Brain on Fire Quick Summary

Brain on Fire; Chapter Notes

PART 1

Chapter 1

Immediately, the reader notices the powerful imagery given to describe the bed bug bites and the atmosphere of the office. We learn that the main character has worked at the Post since she was 17. There are lots of New York related allusions. We meet the author’s closest friend at the paper, Angela and the Sunday editor, Steve, who calls Susannah (main character) in for a weekly meeting that she is unprepared for. In Steve’s office we meet Paul, who is the Sunday news editor and close friend of Susannah’s. Paul has been a mentor and friend to Susannah and has given her countless opportunities that have helped her to get where she is today. In this moment, she is embarrassed and is afraid to have disappointed Paul because she is not ready for her meeting. Susannah returns to her desk and to Angela feeling awful and emotional from her stressful morning (bedbugs and meeting). Angela comforts Susannah but she is still fairly upset. Susannah goes home to her small apartment and is going through all her things. Paranoid about the bed bugs, Susannah throws out a lot of her items including her old articles that mean a lot to her. She remembers her best article. This was an article that brought on a lot of controversy and stressed out Susannah but Paul was able to help her through it. We learn the medical terms for all of the unusual behavior and feelings that Susannah is experiencing. At the end of the chapter we learn that Susannah experiences stroke like symptoms and stumbles to the bathroom. She tells us that her universe had been flipped upside down that doctors don’t know how it started leaving the reader wondering what happened.

Chapter 2

Susannah wakes up a few days later in her boyfriend, Stephen’s, bed. She talks about how she had gone to introduce her dad and stepmom to Stephen the night before and gives us information about the awkward relationship between her dad and herself. We learn Susannah’s parents divorced when she was 16 and her she has a much closer relationship to her mom. We also learn the history between Stephen and Susannah and about their 4-month relationship. Susannah has an urge to read Stephens e-mails, which is uncharacteristic for her. She fights with herself but ends up reading the emails, one of which is from Stephens ex-girlfriend and makes Susannah angry even though she knows that it shouldn’t. She also goes through Stephen’s draws and finds pictures and letters between the two from the past. She feels awful for invading his privacy. She begins to feel sick again and experiences pins and needles in her left hand before it goes numb.

Chapter 3

Susannah feels incredibly guilty and bewildered about her behavior in Stephen’s apartment. She is so distracted by these feelings that she neglects to be worried about the pins and needles and numbness that she is still experiencing. In this chapter we meet Mackenzie, “a friend who is as prim and put together as a character from Mad Men.” Susannah confides in Mackenzie and Paul about her guilt for going through Stephens personal property. Both tell her not to do it again but that it’s okay and it happens to everyone. She goes into her office and notices the numbness in her hand and decides to call Stephen about it and she suggests going to a doctor about it. Angela and other colleagues of Susannah’s tell her to get it looked at by a doctor. Finally, she decides to call her gynecologist and good friend, who takes the matter very seriously. Due to this reaction, Susannah goes to a doctor right away. While waiting the waiting room, Susannah sees a 1978 Miro painting called Carota which she thinks about several more times in the coming months. We find out while she’s having her tests done that Susannah has a lucky gold right with a black hematite cat’s eye, known to ward off bad luck. Susannah leaves this ring in the box at the hospital. Later that day, Susannah feels so sick that Angela walks her home but Susannah is dry heaving every few steps. She calls her gynecologist and he says her tests were normal except for the possibility of mono.

Chapter 4

Susannah is relieved to know what is making her so sick. Susannah still feels awful but goes out with her boyfriend’s sister, Sheila and her husband Roy. She doesn’t talk and feels she is making a bad impression. They go to a concert that Susannah can not enjoy because she feels so sick and can barely remember it afterwards even though she loves the band that was playing. Susannah takes three days off work, which is out of character for her. She tells her parents about her symptoms and her dad comes to see her in New York. They go see a movie called, “The Wrestler” in which Susannah becomes very emotional during an affectionate father-daughter scene. We learn Susannah’s dad does not trust medical authority. They return to Susannah’s studio together where the topic becomes Susannah’s unsanitary living habits and the bed bugs cross her mind once again.

