At 24, Susannah Cahalan, life was just about perfect. She was a budding journalist working for the New York Post, she went home to a tiny but cozy Manhattan studio, and she had just started a promising new relationship. And then the madness set in, starting with bedbugs – that didn’t exist. In a matter of weeks, she went from trying to convince a puzzled exterminator that her Hell’s Kitchen apartment needed be chemically saturated, to inexplicable paranoia, violent outbursts, and withdrawal.
Doctors tell her worried parents she’s exhausted, partying too much, having alcohol withdrawal. After endless examinations, tests, and scans, Cahalan ends up in the epileptic floor of a major hospital – still misdiagnosed. The breakthrough comes when the “brilliant and selfless” Dr. Souhel Najjar – whom Cahalan calls ‘Dr. House‘ – finally figures out that Cahalan is not psychotic, but that her psychotic symptoms are the result of anti-NMDA-receptor encephalitis, a disease so rare that only a handful of patients have been correctly diagnosed. Finally, her arduous, uncertain journey to recovery begins.
In spite of her horrific experience, Cahalan knows with absolute certainty she’s one of the lucky ones: “Dedicated to those without a diagnosis,” she introduces her swiftly moving memoir. Anti-NMDA-receptor encephalitis is a highly elusive disease that’s been fooling medical teams for decades, masquerading as variations of autism and schizophrenia: “How many people currently are in psychiatric wards and nursing homes denied the relatively simple cure …?” Cahalan questions as she recovers.
As elusive is her disease, so, too, are Cahalan’s memories: “I remember only flashes of actual events, and brief but vivid hallucinations from the months in which this story takes place,” she explains immediately and prominently in the opening “Author’s Note.” Her journalistic skills get a major workout recreating her own life. From interviews, medical records, her father’s journal, video footage, a notebook that her divorced parents used to communicate with each other (!), and more, Cahalan reconstructs her “evasive past.” She’s the first to admit she’s “an unreliable source,” and yet “[w]hat is left … is a journalist’s inquiry into that deepest part of self – personality, memory, identity – in an attempt to pick up and understand the pieces left behind.”
Choosing the audible option for this title – Heather Henderson makes for an excellent narrator, balancing just the right blend of alarm and detachment – adds an extra layer of immediacy … you can feel the paranoia taking over Cahalan’s disappearing rationality. Be warned that the lengthier passages of medical details might occasionally prove mind-numbing, although you might bypass such a reaction by reading on the page. That said, the emotional intimacy trumps any possible eye-glazing; go ahead, go audible.