Enter the Void: Identity and Recovery in Brain on Fire

In Brain on Fire: My Month of Madness, Susannah Cahalan struggles to reconstruct the events during her month of madness in which Susannah’s twenty-four years of normality is suddenly lost in a matter of weeks. As her consciousness and physical body are no longer compatible, she is no longer able to comprehend what she is doing, and thus can no longer understand what she is becoming. With virtually no recollection of her actions, Cahalan’s self is fragmented, and she uses Brain on Fire to pioneer through her journey in hopes of redefining her identity.

Due to the lack of control that Susannah has over her actions, Susannah uses words such as monster and stranger to describe the part of her that she and her family repeatedly have to confront. For example, when she re-reads the journal entries of old Susannah “urgently [attempting] to communicate some deep,dark part of herself”(60), she describes it as incomprehensible even though she wrote it herself. This part of Susannah is a complete stranger, and a dysfunctional one. Her boyfriend, Stephen, stays by her side and Susannah describes it as Stephen “loving [her] enough”(58) to look past the sick Susannah and see the old Susannah in her. Just by saying this, she implies how her illness created this negative exterior that blocked the ‘real’ Susannah from everyone else, hence a separate categorization. Although Susannah’s emotional and physical well being relies on the support of her family, it begins to take a toll on her when it begins to seem like “pity radiating” from them. So not only does Susannah need to rely on them for basically everything, she needs to be able to feel their support. This dependent, insane, and unpredictable side of Susannah is what pushes her to characterizes herself as a monster.

As Susannah’s state of being rapidly deteriorates, she relies on her family and friends and outside sources to help her piece together the mystery of “new Susannah”. In the earlier stages, Stephen witnesses one of Cahalan’s seizures. Although she vividly describes the scene, Susannah has not regained the memory of this seizure, saying that she instead relied on Stephen’s recollection(41). This event signified a turning point in Susannah’s life, where she would look back at it and only remember a significant disconnection. Later on, for Susannah’s birthday, her cousin Hannah gives her a gift that she has trouble unwrapping. She says her “physical slowness and awkward speech pattern reminded Hannah of a Parkinson’s patient”(104). In fact, when the gifts turn out to reflect the books that she previously read, Susannah says that she has never read them. This observation from Hannah and her mother are an outside source that clearly exhibit how forgetful Susannah was during her illness, further shown by the fact that she can’t remember the whole event after her illness regardless. When her friends visit her in the hospital and try to find out what’s going on, she once again says “I…….don’t……remember”(111). This repeated forgetfulness portrays a struggle between the old Susannah and the new Susannah with doing everyday normal things, such as carrying a casual conversation with friends she’s had for years.

During her month of madness, there are always people around her wondering “do you think she’s ever going to be the same” (111). As she delves deeper into the mystery of her illness, Susannah not only disconnects from her old self, but loses it completely as the insanity takes over. Her illness caused her behavior to deviate from what she understands to be the social norm, and as a result makes way for a multitude of binary constructions. In the beginning, when Susannah tries to pinpoint a reason for why she is the way she is, she ends up going back and forth with her mom and Allen because of multiple illogical reasons she comes up with(56). This is a signifier to post-recovery Susannah and to her mother and Allen of how the rational Susannah has been replaced with an erratic one during her illness. Although Susannah has maintained a professional and normal lifestyle hitherto, she quickly becomes impulsive and delusional. This is reflected when she tries to jump out of the car shortly after hallucinating (61). Susannah also has a significant problem with her speech, a problem that she as a professional journalist has never dealt with prior to her illness. She says that “I had been a professional conversationalist, normally the kind of person who could make small talk with a brick wall” (109). During her illness, however, Susannah recounts how people can barely understand what she says half the time. This is a signifier of a new self emerging and also perhaps the loss of her old identity. In one of the EEG videos, Susannah is seen turning on the TV and speaking to it, and then freaking out when the nurses turn the TV off(87). Since at this point nobody has identified the illness in Susannah yet, these delusions not only impact Susannah, but the doctors trying to help her. They associate terms such as “schizoaffective disorder” and “psychosis” to Susannah, which only pushes her into confusion even more.This confusion can be seen as doctors continue to associate terms with her symptoms but are unable to pinpoint a specific cause with their MRIs and CT scans (114). In fact, at one point a nurse tells her that she’s seen Susannah’s situation before and that it’s all in her head because of the stress fro Susannah’s work (64). Susannah takes it quite literally and ends up thinking that everything was a trick and the nurse was a hired actor. As a result, this deflates Susannah’s motivation of finding answers, which expands the hole in her identity that she is working to fill in.

