I had never heard of this book, but it caught my eye when I first walked into Chapters in Toronto where it was prominently displayed. I studied psychology as one half of a double major in an undergraduate degree, and was always particularly interested in neuroscience and how the brain worked, so when I read the blurb on the jacket I was fascinated: a girl on the brink of successful adulthood, having graduated from college and started work as a journalist at the New York Post, wakes up one day to find a month of her life is missing from her memory, and discovers that she had quite literally descended into madness during that month. As a concept, it's terrifying but also gripping. As a true story, it is chilling. I am generally not much of a non-fiction reader - I don't mind it, as such, but as I prefer fiction and there are so many books to read, I don't often find myself thrown off course into the world of non-fiction. But this tempted me away from my usual fare.
The first part of the book is enthralling, I couldn't put it down. After becoming convinced that she has been bitten by a bed bug, and that her apartment is in fact overrun by bugs (in spite of evidence from an exterminator that this is not the case) journalist Susannah Cahalan finds herself behaving strangely out of character, - forgetting to prepare for important meetings, caring so little about important interviews that she neglects to do any research beforehand, snooping on her boyfriend's computer, crying at the office for no discernible reason. And then it gets worse. Her speech becomes impaired and she starts having seizures, from which she has never previously suffered. She lashes out at people she loves and imagines she can hear them saying vicious things about her. She starts to lose herself. And when her family seeks medical assistance on her behalf, the doctors all turn her away - one of them, in spite of Cahalan's assertion that her alcohol intake, whilst not ideal, is limited to two glasses of wine a night, dismisses her as a young alcoholic suffering from withdrawal.
Eventually Cahalan's mother commits her to hospital, where she is housed on the epilepsy ward, and where doctor after doctor tries and fails to identify her symptoms and diagnose her with anything beyond full psychiatric breakdown. This forms part two of the book, where Cahalan's journalistic training really comes into play. The book continues to be interesting, but not in the un-put-downable manner of part one. Cahalan herself doesn't remember the month she spent in hospital, so she has had to re-create the sequence of events through her parents' journal entries, interviews with doctors and video taken of her whilst in hospital. And because Cahalan is a journalist and this is a book about a medical phenomenon, the text becomes increasingly peppered with detailed scientific information about what was happening in her body and in her brain. I was quite pleased to be re-visiting and re-learning some basic anatomy and functions of the brain, but I suspect many readers will find these scientific passages to be rather dull, and certainly they do not pull the reader in like the earlier vivid descriptions of a normal person in the throws of a breakdown. The reading was slower here, and continued to be so for me until the end of the book, when a new doctor finally diagnoses Cahalan with a disease that is only just becoming known, and she receives treatment to ease her towards gradual recovery.
But the thing that will probably be my take-home point from this book is only discussed briefly at the end: the illness Cahalan suffered from, in which the body essentially attacks the brain, may well be responsible for many incidents recorded throughout history of people being 'possessed' by evil spirits. The behaviour recorded on video while Cahalan was in hospital is not unlike that experienced by Regan, the possessed child in The Exorcist: at times she spoke in a voice much deeper than her own; she occasionally moved suddenly from a prone position to sit fully upright in her bed, arms rigidly out in front of her; she would yell expletives and attack those close to her. And other people who have been diagnosed with the same disease - many of whom are children - have been known to crab-walk, to speak in foreign or unusual accents, and so on. It would be all too easy, I imagine, when faced with the apparent disappearance of a person one knows from their own body and the appearance instead of a collection of such unexplained symptoms, to interpret the resulting state as a spiritual evil. I find this fascinating. I would love to read a book that took this as a starting point and compared reports of demonic possession throughout the ages with what we now know is symptomatic of the brain being under attack. It takes the sting out of those nasty Paranormal Activity movies, doesn't it? God I hate those films, they haunt me for months afterwards. And did you know there is a full-time exorcist on staff at The Vatican? Possession is a notion that has captivated people forever, and it makes such beautiful sense to me that it all comes back to the brain. It makes me wish I had pursued neuroscience at a higher level, to better understand this kind of thing.
Overall assessment: 3 out of 5. This is a book that should appeal to most people in the sense that it describes the true story of a regular person 's literal descent into madness - something that touches a vulnerable, fearful place in all of us. But because much of it is necessarily journalistic and scientific, it is not as absorbing as I had hoped it would be based on the first few chapters.
I should add, however, that Cahalan's motive in writing this book is broader than I have suggested above. Because this illness is still relatively unknown, she hopes that giving a public voice to her own experience might allow for the earlier diagnosis of future sufferers. Had Cahalan not been correctly diagnosed, it is likely she would have died. The psychotic state into which she entered eventually gave way to a catatonic one, and some of those affected by this illness do not recover fully if they are not diagnosed early. Cahalan describes towards the end of the book a moment that touches her deeply, when she receives a letter from a father whose daughter exhibited symptoms similar to Cahalan's. Had it not been for the fact that this father had read an article Cahalan had published in the New York Post detailing her own experiences, his daughter would not have been diagnosed and treated, and in all likelihood she would have died. But because he had read Cahalan's story, he was able to raise the alarm with his daughter's doctors, and she was saved. So I feel that assessing this book on the grounds of pure literary merit or enjoyment of reading is unfair. It is a book that should be read regardless, if only to spread awareness of anti-NMDA-receptor autoimmune encephalitis (phew, what a mouthful!).
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