CAHALAN, Susannah - Brain on Fire

Brain on Fire by Susannah Cahalan

QUOTES FOR DISCUSSION

The existence of forgetting has never been proved we only know that something's do not come to our mind when they want them to. - Frederick Nietzsche

-Author's Note Page

What I didn't know then is that bug obsession can be a sign of psychosis.

Pg. 8

But there likely was a pathogen of some sort that had invaded my body, a little germ that set everything in motion. ... The doctors don't actually know how it began for me. What's clear is that if the man had sneezed on you, you'd most likely just get a cold. For me, it flipped my universe upside down...

Pg. 9

I would never again be the same person. This was the start of the dark period of my illness, as I begin an existence in purgatory between the real world and a cloudy, fictitious realm made of hallucinations and paranoia. From this point on, I would increasingly be forced to rely on outside sources to piece together this "lost time."

Pg. 41

But it takes only one dissident instrument to mar the cohesion of a symphony.

Pg. 41

"But this is an emergency room and we can't just keep her to see... I'm sorry."  ...The doctor nodded patiently and departed to address the gunshot wounds and drug overdoses that awaited him.

Pg. 44

Bipolar disorder. Even though it would have sounded groom at any other moment now the idea was a relief. ... I spent the night in a state of ecstasy. I had a name for what plagued me, and those two words, which fell off the tongue so sweetly, meant everything.

Pg. 48

"Her EEG was completely normal," Bailey protested, looking through my file. "MRI normal, exam normal, blood work normal. It's all normal."

"Well, she's not normal," my mother snapped as I sat there, quiet and polite with my hands folded in my lap.

Pg. 70

After the neurological exam, he extended his hand my mother and said, "We'll figure this out. Susannah will be fine." My mother clung to those words like a life raft.

Pg. 82

The mind is like a circuit of Christmas tree lights. When the brain works well, all of the lights twinkle brilliantly, and it's adaptable enough that, often, even if one bulb goes out, the rest will still shine on. But depending on where the damage is, sometimes that one blown bulb can make the whole strand go dark.

Pg. 83

Though I was no previous history of mental illness, I was within the age range for psychotic breaks, which tend to occur in the late teens or early twenties, but also frequently happen later in life for women.

Pg. 83

"Transfer to psych [ward] if psych team feels this is warranted." Like Dr. Arslan, she chose not to tell my parents about this new suggestion.

 Although many of these findings were kepted from my family and me, it was clear that my place on the epilepsy floor was becoming more and more precarious, just as the nurse had warned my father, both because my seizures seemed to have stopped and because I was such a difficult patient.

Pg. 92

In the few weeks since my strange symptoms had begun, my dad had been spending much more time with me than usual. He was determined to support me as much as possible, but it was taking a toll on him;

Pg. 95

Stephan thought the music might somehow help bring me back. Instead, Every time I watched this DVD, it was as if for the first time. My short-term memory had been obliterated,

Pg. 101

 It was a strange relief for her to finally have confirmation that something physical, as opposed to emotional, was happening to me.

Pg. 108

I seemed to be able to pull myself together when I had visitors but it would often leave me depleted and unable to communicate for hours afterwards, as if I had devoted all my energy to acting normal.

Pg. 111

Although developed in the mid-1950s, the clock had been entered into the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders only in 1987 and is used to diagnose problem areas of the brain in Alzheimer's, stroke, and dementia patients. Dr. Najjar handed me a blank sheet of paper that he had ripped out of his notebook and said, "Would you draw a clock for me and fill in all the numbers 1 through 12?"

Pg. 131

"Her brain is on fire,” he repeated. ... "Her brain is under attack by her own body."

Pg. 134

If it took so long for one of the best hospitals in the world to get to this step, how many other people were going around untreated, diagnosed with a mental illness or condemned to life in a nursing home or psychiatric ward?

Pg. 151

I seem to realize that I wasn't getting it right, which frustrated me deeply. It was clear that, for all my other impairments, I knew that I was not functioning at the level I was used to.

Pg. 155

It was time to figure out what treatment to save me. If he miscalculated I might never recover. He had spent the night deliberating about what to do, waking up in sweats and rambling to his wife. He had finally decided to act with abandon. He didn't want to wait for things to worsen; I was already too close to the edge.

Pg. 162

Finally, here was the confirmation he had been waiting for all these weeks: I was still in there.

Pg. 171

What did it feel like to be a different person?

Pg. 176

I remained silent for a large portion of the night, as Stephen, Grisell, and my father chatted. Whenever they'd try to include me in the conversation, I shook my head and returned to unconsciously smacking my lips together.

Pg.194

The brain is radically resilient; it can create new neurons and make new connections through cortical remapping, a process called neurogenesis.

Pg. 197

He was a wreck. When other family members called for updates he would wave away the phone, certain that he would lose his hard-won composure once he heard familiar voices.

Pg. 198

Perhaps because my dad had been more of a footnote in my life, whereas my mom was a dominant force, it was easier for my father to engage with this "new" me.

Pg. 200

"How are you?" people continued to ask me constantly. How was I? I didn't even know who "I" was anymore.

Pg. 205

I was feeling like a billion dollars as ice under down the subway stairway...

...to find my ex-boyfriend a few stairs below me. I had not spoken to him since long before my illness.

 "I'm sorry I didn't call, but I didn't think you'd want to hear from me."

This should have been the perfect moment to run into an ex, fresh out of the salon. But it was destabilizing and not in a good way. I could tell that he felt sorry for me and there's nothing worse than seeing pity radiating from the eyes of a former lover.

Pg. 216

How many children throughout history have been "exorcised" and then left to die when they did not improve? How many people currently are in psychiatric wards and nursing homes, denied the relatively simple cure of steroids, plasma exchange, IVIG treatment, and, in the worst cases, more intense immunotherapy or chemotherapy?

Pg. 223

Dr. Najjar, for one, is taking a link between autoimmune disease and mental illness one step further: through his cutting-edge research, he posits that some forms of schizophrenia, bipolar disorder, and obsessive-compulsive disorder, and depression are actually caused by inflammatory conditions in the brain.

Pg. 225

The girl in the video is a reminder about how fragile our hold on sanity and help this and how much we are at the other women are Brutus bodies, which will inevitably, one day, turn on us for good. I'm a prisoner as we all are.

Pg. 227

Autoimmune diseases are most likely the number one cause of disability in women of all ages.

Pg. 229

The amygdala, an almond-shaped structure situated atop the hippocampus, located at the sides of head above the ears in the temporal lobes, is a structure intimately involved in emotion and memory, helping to choose which memories should be kept and what should be discarded, based on which events have traumatized or excited us.

Pg. 244

"When people think about a past event, they can incorporate new information in their recollection, making a new memory," explained psychologist Elizabeth Loftus. Dr. Loftus has spent a lifetime working on the assumption that memory is often inaccurate.

Pg. 244

Although the photographs established that the car had encountered a stop sign, when Dr. Loftus questioned the subject, she inserted intentionally misleading questions, like, "What color was the yield sign?" The study showed that subjects given leading information were more likely to answer incorrectly than those who weren't. These findings have challenged the power of eyewitness testimony.

Pg. 245

"You integrate fragments, scenes of things that you could not truly remember." Similarly, a retrieval mechanism is triggered in the brain when we see something recognizable. Smells or images will instantly transport us back in time, unlocking forgotten memories.

Pg. 246

There was not one shred, one Iota, one shard of memory that connected me with that museum visit. I could not recall going to the Met that February day.

Pg. 248

The existence of forgetting has never been proved we only know that something's do not come to our mind when they want them to. - Frederick Nietzsche

Pg. 248