Even though Susannah’s deviation becomes apparent to herself at one point, she still has a hard time adapting and conforming to it appropriately. Although, many of her reactions were greatly influenced by her illness. For example, this is evident when Dr. Najjar redirected Susannah to a brain biopsy, Susannah reacted with childlike enthusiasm that quickly turned to fear and distress (137). Furthermore, Susannah’s new self is so deviated from her old self, that even she barely recognizes herself. When Susannah describes re-watching video tapes of herself, she says that she “could never have imagined [herself] capable of such madness and misery” (175).

Susannah’s identity is also shaped and impacted in many ways by the relationship with her family, boyfriend and friends. Throughout the memoir, Susannah often reveals how much the support of these people contributed to Susannah’s road to recovery. When Susannah’s old self emerges amidst the abnormality and insanity, it is clear that it excited the characters around her because it represents progress. This can be seen when Susannah and her boyfriend Stephen begin singing the chorus of a song they both love together towards the end of the book (171) and Stephen reacting in astonishment. Susannah’s relationship with her dad is also very significant. At the beginning of the memoir, her dad is very apprehensive and cautious. As the story progresses, Susannah’s illness breaks down her dad enough that he becomes vulnerable to her. For example, during one of her paranoid outbreaks, her father shifts his attitude from fed up to troubled, and he asks her “‘Why are you doing this to me”(67). Susannah, of course, with waning mental stability, doesn’t know and doesn’t care, which troubles her father even more.

Later on though, Susannah says that weeks after the illness began, her father spent more time with her than usual and was determined to support Susannah as much as possible. Susannah describes how her father kept a journal as well, and wrote about how he prays “God would take him instead of [her]” (95). It is heartbreaking to Susannah, and very clearly exhibits the level of compassion that Susannah’s father has toward supporting his daughter. This is very important in terms of Susannah’s recovery, because it indeed does help. After all, Susannah’s dad suggested for Susannah to keep a journal, which turned out to not only benefit Susannah during her illness, but help Susannah understand herself after the illness, too. Her dad played a crucial role in the improvement of Susannah’s health solely because of his persistence and positivity (94).In the pursuit of recovering her lost identity, Susannah uses professional techniques to assist her in doing so. In her author’s note, Susannah describes her story as “a journalist’s inquiry into that deepest part of self-personality, memory,identity.” A resourceful person, Susannah uses her computer diaries as a way to try to delve into the mindset of herself while she was sick (59). Susannah also uses videotapes of therapy sessions, hospital sessions and more to gain more insight. When watching the videos, Susannah does not refer to herself as “me” but as “her” (175). This is very significant because even while trying to reconnect the missing pieces, Susannah is unable to comprehend how sick Susannah was the same as normal Susannah.

Brain on Fire provides an unconventional approach to understanding an illness, in this case an autoimmune disease, that is more to provide closure to the author herself then to explain the situation to the readers. In an attempt to comprehend herself during this illness, Susannah plunges into the world of mystery and uncertainty that is her sickness. It is vital for her to do so because she has lost a significant part of herself with this disease. She recognizes that she can perhaps never get it back, but the journalist intuition in Susannah pushes her to take the risk to attempt to pick up and understand the pieces left behind.

Works Cited

Cahalan, Susannah. Brain on Fire: My Month of Madness. Simon & Schuster Paperbacks. New York. 2012. Print.