Brain on Fire Summary and Study Guide

Susannah Cahalan

Brain on Fire

  • 44-page comprehensive study guide
  • Features 53 chapter summaries and 5 sections of expert analysis
  • Written by a literary scholar with a PhD in Philosophy
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Brain on Fire Summary and Study Guide

SuperSummary, a modern alternative to SparkNotes and CliffsNotes, offers high-quality study guides for challenging works of literature. This 44-page guide for “Brain on Fire” by Susannah Cahalan includes detailed chapter summaries and analysis covering 53 chapters, as well as several more in-depth sections of expert-written literary analysis. Featured content includes commentary on major characters, 25 important quotes, essay topics, and key themes like Philosophy: Existentialism and Epistemology and Epiphany and Self-Awareness vs. Denial and Self-Sabotage.

Plot Summary

Brain on Fire is a memoir by New York Post writer Susannah Cahalan and details her struggle with a rare autoimmune disease, anti-NMDA-receptor autoimmune encephalitis. Cahalan wakes in a hospital with no understanding of how she got there. We learn she has been in the hospital for a month, and, during this time, has been delusional and violent. Physicians are unable to accurately diagnose her. With time, Cahalan does receive a correct diagnosis, and begins the journey to recovery.

In her book, Cahalan documents how her body attacked her and how she recovered. Cahalan begins with exactly how and why she is an unreliable source for answering foundational questions about her own medical case. This is rare because often, particularly in autobiographical nonfiction texts, an essential element of the infrastructure in the storytelling is the reliability of the narrator/narration. With scientific, philosophical, and anecdotal evidence, Cahalan presents the limitations of her narrative abilities, in addition to evidence of its necessity and authenticity, as these limitations provide the highest accuracy to her story.

The reader is introduced to the normal world of this New York City reporter: her friends, her work, her romantic life. Although her parents are divorced and relatively stoic and private, Cahalan maintains healthy relationships with her parents, step-parents, and especially her younger brother, James.

The narrative consists of several elements that are at times, intentionally interwoven, and at others, and equally seamlessly, interwoven abruptly and for visceral, shock value. Much of the text consists of the voice of Cahalan after she has been released from the hospital and has experienced multiple stages of recovery over a few years. There are other pieces of the text that are excerpts from journals kept from people such as her father, her mother, and herself. Other pieces of the text are medical scans and sections of Cahalan’s actual medical records during the period in which the book covers. Furthermore, there are excerpts of the text that are writings she made over the course of her illness. There is a clear effort to provide a broad, comprehensive, yet meticulously-detailed account of her experience to the reader. These numerous modes of text that comprise the memoir also give the book, at times, the feel of textual collage.

The reader begins the journey of learning about Cahalan and the story of how this book came to be with some strange, uncharacteristically-paranoid thoughts Cahalan has had. She does not communicate her symptoms to anyone—not her boyfriend, not her mother, and not her professional mentors—even as her symptoms expand, intensify, and escalate over a number of months. Cahalan guides the reader through her journey into the American healthcare system, full of professionals who do not dig deep enough and take only her word for the status of her conditions, and simply do not have the expertise for prognosis and treatment. It is not until Cahalan is nearly dead and her family is at wits’ end that they experience a miracle: a doctor who listens and treats them humanely.

Cahalan’s recovery is not easy. It is littered with struggles, embarrassments, and unforeseen violence; however, because of her history as a journalist, Cahalan shares her story in such a way that enables the doctors who healed her, and the others who live with similar diseases to receive more positive attention.


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