Chapter 5

Susannah is able to return to work and create a story and two pitches but is proud of neither of them. She is dealing with extreme insecurity issues and has felt uncomfortable in her “journalist skin” for weeks now. Frustrated with herself, Susannah goes home hoping that a good night’s sleep will help her feel better and like herself again just to toss and turn at night and calling in sick again the next day. She wakes up a few hours later feeling like the past is a distant nightmare. Susannah calls Stephen and tells him that they should go to Vermont as they had planned before she got sick but he protests. Dr.Rothstein calls to tell her that her tests for mono were negative. Stephen agrees to go to Vermont. They have a good weekend and get snowed in an extra day. On the extra day Susannah goes skiing and is suddenly overcome with fear and anxiety that passes on the way down the hill. This anxiety is more than just a fear of heights but Susannah does not mention that to Stephen. In her mother’s house in New Jersey, Susannah is overcome with a feeling of nostalgia. She learns later that the intense emotions she has been having are a result of an illness.

Chapter 6

Susannah is at the office again and is relieved that Steve is giving her an interview despite her low performance and attendance. She lacks her usual excitement for the job and has trouble focusing. She asks the Post’s librarian Liz for a tarot card reading. Susannah is doubtful of witchcraft and religion but is willing to listen because she’s been having a tough time. The reading shows positive things and gives Susannah the reassurance that everything is going to be okay that she needed. Liz says she’s feeling ‘floaty’ and Susannah can’t help but agree. She returns to her desk to find out a co worker has passed away from melanoma and can’t get the bad news out of her head. She can’t sleep that night and when she gets to her interview she feels strange symptoms while walking through the hall “like looking down from the window of a hundred-story skyscraper, knowing you won’t fall.” (pg. 20) She can’t seem to concentrate on John Walsh’s words and his publicist interrupts the interview. She begins to lose her balance and falling over everywhere. This is the last interview she conducts in 7 months and the story never runs.

Chapter 7

Susannah can’t remember how she got home from the interview but heads to work the next day. The weather is nice but her walk to work is not. She runs into billboards and is overwhelmed by the sights and sounds of New York City. Susannah confides in Angela telling her she feels she might be crazy. (pg.31) “It wasn’t until this morning that my ramblings had begun to frighten her.” (pg.32) Susannah is frustrated with her inability to communicate her problems and has an outburst. Susannah is have a break down in her office, hates the attention and is frustrated and confused about what is happening to her. Suddenly, Susannah feels very happy. She asks Mackenzie for advice of what has just happened to her. Mackenzie suggests writing down all the symptoms and going to a doctor but while writing down her symptoms, Susannah gets distracted. Susannah suddenly feels in control and happy and runs into Paul who says she’s looking much better but about ten minutes after talking to Susannah, he goes and calls Angela about getting Susannah some help. Susannah continues to have extreme mood swings and feel out of her own body. Angela takes her to a bar to try and figure out more about the situation. They agree that there is something other than the normal stresses of life making Susannah feel so terrible. When she gets home, she lies to Stephen about her state of being, doesn’t eat or drink but smokes all night. At the end of the chapter, Stephen and Susannah are watching T.V. when things go hazy for Susannah. “Darkness.” (pg.39)

Chapter 8

Stephen wakes up because Susannah is making noises in her sleep to find she is having a seizure and calls 911. Susannah does not remember the seizure or any of the ones in her future and sees her first black out as the line between sanity and insanity. Susannah compares a healthy brain to a symphony and an orchestra playing non-stop and out of tune due to illness or other causes is what leads to a seizure. (pg.41) Several types of seizures are described and explain many of the strange symptoms Susannah has been feeling. The chapter ends with an out of body experience she has, watching herself getting pulled into an ambulance on a gurney.

Chapter 9

Susannah wakes up with sick people around her wondering if she is dead and lashes out, out of anger that they would put her there. Looking back on this, she realizes the illness was starting to affect her personality and take over the positive parts of it. In her mind, she blames the MRI technician who had flirted with her for everything that is happening to her and demands to leave the building immediately. This scares Stephen. She is moved by the doctors and begins to focus on whatever power she has. She tells Stephen she’s dying of melanoma, somehow because of the lab technician and is positive that this is what’s wrong. Stephen is upset that the emergency room is discharging Susannah even though they don’t know what’s wrong and Susannah is continuing about suing the lab technician. The doctors recommend going to see a neurologist. Stephen calls Susannah’s mother and her and Susannah’s stepfather come to see her the next day. Susannah’s mother is crying uncontrollably and notices it’s Friday the 13th. When her mother arrives, she asks question after question but is able to be calmed down by Allen. “His warmth and calm, not to mention his experience with mental illness, would prove invaluable over the coming weeks.” Susannah reluctantly moves to New Jersey with her mother. Instead of feeling nostalgic in her old home, Susannah becomes obsessed with her Manhattan life and spends lots of time on an insignificant article. Susannah “freezes up” again and her parents book an appointment with a Dr. Bailey. She spends the weekend ignoring all worried calls except for Julie’s and tells her everything. Julie suggests bipolar disorder and seeing a psychiatrist. “No great mind has ever existed without a touch of madness” – Aristotle (pg. 48) Susannah desperately wants to believe that she is suffering from bipolar disease and nothing else. At the doctors appointment, Dr. Bailey points her to a psychiatrist and gives her a prescription for anti-seizure medication. The doctor tells her mother that he thinks all this is just a result of partying, lack of sleep and over working which is the answer Susannah’s mother wants to hear.

