Book excerpt: Brain on Fire by Susannah Cahalan

Our book club pick of the month is a riveting memoir about a young woman's terrifying experience with an undiagnosed illness. Is it possible Susannah has gone mad over the course of a single month?
By Laurie Grassi
Brain on Fire by Susannah Cahalan Brain on Fire by Susannah Cahalan

In this excerpt from the New York Post journalist Susannah Cahalan's riveting memoir, it quickly becomes clear how horribly awry her life is going  and how ill she's becoming  as she reaches out to friends, desperately concerned about what is happening to her.

I don't remember how I got home after the interview or how I filled the hours in the wake of yet another professional debacle, but after still another sleepless night—it  had now been over a week since I’d slept fully—I headed to the office. It was a gorgeous early March morning, the sun was out, and the temperature was a crisp thirty degrees. I had walked through Times Square twice a day for six months, but today, once I hit the rows of billboards at its center I was accosted by its garish colors. I tried to look away, to shield myself from shock waves of pigment, but I couldn’t. The bright blue wedge of an Eclipse gum sign emitted electric swirls of aqua and made the hair on the back of my neck stand up. I could feel the colors vibrating in my toes. There seemed to be something exquisite about that rush; it was simultaneously enervating and thrilling. But the thrill lasted only a moment when, to my left, the moving scroll of “Welcomes you to Times Square” caught my attention and made me want to retch in the middle of the street. M&M’s on an animated billboard to my left pirouetted before me, forging a massive migraine in my temples. Helpless in the face of this onslaught, I covered my eyes with mittenless hands, stumbling up Forty-Eighth Street as if I had just gotten off a death-defying roller coaster, until I hit the newsroom, where the lights still felt bright but less aggressive.

“Angela, I have to tell you something strange,” I whispered, concerned that people might be listening in, thinking I was crazy. “I see bright colors. The colors hurt my eyes.”

“What do you mean?” she asked, worry evident in her smile. Every day my behavior had been growing increasingly erratic. But it wasn’t until this morning that my ramblings had begun to frighten her.

“Times Square. The colors, the billboards: they’re so bright. Brighter than I’ve ever seen them before.”

“You must be really hung over.” She laughed nervously.

“I didn’t drink. I think I’m losing my mind.”


“If you’re really concerned, I think you should go back and see a doctor.”

There’s something wrong with me. This is how a crazy person acts.

Frustrated with my inability to communicate what was happening to me, I slammed my hands down on the keyboard. The computer glowed back at me, bright and angry. I looked at Angela to see if she saw it too, but she was busy with her e-mail.

“I can’t do this!” I shouted.

“Susannah, Susannah. Hey, what’s going on?” Angela asked, surprised by the outburst. I had never been histrionic, and now that everyone was staring at me, I felt humiliated and on display, and hot tears streamed down my face and onto my blouse. “Why are you crying?”


I shrugged off the question, too embarrassed to go into details I didn’t understand.

“Do you want to go out for a walk or something? Grab a coffee?”

“No, no. I don’t know what’s wrong with me. I’m all fucked up. I’m crying for no reason,” I sobbed. As the crying spell took over my whole body, I became prisoner to it. The more I told myself to stop, the more powerful the sensation became. What was causing these hysterics? I fixated on anything my mind could grasp, picking apart the minutiae of my life, anything that felt uncertain. I’m bad at my job. Stephen doesn’t love me. I’m broke. I’m crazy. I’m stupid. Many of my colleagues were now returning to the office, dressed in black from the reporter’s funeral, which I had not attended because I was too consumed by my own problems. Was this the reason I was crying? I hardly knew the man. Was I crying for myself? Over the possibility that I might be next?

Another reporter, who sat directly across from Angela, turned around. “Susannah, are you okay?”

I hated the attention. I shot her a derisive look, heavy with loathing. “Stop. It.”


The tears continued down my face, but I was surprised to realize that instantly I was no longer sad. I was fine. Not fine. Happy. No, not happy, sublime, better than I had ever felt in my entire life. The tears kept coming, but now I was laughing. A pulse of warmth shot up my spine. I wanted to dance or sing, something, anything except sit here and wallow in imaginary misery. I ran to the bathroom to splash some water on my face. As the cold water flowed, the bathroom stalls suddenly looked alien to me. How was it that civilization had gotten so far but we still defecated in such close proximity to one another? I looked at the stalls and, hearing the flushing of toilets, I could not believe that I had ever used one before.

When I got back to my desk, my emotions now relatively stable, I called Mackenzie, who had been so helpful with my snooping problem weeks ago, and asked her to meet me downstairs. I wanted her opinion on what had just happened to me. When I found her behind the News Corp. building, I noticed that she too was wearing black and had just arrived from the reporter’s funeral. I suddenly felt ashamed for being so self-obsessed.

“I’m so sorry to bother you when you’re suffering,” I said. “I know it’s really selfish of me to behave like this right now.”

“Don’t worry about it. What’s going on?” she asked.

“I just. I just. Do you ever not feel like yourself?”


She laughed. “I hardly ever feel like myself.”

“But this is different. Something is really wrong. I’m seeing bright colors, crying uncontrollably. I can’t control myself,” I repeated, wiping away the remaining moisture from my swollen eyes. “Do you think I’m having a nervous breakdown? Do you think I’m going nuts?”

“Look, Susannah, this isn’t something you can do yourself. You really need to just go see a doctor. I think you should write down all your symptoms, as if you were going to write up a story about it. Don’t leave anything out. As you know, even the smallest details can turn out to be the most important.”

It was genius. I nearly ran away from her to go upstairs and start writing. But when I got to my desk, I wrote only the following:

Insomnia / Vision


Then I began  doodling, though I don’t  remember scrawling out the drawing or what  prompted it:

People are desperate,

   They'll do anything.

