article at a neurologist, who agreed to test her for the disease. Emily was moved to the University of Pennsylvania, where Dr. Dalmau's colleagues treated her. Emily made a full recovery. Her dad later sends Susannah a video of Emily ice-skating after her recovery.
Emily seems to have gotten her “spark” back, just like Susannah did. Her success and recovery show again that it's sometimes necessary to circumvent the usual medical system to get the care a patient needs. 
Themes
Identity and Illness Theme Icon
Responsibility and the Medical System Theme Icon