Chapter 10

Susannah, her mother and Allen go to see Sarah Levin, the psychiatrist. Her home and office seem to be “right out of a Woody Allen film.” Susannah is excited to see the psychiatrist to get her condition confirmed and because she finds psychiatric visits entertaining on some level. Dr. Levin takes a photo of Susannah as she does with all her patients and then asks her why she’s there. Susannah tells the doctor it’s because she’s bipolar. The doctor asks Susannah some questions and writes her a prescription for Zyprexa, an antipsychotic. Susannah’s mother calls Susannah’s brother and discusses the matter with him asking him if he thinks Susannah could be an alcoholic or manic-depressive, both to which he answers no and that Susannah is tough. Her mother agrees.

Chapter 11

Susannah believes that Keppra is causing all her symptoms even though she has just started taking the prescription. She continues to take the medication because her mother urges her too but is so desperate to get it out of her system that she begins forcefully dry heave in the middle of the night. Susannah goes to her mother’s room and they lie down together and try to get to sleep. Susannah’s father tells her to start writing in a journal so she does and it allows her to get her thoughts out of her mind and somewhat in order. She writes about journalism, her personal life, her doubts as well as what is important to her in her life. Susannah begins to question everything in her life including her boyfriend, job and all around New York lifestyle, blaming one after another for her recent problems. Susannah is running back and forth in her mother’s house when she falls and has another seizure. The doctor suggests taking an electroencephalogram (EEG) to test the electrical activity of her brain. Later that week, Stephen comes to visit and take Susannah out to a pub where she finds there are too many people and becomes overwhelmed. They leave because of the long wait for a table and go to a different restaurant where Stephen orders for Susannah but she doesn’t eat. This night, Susannah feels both the urge to end her relationship and to profess her love for Stephen. She tells him she really loves him and he tells her he loves her too. This is a big moment for Susannah. The symptoms are getting worse. Susannah is starting to feel distant from her mother because she babies her too much. The author tells us that reading her old journal entries is like reading those of a person incomprehensible even to herself.

Chapter 12

Susannah’s family and boyfriend try to get her back to Dr. Bailey’s office but Susannah insists that she doesn’t need the appointment. Susannah becomes angry at something she mistakenly believes to hear Allen say and tries to jump out of a moving vehicle. Stephen grabs her, saving her life and Allen stops the car. Susannah protests but eventually becomes too tired to argue but when she wakes up still in the car she demands coffee and a meal. They stop and Susannah barges into a diner, commands food form the waitress and then throws it on the car floor when they get back saying that she isn’t hungry anymore. They finally get to the doctors office and the EEG is conducted. The doctor tells her there’s nothing wrong and all this has been a result of her stress at work and that it’s all in her head. Susannah gets paranoid that the doctor is an actress and the appointment is all just a trick and yells at her mother for setting it up.

Chapter 13

Due to Susannah’s constant begging to go back to Manhattan, her mother allows it as long as Susannah stays the night at her dad’s house. Susannah is relieved to be back with her cat and in her home. Susannah’s dad and Giselle clean the apartment as Susannah watches and then asks her to leave with them to which she responds negatively. Eventually she agrees to go with them but becomes paranoid that her father is kidnapping her and begins yelling and screaming that she will call the police. Her father asks her softly why she is doing this to him but Susannah doesn’t have a response. Once they get to Susannah’s fathers apartment, they have dinner, though Susannah doesn’t eat. She thinks she hears Giselle tell her she’s a spoiled brat even though her lips don’t move. Susannah and her father are sitting together when she suddenly bursts out and alternates between yelling at her father to stay with her or to leave the room. Susannah imagines that there is pounding all around her and that she is being locked up and will be killed. She locks herself in the bathroom and plans to jump out the second story window to escape but is stopped by a smiling Buddha in the bathroom that ensures that everything will be alright.

