Brain on Fire: My Month of Madness

by

Susannah Cahalan

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Brain on Fire: My Month of Madness: Chapter 9 Summary & Analysis

Summary
Analysis
When Susannah regains consciousness, she sees a homeless man vomiting and another bloody, beaten man handcuffed to a bed. She wonders if she's dead and feels furious. Susannah tells the reader that she knows now that at this point in the hospital, her body and personality had already surrendered to the disease and her malfunctioning brain.
Susannah insists that her behavior up until much later isn't "her"—her identity and personality here is something entirely separate from the person her friends and family knew her to be. She implies that errant brain chemistry can fundamentally change a person.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Responsibility and the Medical System Theme Icon
Susannah thinks that she's dying because of the MRI lab technician who flirted with her, and she commands Stephen to get her out of the room immediately. Stephen looks frightened. When a doctor assures Susannah that they'll move her, Susannah is thrilled to discover she has power. She holds Stephen's hand tightly as a nurse wheels her bed away, feeling sorry for him because he doesn't know she's dying.
Though Susannah's thoughts are absolutely not normal or correct given what she's already explained about her illness, it's worth noting that she's not totally wrong that she's dying: without proper medical intervention she probably will die.
Themes
Identity and Illness Theme Icon
Responsibility and the Medical System Theme Icon
Susannah quietly tells Stephen that she's dying of melanoma. When she sees tears in his eyes and he tells her that she doesn't know that, Susannah yells that she's going to sue the MRI guy who hit on her for not catching her melanoma. A young doctor interrupts Susannah and offers to recommend a dermatologist, but insists that they have to discharge her. Stephen is distraught, but the doctor explains that seizures are common and often are one-off events. He suggests that Susannah see a neurologist.
When the ER doctor insists he needs to discharge Susannah, it's another example of the medical system failing to recognize that something is truly wrong. In an emergency room setting, doctors aren't prepared to spend too much time with any one patient, as crisis management is the focus. This makes it clear that Susannah will need to appear extremely ill physically before she'll get thorough help.
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Stephen insists he has to call Susannah's mom, but Susannah, suddenly back to her normal self, doesn't want Mom to worry. Stephen steps into the hallway and calls Mom's house. Her husband, Allen, picks up, and Stephen explains what happened. Allen tells Stephen to go home, and promises that they'll come in the morning. Mom begins to cry.
Susannah sometimes returns to her “normal” self, suggesting that the illness isn't compromising her personality all the time—which makes it all the more confusing. However, this also makes it clear that Susannah desperately wants to care for her mom and her emotions.
Themes
Identity and Illness Theme Icon
Love and Family Theme Icon
Responsibility and the Medical System Theme Icon
Related Quotes
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Brain on Fire: My Month of Madness PDF
The next morning, Mom bombards Stephen with anxious questions. Stephen, Mom, and Allen try to convince Susannah to move back home to Summit, New Jersey, but Susannah refuses. She feels that staying in her own apartment is exceptionally important, but finally, they convince her to go.
Susannah's desperate desire to be alone is an example of her actively refusing care and love from her family, as it's evident to everyone else that she's incapable of living alone. Her illness makes her paranoid, and so she pulls away from people she loves.
Themes
Identity and Illness Theme Icon
Love and Family Theme Icon
Rather than relax in her childhood home, Susannah becomes obsessive about clinging to her Manhattan life. On Sunday afternoon, she tries to write a simple article about a dance troupe, but she can't make it past the first line. She begins to pace and wanders into the family room, where Mom and Allen are watching the medical drama House. The green couch suddenly looks garish and the room begins to pulsate. Susannah wakes up on the couch with Mom rubbing her feet, which are stiff and painful. Mom schedules an emergency appointment with Dr. Bailey for Monday.
Cahalan's occasional mentions of House reinforce the idea that her illness is a medical mystery or anomaly (House follows a doctor who deals almost exclusively with unique cases). In turn, it also foreshadows Susannah's own treatment trajectory, as a majority of Dr. House's patients are shockingly close to death before he miraculously diagnoses and treats them.
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Responsibility and the Medical System Theme Icon
Over the weekend, Susannah ignores calls from concerned friends and coworkers because she's embarrassed by her behavior. Susannah picks up the phone once for a friend, Julie, and tells her everything that's been going on. Julie suggests that Susannah might have bipolar disorder and is possibly having a manic episode. Susannah is relieved to have an answer and thrilled to discover that she's in a league with a number of famous creative people who are believed to have bipolar disorder, including Jim Carrey, Mark Twain, and Beethoven.
A diagnosis of bipolar disorder allows Susannah to take on the identity of a somewhat tortured, eccentric creative—an identity that, incidentally, plays directly into her desire to move back into her apartment alone and be independent. Again, even though this diagnosis isn't correct, it does provide comfort for Susannah as it at least gives her the language to describe what's going on.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Responsibility and the Medical System Theme Icon
Regardless, Allen and Mom drive Susannah to Dr. Bailey's on Monday. The painting in the waiting room seems to match Susannah's mood. Dr. Bailey doesn't seem nearly as jolly this time, and the exam yields normal results yet again. However, Susannah mentions to the reader that Dr. Bailey was missing important details—he noted on his chart that Susannah was on a plane when she had her first seizure.
Dr. Bailey continues to miss things and seems far too sure that he's correct, ignoring Susannah’s sense of her own health. This is probably a byproduct of not being able to spend much time actually getting to know his patients. Even though he's wrong, his status as a renowned neurologist means that his notes take on their own kind of truth, simply because he believes they're true and his opinion is respected by other doctors.
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Dr. Bailey asks Susannah about her alcohol consumption. She thinks she hasn't had any in the last week, but admits that she usually has two glasses of wine every night. She tells the reader she didn't know then that doctors often double or triple what patients report. Susannah tells Dr. Bailey that she thinks she has bipolar disorder, and he writes her a prescription for an anti-seizure medication and refers her to a psychiatrist. He pulls Mom aside afterwards and tells her that he believes Susannah is partying too hard, working too hard, and not sleeping. Mom is relieved.
Here, Mom gets the relief that comes from a diagnosis, which gives her the words to make sense of what's going on. When Susannah mentions that Dr. Bailey is multiplying her alcohol consumption, it's worth noting that a bottle of red wine contains four glasses, and three drinks in one night is sometimes considered an episode of binge drinking for women. Thus, Dr. Bailey is "discovering" that Susannah is binge drinking nightly.
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Love and Family Theme Icon
Responsibility and the Medical System Theme Icon