Neuro Note: Brain on Fire

     The book Brain on Fire: My Month of Madness by Susannah Cahalan is a memoir about and by Calahan, a journalist for the New York Post in her mid-twenties. Typically an intelligent, outgoing, and friendly woman, she starts experiencing strange symptoms that first seem like the flu but then become more psychiatric in nature and much more concerning, such as hallucinations, seizures, and behavioral outbursts that were very unlike her normal self. After visiting several different doctors and a month-long stay at the hospital, Susannah is finally diagnosed with anti-NMDA-receptor encephalitis, a rare and likely under-diagnosed autoimmune disease. The disease has a roughly 75% chance of normal recovery or mild side-effects, and a 25% chance of severe side-effects or death, even if it is caught early and treated. Luckily, Susannah makes a full recovery and is later able to return to her life as a journalist and continue in her relationships, both with her boyfriend and other friends and family.

     I chose Brain on Fire because it was a book I had read my freshman year of college for an introduction to psychology class. (Funnily enough, it was for extra credit in that class, as is this neuro note that I'm writing. I've always been a sucker for extra credit points.) I enjoyed the book back then, and when I saw it on the list of resources, I thought it would be interesting to reread it now- five years later, with a bachelor's degree and a semester of occupation therapy school under my belt. I now have a much deeper understanding of many of the neurological terms used in the book and I have a greater appreciation for the book and the doctors mentioned in it.

     While Susannah did not see an occupational therapist, there were a few places I could see her benefitting from occupational therapy. As she is recovering from the disease, a months- and years-long process, Susannah is very nervous to return to living by herself after living with her parents during this time, but she is also desperate for the freedom that it will allow her. I think seeing an OT would have helped her re-learn her usual occupations and also increase her confidence about living by herself.

     Something that I took away from this book is that it can be incredibly helpful to get a second opinion as practitioners when we are working with a client who is outside our area of expertise. Susannah saw several different doctors and got several incorrect diagnoses until her neurologist at the hospital sought the help of someone who had experience in cases like Susannah's. This doctor was finally able to correctly diagnose Susannah and get her the treatment needed to start on the road to recovery. While we as OTs will not be diagnosing people, we can learn from this and refer clients to other therapists or get ideas from them to best help our clients when we may not know exactly what to do. I am so glad that I chose to reread this book, and I highly recommend others to read it as well.

Cahalan, S. (2012). Brain on fire: My month of madness. New York, NY: Simon & Schuster
     Paperbacks