Chapter 14

Allen and Susannah’s mother come to pick her up in the morning and Susannah is overjoyed to see them telling them how she was kidnapped and in danger. Susannah’s mother and father are now decided on getting Susannah admitted into the hospital but NOT a psych ward, however, Dr. Bailey is still convinced that Susannah’s recent behavior is a consequence of Susannah’s lifestyle. Despite the doctor’s opinions, he makes a call to NYU to see if there is an available spot in the hospital. They get to the hospital and are at the admitting desk when Susannah decides she needs coffee. She goes to get one, comes back and has a seizure. The author cannot remember anything from this point forward and this is the point in her life where she feels “the break between my consciousness and my physical body was now finally fully complete. . . This was the beginning of my lost month of madness.” (pg.72)

PART 2

Chapter 15

On March 23rd, Susannah is admitted into the NYU Langone Medical Center. Due to lack of space, she is placed in the advances monitoring unit. There will be video and electrical monitoring of her behavior and her brain behavior. She shares a room with three other patients. Everything is going okay until the technician comes to place electrodes on her head. Susannah calms down but is still upset when the technician hands her the small box that all the wires lead to. She lashes out at everyone she sees including Allen and her father. A neurologist comes to conduct a basic health history interview and notices Susannah is prone to mood swings and switches from topic to topic without clear transitions. The neurologist predicts that Susannah may be hallucinating and calls in a member of the psychiatric team to do a closer examination after Susannah accuses her father of changing into people to trick her. We learn that Susannah has been having paranoid hallucinations and is experiencing Capgras Syndrome. Susannah has several instances in her time at the hospital where she feels unsafe, watched and endangered by the doctors and nurses. She imagines that the nurses and doctors are saying things that they aren’t. She tries several times to escape the hospital, the first time being 1 a.m. on March 24th.

Chapter 16

In the morning, Dr. Deborah Russo, the attending neurologist and her team visit Susannah. Susannah tells the doctor that she needs to leave the hospital because the people on T.V. are saying bad things about her. She has an outburst during the examination. Dr. Russo writes that she is manic and psychotic and that Susannah is suffering from either bipolar syndrome of postictal psychosis. Later that day, William Siegel, a third doctor, comes to perform a neurological exam. Susannah says that Siegel was charismatic and approachable on top of having a stellar reputation.

Chapter 17

Pg. 83 first paragraph is a great metaphor comparing the brain to a strand of Christmas lights. The next day, Dr. Sabrina Khan introduces herself to Susannah and Stephen. She writes about Susannah’s disheveled appearance. Susannah says she is suffering from multiple personality disorder (dissociative identity disorder). She tells Dr. Khan that a better place for her to stay is in a psychiatric ward and everyone in the hospital and in the world are making fun of her and trying to hurt her. Dr. Khan writes down differential diagnosis including Psychotic disorder and Mood disorder and suggests the look for neurological causes. Dr. Khan suggests getting Susannah a one on one security guard. Susannah is having hallucinations in which she feels she is able to age people with her mind, making her feel powerful and stronger than ever.

Chapter 18

A fifth doctor is joining the team. His name is Dr. Ian Arslan and he is a psychopharmacologist described as a “walking beatnik dictionary”. Dr. Arslan interviews Susannah’s mother, then father and calls Dr. Bailey who tells him Susannah had been an excessive drinker before interviewing Susannah to get a complete picture of the past few weeks. Dr. Arslan writes down two diagnoses he wants to rule out: postictal psychosis and schizoaffective disorder. Susannah has another break down in the middle of the night where she screams about being on the news and is desperately asking for a doctor. She thinks her father killed Giselle. Susannah was feeling like everyone was spying on her and ready to hurt her. She tries to escape from the hospital.