“People are  desperate,  they’ll  do  anything,”  I’d written. Abruptly I stopped writing and began to clear everything off my desk—all the water bottles, the half-empty coffee cups, and the old articles that I would never read again. I lugged armfuls of books that I’d been saving for reasons I could no longer remember to the floor’s Dumpster and discarded them all, as if they were evidence that I was a hoarder who had been unraveling for months. I suddenly felt in control of every part of my life. That buoyant happiness had returned. But even then I recognized it was a perilous happiness. I feared that if I didn’t express it and appreciate it, the emotion would blaze and burn away as quickly as it came.

When I got back to my desk, I slammed my hands down on top of it.


“Everything is going to be great!” I announced, ignoring Angela’s astonishment. I sauntered over to Paul’s desk, high on my brand-new, wonderfully simple theory on life.

“Let’s go downstairs for a smoke!”

As we took the elevator, Paul said, “You look much better.”

“Thanks, Paul. I feel so much better. I feel like myself again, and I have so much to talk to you about.” We lit cigarettes. “You know, it’s finally dawned on me what is wrong. I want to do more stories. Better stories. Bigger stories. Not the feature bullshit. The real stuff. The real hard-hitting investigations.”

“Well, that’s great,” Paul said, but he also looked concerned. “Are you okay? You’re talking a mile a minute.”


“Sorry. I’m just so excited!”

“I’m glad to hear you’re excited, you know, because some people had told me that  you’ve been upset at your desk and you’ve been so sick the past month.”

“That’s over. I’ve seriously figured it out.”

“Hey, have you talked to your mom recently?” Paul asked.

“Yeah, a few days ago. Why?”


“Just curious.”

Paul was busy building a mental picture, ready to relate to Angela what he felt were the beginning signs of a breakdown. He had once seen another reporter whom he cared about fall apart. She began wearing bright, inappropriate makeup and acting strange, and she was later diagnosed with schizophrenia.

After ten minutes of my ramblings, Paul headed back inside and called Angela. “Someone needs to call her mom or someone. This just isn’t right.”

While Paul was upstairs talking to Angela, I stayed outside. If anyone looked at me then, they would have assumed that I was deep in thought or working out a story in my head—nothing out of the ordinary. But in fact I was far away. The pendulum had swung again, and now I felt wobbly and height-sick, that same feeling I’d had at the top of the mountain in Vermont, except without the terror. I floated above the crowd of News Corp. employees. I saw the top of my own head, so close that I could almost reach out and touch myself. I saw Liz, the Wiccan librarian, and felt my “self” reenter my grounded body.

“Liz, Liz!” I shouted. “I need to talk to you!”


She stopped. “Oh, hey, Susannah. How’s it going?”

There was no time for pleasantries. “Liz, did you ever feel like you’re here but you’re not here?”

“Sure, all the time,” she said.

“No, no, you don’t understand. I can see myself from above, like I’m floating above myself looking down,” I said, wringing my hands.

“That’s normal,” she said.


“No, no. Like you’re outside of yourself looking in.”

“Sure, sure.”

“Like you’re in your own world. Like you’re not in this world.”

“I know what you’re saying. It’s probably just residue from the astral travel you experienced during the reading we did yesterday. I think I may have taken you to another realm. I apologize for that. Just try to relax and embrace it.”

Meanwhile, Angela, worried about my erratic behavior, got permission from Paul to take me to the bar at a nearby Marriott hotel for a drink—and to tease some more information out of me about why I was acting so out of character. When I returned to the newsroom, Angela convinced me to gather my things and join her on a walk a few blocks north up Times  Square to the hotel bar. We walked into the hotel’s main entranceway through revolving doors and stood beside a group of tourists waiting to take the transparent elevators to the eighth-floor bar, but the crowd bothered me. There were too many people around. I couldn’t breathe.


“Can we please take the escalator?” I begged Angela.

“Of course.”

The escalators, decorated on each side with dozens of glowing bulbs, only intensified my jitters. I tried to ignore the heart palpitations and the sweat forming on my brow. Angela stood a few steps above, looking concerned. I could feel the pressure of fear rise in my chest, and suddenly I was crying again.

At the third floor, I had to get off the escalator to compose myself because I was sobbing so hard. Angela put her arm on my shoulder. In total, I had to get off the escalator three times to steady myself from sobbing during that eight-floor trip.

Finally we reached the bar floor. The rugs, which looked as if they belonged in an avant-garde production of Lawrence of Arabia, swirled before me. The harder I stared, the more the abstract patterns merged. I tried to ignore it. The hundred-plus-seat bar, which looked down over Times Square, was almost completely empty, with only a few groups of businessmen dotting the chairs around the entranceway. When we walked in, I was still bawling, and one group looked up from their cocktails and gawked at me, which made me feel worse and more pathetic. The tears kept coming, though I had no clue why. We positioned ourselves in the center of the room at seats with high chairs, far away from the other patrons. I didn’t know what I wanted, so Angela ordered a sauvignon blanc for me and an Anchor Steam for herself.


“So what’s really going on?” she asked, taking a small sip of her amber-colored beer.

“So many things. The job. I’m terrible at it. Stephen, he doesn’t love me. Everything is falling apart. Nothing makes sense,” I said, holding the wineglass like a comforting habit but not drinking.

“I understand. You’re young. You have this stressful job and a new boyfriend. It’s all up in the air. That’s scary. But is it really enough to make you feel this upset?”

She was right. I had been thinking about all of that, but it was a struggle to make one detail fit well enough to solve the entire problem, like jamming together pieces from incongruent sets of puzzles.

“There’s something else,” I agreed. “But I don’t know what it is.”


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