Brain On Fire

Cahalan is inspired while writing the article about her illness. The history and statistics she unearths are starling. Cahalan’s knowledge and interest grow as she learns about people throughout history who have suffered from the same illness and were not properly treated. Cahalan also reflects and gains perspective on her experiences in the American healthcare system, on her appointments with Dr. Bailey, and her treatment from Dr. Najjar.

Cahalan’s article is mostly well-received. There are people who contact her telling her that they can relate and share their stories of hope. There are also people who contact her out of hate and spite because she lived, and their loved ones did not, such as the newlywed whose wife was ill: “‘And how come you got better while my wife is still sick, even though she was diagnosed before you?’ ‘I, I don’t know.’ Two weeks later, he called me back. ‘She’s dead. She died last week, I thought you should know’” (232).

Cahalan develops Survivor’s Remorse, a form of PTSD, and she shares a poignant story of a young woman, Emily, who was able to recover like Cahalan did in part because of the article Cahalan published.

Cahalan is invited to Dr. Najjar’s home, where she is provided with profound insight into his harrowing, uplifting personal story. Dr. Najjar was born and raised in Syria. His family was poor. As a child, Najjar did not perform well in school, and Najjar’s father believed his poor performance in school meant he would never achieve greatness. Young Najjar worked hard and had one teacher that believed in his ability to improve and succeed. When Najjar brought home a report card reflecting high grades, Najjar’s father believed Najjar has cheated, and that his teachers were too stupid to have caught him. Najjar’s father confronted the teacher about his son’s grades, and the teacher confirmed the boy’s talents. Najjar continued to work hard, attending medical school in Syria and then in the United States.

Because of her article, Cahalan has improved Dr. Najjar’s life with positive press and admiration from his once-doubting father. Dr. Najjar becomes the recipient of prestigious awards, receives personal phone calls from ambassadors, and gets press in his native country of Syria.

At this stage of Cahalan’s recovery, she is no longer required to take medications. She has become philosophical about life, especially regarding the differences between her pre- and post-illness selves. Her relationship with Stephen suffers briefly, then rebounds, resulting in them moving in together. Her parents revert back to barely speaking to each other.

Cahalan is dubious about the reliability of human memory. She has persistent memories that arrive as half real. She is stunned as she questions and then realizes, “If all remember are hallucinations, how can I rely on my own mind? To this day, I struggle with distinguishing fact from fiction” (242). She now lives with lifelong uncertainties. She questions the memory of the FLIGHT RISK wristband in the hospital, a memory which anchored her in reality when she was otherwise adrift in her illness.

Cahalan continues to cope with her memory and her “new” identity. She experiences unexpected memories throughout her ordeal. She has been living with Stephen for a year. She is full of questions about existentialism and epistemology: if the human memory is so fallible and identity is based on what we remember about ourselves, how can we trust what we think we know, including who we are?

Two years after her month-long stint at NYU, Cahalan returns for a checkup. Everything is unfamiliar, and she believes her memory to remain unsteady. One persistent hallucination and doubted memory of the “Purple Lady” still haunts her. When Cahalan was in the hospital, she experienced intense delusions and hallucinations because of her illness and because of some of the medications she took. Cahalan was unsure if she had hallucinated or actually legitimately remembered a woman she calls the “Purple Lady.” Upon her visit to the epilepsy floor, she learns that the Purple Lady is real and remembers her as one of her favorite patients.

Cahalan expresses the realization that if she had the chance to take back the experience of illness, diagnosis, treatment, and recovery, she would not. She is comfortable with the life she has—the good, the bad, and the ugly parts of it.