Chapter 19

A nurse warns Susannah’s father that if the reckless behavior doesn’t stop, she’ll be sent to a psychiatric ward and that she won’t like it there. Her father quits his banking job to stay with her even though she still won’t let him in the room because she thinks he murdered Giselle. The tests for PIP come back negative but the doctors cannot test her for psychosis because the tests are too invasive for a patient in Susannahs state. “Alone I could not fight this battle.” (Pg. 92) Susannah’s parents work together to fight for her life even though they can barely stand to be in the same room as one another. Stephen arrives at the hospital everyday and without missing a single day and Susannah relaxes when he comes to visit. Four more doctors join the team. Susannah gets placed on blood pressure medication. As Dr.Friedman leaves, he talks to Susannah’s dad about what she used to be like and her dad breaks down. (Pg.94)

Chapter 20

Susannah’s dad is giving up his life for her and keeps a journal to cope. He is going to visit her in her new private room when another patient tells him that she doesn’t like what they’re doing to his daughter. He knows better, but he worries. This day is the first time Susannah greets her dad with a smile in a long time. The two of them go on a walk, which is physically difficult for Susannah. “What is the slope of the line? . . . It’s positive, . . . It means we make progress everyday.” (Pg. 97) Susannah is deteriorating physically but her psychosis is receding which makes it easier for the doctors to do tests. Susannah has to get a spinal tap for one of the procedures and her father is by her side but he’s not only worried about the procedure, he’s worried about whatever else the doctors may be doing.

Chapter 21

After a week in the hospital, Susannah and her family have developed a routine. Susannah has developed relationships with two nurses, Edward and Adeline. Her father brings her homemade desserts everyday. Stephen is permitted to stay long hours because he calms Susannah and she doesn’t try to escape. Stephen leaves on a DVD to help Susannah get to bed, hoping it will bring her back but every time Susannah watches it, she feels it’s for the first time. She relates this and herself to H.M. and his hippocampus being removed, thereby destroying his ability to create new memories and Clive wearing who also lost part of his brain function and memory. Susannah finds herself obsessed with apples and cleanliness. Susannah’s parents allow her cousin Hannah to visit. She brings Susannah a book by the same author who wrote a book she adored but Susannah cannot remember the author.

Chapter 22

In the second week of Susannah’s stay at the hospital, she develops frightening new physical symptoms like drooling and the lack of the ability to speak. The doctors find that Susannah’s body has an excess amount of white blood cells. Susannah calls her mom later to tell her that the nurses are yelling at her for peeing. Susannah’s second week into the hospital, her parents allow for a nonfamily friend, Katie, to visit. Katie is shocked by Susannah’s state but is able to make her laugh. Next, Angela and Julia visit her. Susannah’s friends are able to make her laugh and feel happy but after her visitors leave, Susannah feels exhausted. Because she is still able to write, Susannah has her father help her make a list of people to thank for gifts and flowers.

Chapter 23

The blood tests and autoimmune tests all come back negative. Everyone is beginning to feel desperate and Susannah’s mom feels betrayed, alone and scared when Dr. Siegel leaves Susannah’s case. This is the same day that Dr. Najjar is put on Susannah’s case. After several tests come back negative, Dr. Najjar suggests an IVIG. Pg (115)

Chapter 24

The IVIG is an infusion of antibodies into the blood stream. Susannah is imagining being at Stephens concert when the nurse waked her up. Susannah feels angry and punches the nurse in he chest. The next day James, Susannah’s brother, gets informed on how serious Susannah’s illness is. He decides to come home and reassures her that she’ll be okay. The next day, Dr. Arslan suggests catatonia. (Pg.119) Stephen and Susannah’s father agree that the person they’re fighting for, the Susannah they know and love, is still in there and Susannah’s father’s admiration of Stephen increases significantly.

Chapter 25

After eighteen days in the hospital, Susannah is getting worse. Stephen is by Susannah’s side when she awakes to seizure like symptoms and he cried when the doctors and nurses are trying to help her. There are several instances of this sort. Finally, after a long wait, the doctors are able to confirm that Susannah is experiencing brain inflammation. (Pg. 124). Hannah visits again and Susannah is frustrated at her inability to communicate. Hannah is reading Catcher in the Rye when Susannah starts yelling “Tlantyoiforslen” and “Slefeen”. Susannah instantly calms down when Hannah brings Stephen in. At points, Susannah seems to show aspects of her old personality, however symptoms of her psychosis resurface as well.

Chapter 26

Susannah’s family has gotten used to the state that she’s. Her father finds it hard to be enthusiastic but her mother is excited to finally meet Dr. Najjar. Unlike the other doctors, Dr. Najjar looks at all of Susannah’s symptoms as one big picture and asks talks to Susannah like as a friend and not a helpless patient. We learn about the doctors past and why he approaches his practice in the way he does. (pg.129) Dr. Najjar asks Susannah a series of questions followed by the clock test (Pg.132) that reveals the right side of Susannah’s brain is inflamed. This both scares and gives hope to Susannah’s parents. The results of the clock test reveal and explain lots of Susannah’s symptoms and Dr. Najjar concludes that Susannah must be suffering from an autoimmune disease. “Her brain is on fire” (Pg.134) A brain biopsy may be the only way to cure Susannah.

Chapter 27

Susannah’s parents and Dr. Najjar talk about the possible next steps to Susannah’s treatment including the brain biopsy, which Susannah’s parents are very skeptical of. Susannah and her parents are all having a tough time processing the biopsy; her parents both turn to religion. Susannah confides in Lindsay and Zack who bring the reality of the situation to Susannah’s attention. The doctor explains the procedure and Susannah seem calm but later that night Susannah and her father cry together. They end up laughing about looking funny as they cry and trying to remember to be optimistic. The next day, Susannah’s father brings her an Easter basket. Susannah is surprisingly calm throughout the preparation for the biopsy. The surgery goes well but Susannah is having dreams about being mistreated in the hospital while it happens. After the surgery, Susannah’s dad stays and sees her in recovery despite the doctors and nurses instructions. Susannah tells her dad that she can’t move her legs but after an MRI, the doctors tell him everything looks fine and he finally goes home but only after Susannah falls asleep.

Chapter 28

The results of the biopsy confirm that Susannah is suffering from an autoimmune disease. This means that Dr. Najjar can prescribe her steroids to reduce the inflammation. The symptoms appear to be getting worse at first but Susannah can pull herself together for guests, laugh and appear happy. The woman Susannah had been sharing a room with was allowed to leave a few days later.

Chapter 29

Dr. Russo mentions to Susannah’s mom it could be cancer, her worst nightmare. Dr. Dalmau is doctor whose team discovered anti-NMDA-receptor autoimmune encephalitis. He can test Susannah’s spinal tap to see if Susannah should be diagnosed with anti-NMDA-receptor autoimmune encephalitis. Susannah would be the 217th person in the matter of a few years to be diagnosed and this leaves her wondering how many people would go undiagnosed.

Chapter 30

A speech pathologist and neuropsychologist visit Susannah. Everything goes well until some of the neurological tests are too difficult for Susannah and she starts to get frustrated. The neuropsychologist recommends for Susannah to receive cognitive therapy.

Chapter 31

The tests for anti-NMDA-receptor autoimmune encephalitis return positive. Susannah’s father is relieved that they finally have a diagnoses and perhaps a cure. The doctors explain that the cause may be a tumour and that there is a possibility that chemo will be necessary. Susannah and her father both get very upset but her father is able to calm her. Students from the university are constantly coming in and looking at her like an animal. One time when her father is with her, a group of students comes in and talks about the possibility of Susannah’s ovaries being removed. Her father gets angry at the students and throws them out.

Chapter 32

The next day, doctors check for melanoma and tumours to find there aren’t any signs of either. Dr. Najjar has a plan in mind and believes Susannah will be 90% herself agan in no time. After 28 days in the hospital, Susannah is released. The nurses come to say goodbye. Lindsay comes to help with the transition home and Susannah is so glad to finally be going home. The doctors and Susannah’s family and friends have a plan for her but there is still the four percent mortality rate of patients diagnosed with this disease that looms in everyone’s minds.

Chapter 33

Susannah sees the house more beautiful than ever when she finally gets to return. She showers on her own but needs Lindsey’s help to get the sipper up on her hoodie. Stephen makes pasta for dinner and he and Lindsey go out for a cigarette. Susannah panics and calls her mom crying that Stephen is going to leave her for Lindsey. Susannah’s mom calls the doctor afraid that Susannah is slipping back into psychosis. It is later discovered that this is natural in the process of getting better. Jeff comes to pick up Lindsey because he wants to see Susannah and is shocked to see the state she’s in. Lindsey, who had been stoic through her visit, cries as she says goodbye to Susannah.

Chapter 34

Less than two weeks later, Susannah returns to the hospital for some more treatments. Stephen cringes as the nurse puts a needle in Susannah’s neck. This is very uncomfortable but needs to stay in for a week. Susannah’s friends, Hannah, Jen, Katie and Angela come to visit her. On Susannah’s last night at the hospital the, her roommate gets a diagnosis. Susannah is happy for her because not knowing is substantially worse than being diagnosed. The next morning, Stephen and Susannah go on a drive. California Dreamin’ comes on the speakers and Susannah and Stephen simultaneously sing along to the chorus. This gives Stephen a lot of hope.

Part 3

Chapter 35 Susannah looks back at videos of her stay at the hospital and the person she sees in unrecognizable.

Chapter 36

People ask Susannah what it was like to be a different person but Susannah doesn’t recall enough from that time to answer the question. Stephen and Susannah go see Stephen’s sisters, Rachel and Bridget and their kids, Aidan, Grace and Audrey. Bridget and Rachel are shocked at Susannah’s state. Even in recovery, Susannah looks very different from her former self. “The hummingbird had turned into a sloth.” (pg. 177) Susannah gives the kids all the dolls she accumulated while in the hospital. The visit is uncomfortable as everyone, including Susannah, tries to ignore her transformation. This reminds Susannah that the journey of recovery ahead of her is a long and painful one. Another difficult encounter for Susannah was with her brother. Her brother had been finishing school and not allowed to visit but when he finally sees her, it’s hard for him to see his big sister in this state.

Chapter 37

Susannah is now allowed to go around the corner herself to get a coffee. She spends a lot of time with James who has taken some time, but has now gotten used to the new Susannah. Susannah asks her brother to drop her off to get a pedicure for an hour but her father gets nervous when she doesn’t call for more than two hours. He finds her and has to control his emotions when he sees there are some people treating Susannah with disrespect. Her mother also gets angry when someone calls Susannah “sweet”. Though Susannah feels powerless and scared, the people around her have lots of hope and see glimpses of Susannah’s old self form time to time.

Chapter 38

Stephen comes home on the train looking better than ever and Susannah feels very lucky to be with him. Susannah asks Stephen why he stayed and he says, “Because I love you, and I wanted to, and I knew you were in there.” (Pg.184) Susannah and Stephen go to a barbeque where Susannah feels like the centre of attention. Stephen protects her. “Like my plastic smile, Stephen became another layer in my protective armor.” (Pg. 185) Susannah also attends her stepbrother, David’s wedding. She was supposed to be a bridesmaid before she got sick. She is determined to look “normal”. She has a couple glasses of wine despite her mothers wishes because to Susannah, they represent a little bit of independence and her old self. Her mother is happy and proud to see Susannah having a good time until a woman offers her condolences for Susannah’s awful condition. (Pg. 188)

Chapter 39

Susannah has gotten a lot better over the past few weeks but she still has to take lots of medication. They represent Susannah’s infantile state and make her sleepy and slow. The pills also cause problems between Susannah and her mother because Susannah is so resistant on taking them and her mother is resilient on making Susannah take them. At the time, Susannah felt anger towards her mother and how much she was suffering. Susannah regularly visits a psychiatrist who runs a few tests. The first time, Susannah is placed in the borderline impaired range for several tests but proved to be doing great in tests that involved logical thinking. It seems that social situations are so difficult for Susannah because she is aware of her weaknesses but cannot change her behavior and has difficulty improving them. There is a barrier between her mind and physical body.

Chapter 40

Susannah hates the idea of having to return to the hospital for more treatments. She spends the night with her family and Stephen to make her feel better but is very paranoid about being boring and dull. Susannah’s frontal lobes are taking longer to repair themselves than others. Susannah dances awkwardly but freely to the song Umbrella. Stephen is filled with happiness when he sees that Susannah is able to move freely and dance. They laugh and dance together at the idea that Susannah is really getting better.

Chapter 41

During the third hospital stay is when Susannah really starts to get better and back to her old self. Susannah tries to write down her lost time in chronology with what happened but Susannah cannot remember anything after she bought the cappuccino in the hospital and is still ashamed of her behavior at her fathers. Susannah’s ability to write is getting much better. Together, Susannah and her father try to write down what happened during the “lost months” but they cannot remember everything. Memory loss can be attributed to not only brain damage but to emotional trauma. Susannah’s father had a very hard time dealing with her illness. Susannah comes out of the whole experience with a much closer relationship to her father. Susannah’s relationship with her mother weakens at first but after dinner and a good heart-to-heart, they reconnect again, stronger than ever.

Chapter 42

As Susannah and her father pack up her apartment, she can feel her independence slipping away. She spends her time making lists for herself to complete so she can feel the satisfaction of finishing something. Susannah focuses in on her physical body to distract herself from the issues regarding her mind. Susannah has lost confidence and a sense of self. She is very paranoid about what everyone else is thinking and saying about her. While opening mail from her apartment, Susannah finds one package with her lost lucky ring inside.

Chapter 43

People are constantly asking Susannah what her condition was but she doesn’t really try to explain it until Paul asks her. She feels encouraged when Paul tells her she’s getting her writing style and sense of humor back. Susannah becomes obsessed with learning more about the disease but is frustrated when there isn’t that much information out there. No one knows why the disease first starts or how it’s introduced into the body. Susannah feels very lucky to have been in the right hospital with the right doctors and to be alive and herself again.

Chapter 44

Eventually, Paul asks Susannah when she will be able to return to work and Susannah is excited and filled with adrenaline until she gets to the building, where she begins to feel very nervous. Paul is nervous as well and is unsure how to treat Susannah. They have an awkward and difficult conversation. “As a friend he was deeply concerned about my recovery and y future, but as a boss, he couldn’t help but wonder if I would ever be capable of returning to my duties as a reporter.” (Pg.211) Two weeks later, Susannah is assigned to write an article and has trouble at first but gets her article published. When visiting her co-workers, Susannah is very worried about ever being able to be comfortable in her old work environment again.

Chapter 45

Susannah returns to work but instead of taking it slow at first as HR and her bosses have suggested, she wants to work like a marathon runner, the way she used to. Though slow at first, Susannah is easing back into her work life, enjoying every assignment she gets. Paul and Angela both help her adjust back to reporting. In a few weeks, Susannah feels back to normal; 100% herself again and her family thinks so as well, however, in reality, full recovery takes years. Susannah feels great and confident as she walks out from the salon after getting her hair done but after feeling pitied by an ex boyfriend and seeing her reflection in the subway, that confidence level decreases drastically and she wonders whether she will ever be the same.

Chapter 46

Susannah, her family and some of her friends go to hear Dr. Najjar speak about Susannah and her disease. He ends the lecture by saying that the patient is now fully recovered and working at the New York Post. This makes Susannah and her loved ones feel proud and happy. Steve gives Susannah a chance to share her story through a first person article about her illness. Susannah is nervous but excited by this assignment.

Chapter 47

As Susannah interview her family and friends and does some research on her disease, she comes to wonder how many people might have gone undiagnosed. Most patients with this disease are children and some are diagnosed with autism. Some communities see it as evil and Susannah compares it to The Exorcist. Susannah is very concerned with the number of people who are probably curable but are going undiagnosed in a psych ward or nursing home. Susannah also thinks about the financial burden that diagnosing or treating this disease may have on some people. Fortunately, she had the means to pay for the one million dollar bill her time at the hospital and the tests cost her, but many people do not. Susannah goes back to Dr. Bailey who had never heard of Susannah’s disease although it had been published in all major medical journals. The flaws of in medicine are discussed (Pg. 226). The hardest part of writing the article is watching the tapes from the hospital. Susannah feels vulnerable and exposed. Susannah still feels anxious about how she acted in the hospital and about work but she conjures up all the strength she has to watch her biggest and most personal story be published.

Chapter 48

Susannah realizes that her case, while unique is not as rare as she thought. After the article runs, Susannah gets constant phone calls and e-mails from people who want to know more about the disease because they or their loved ones suffers from it. Susannah relates to the feeling of survivor’s guilt. Susannah gets one call from a man who’s daughter was going through the same thing as Susannah but her doctors couldn’t figure out how to diagnose her until they saw Susannah’s article. Susannah’s article saved this girls life.

Chapter 49

Susannah’s article not only changed her life but Dr. Najjar’s life. Dr. Najjar is recognized by his father, the UN and named one of New York Magazine’s best neurologists in the country.

Chapter 50

Susannah feels completely recovered and independent but will never feel the same as before her Month of Madness. She moves in with Stephen but always fears relapse. Her relationship with Stephen suffers as he takes on a caregiver role but eventually the fall back into playing the roles of equals in their relationship. Her parents go back to not speaking to one another and Susannah is afraid she’s lost some of her spark forever.

Chapter 51

Susannah still has trouble distinguishing fact from fiction; hallucinations from reality. Often memories are inaccurate and if one person remembers incorrectly and shares with a group of people, it can spread.

Chapter 52

Memories flood back with triggers and this happens to Susannah everyday. Things that she thought she had forgotten flood back to her with a sight or smell or sound. Susannah finds a postcard that she bought from the Met the day after her first breakdown at work. She remembers nothing else about that picture or that day and wonders how many other things she has no recollection of.

Chapter 53

A couple years later, Susannah revisits the epilepsy unit and does not recognize the unit until the smell hits her. She sees the purple lady who does not recognize her at first. Upon hearing her name, the lady hugs her and tells her how much better she looks.