brain on fire

"Unforgettable..."
- Elle
"Swift and haunting."
- Scientific American
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SusannahCahalan.com
Facebook.com/BrainonFireBook //@scahalan
Facebook.com/SimonSchuster // @SimonBooks
SimonNovels
PREFACE
A
t first, there’s just darkness and silence.
“Are my eyes open? Hello?”
I can’t tell if I’m moving my mouth or if there’s even anyone to
ask. It’s too dark to see. I blink once, twice, three times. There is
a dull foreboding in the pit of my stomach. That, I recognize. My
thoughts translate only slowly into language, as if emerging from a
pot of molasses. Word by word the questions come: Where am I?
Why does my scalp itch? Where is everyone? Then the world around
me comes gradually into view, beginning as a pinhole, its diameter
steadily expanding. Objects emerge from the murk and sharpen into
focus. After a moment I recognize them: TV, curtain, bed.
I know immediately that I need to get out of here. I lurch forward, but something snaps against me. My fingers find a thick
mesh vest at my waist holding me to the bed like a—what’s the
word?—straitjacket. The vest connects to two cold metal side
rails. I wrap my hands around the rails and pull up, but again the
straps dig into my chest, yielding only a few inches. There’s an
unopened window to my right that looks onto a street. Cars, yellow cars. Taxis. I am in New York. Home.
Before the relief finishes washing over me, though, I see her.
The purple lady. She is staring at me.
“Help!” I shout. Her expression never changes, as if I hadn’t
said a thing. I shove myself against the straps again.
“Don’t you go doing that,” she croons in a familiar Jamaican
accent.
“Sybil?” But it couldn’t be. Sybil was my childhood babysitter. I haven’t seen her since I was a child. Why would she choose
today to reenter my life? “Sybil? Where am I?”
“The hospital. You better calm down.” It’s not Sybil.
“It hurts.”
The purple lady moves closer, her breasts brushing against my
xii  PREFACE
face as she bends across me to unhook the restraints, starting on
the right and moving to the left. With my arms free, I instinctually raise my right hand to scratch my head. But instead of hair
and scalp, I find a cotton hat. I rip it off, suddenly angry, and raise
both hands to inspect my head further. I feel rows and rows of
plastic wires. I pluck one out—which makes my scalp sting—and
lower it to eye level; it’s pink. On my wrist is an orange plastic
band. I squint, unable to focus on the words, but after a few seconds, the block letters sharpen: FLIGHT RISK.
BRAIN ON FIRE
PART ONE
CRAZY
I have felt that odd whirr of wings in the head.
—Virginia Woolf, A Writer’s Diary:
Being Extracts from the Diary of Virginia Woolf

3
CHAPTER 1
BEDBUG BLUES
M
aybe it all began with a bug bite, from a bedbug that didn’t
exist.
One morning, I’d woken up to find two red dots on the main
purplish-blue vein running down my left arm. It was early 2009,
and New York City was awash in bedbug scares: they infested
offices, clothing stores, movie theaters, and park benches. Though
I wasn’t naturally a worrier, my dreams had been occupied for
two nights straight by finger-long bedbugs. It was a reasonable
concern, though after carefully scouring the apartment, I couldn’t
find a single bug or any evidence of their presence. Except those
two bites. I even called in an exterminator to check out my apartment, an overworked Hispanic man who combed the whole place,
lifting up my sofa bed and shining a flashlight into places I had
never before thought to clean. He proclaimed my studio bug free.
That seemed unlikely, so I asked for a follow-up appointment for
him to spray. To his credit, he urged me to wait before shelling
out an astronomical sum to do battle against what he seemed to
think was an imaginary infestation. But I pressed him to do it,
convinced that my apartment, my bed, my bodyhad been overrun
by bugs. He agreed to return and exterminate.
Concerned as I was, I tried to conceal my growing unease from
my coworkers. Understandably, no one wanted to be associated
with a person with a bedbug problem. So at work the following
day, I walked as nonchalantly as possible through the newsroom
of the New York Post to my cubicle. I was careful to conceal
my bites and tried to appear casual, normal. Not that “normal”
means a lot at the Post.
4  BRAIN ONFIRE
Though it’s notoriously obsessed with what’s new, the Postis
nearly as old as the nation itself. Established by Alexander Hamilton in 1801, it is the longest continually run newspaper in the
country. In its first century alone, the paper crusaded for the abolition movement and helped promote the creation of Central Park.
Today the newsroom itself is cavernous yet airless, filled with
rows of open cubicles and a glut of filing cabinets packed with
decades of unused, forgotten documents. The walls are freckled
with clocks that don’t run, dead flowers hung upside down to
dry, a picture of a monkey riding a border collie, and a big foam
Six Flags finger, all memorabilia from reporters’ assignments. The
PCs are ancient, the copy machines the size of small ponies. A
small utility closet that once served as a smoking room now holds
supplies, and is marked by a weathered sign warning that the
smoking room no longer exists, as if someone might accidentally
wander in for a cigarette among the monitors and video equipment. This has been my eccentric little world for the past seven
years, since I started here as a seventeen-year-old intern.
Especially around deadline, the room buzzes with activity—
keyboards clacking, editors yelling, reporters cackling—the perfect stereotype of a tabloid newsroom.
“Where’s the fucking picture to go with this caption?”
“How is it that he didn’t know she was a prostitute?”
“What color were the socks of the guy who jumped off the
bridge?”
It’s like a bar without alcohol, filled with adrenaline-soaked
news junkies. The cast of characters here is unique to the Post:
the brightest headline writers in the business, the hardened newshounds hunting after exclusives, and type-A workaholics who
possess the chameleon ability to either befriend or antagonize
almost anyone. Still, on most days, the newsroom is subdued,
as everyone silently combs through court documents, interviews
sources, or reads newspapers. Often, like today, the newsroom is
as quiet as a morgue.
Heading toward my desk to start the day, I wove through the
rows of cubicles marked by green Manhattan street signs: Liberty
BEDBUG BLUES  5
Street, Nassau Street,Pine Street, and William Street, throwbacks
to a time when the Postwas actually flanked by those downtown streets in its previous home at the South Street Seaport. My
desk is at Pine Street. Amid the silence, I slid into my seat beside
Angela, my closest friend at the paper, and gave her a tense smile.
Trying not to let my question echo too loudly across the noiseless
room, I asked, “You know anything about bedbug bites?”
I often joked that if I ever had a daughter, I’d want her to be
like Angela. In many ways, she is my newsroom hero. When I
first met her, three years before, she was a soft-spoken, shy young
woman from Queens, only a few years older than me. She had
arrived at the Postfrom a small weekly paper and since then had
matured under the pressure of a big-city tabloid into one of the
Post’s most talented reporters, churning out reams of our best stories. Most late Friday nights, you’d find Angela writing four stories on split screens simultaneously. I couldn’t help but look up to
her. Now I really needed her advice.
Hearing that dreaded word, bedbugs,Angela scooted her chair
away from mine. “Don’t tell me you have them,” she said with an
impish smile. I started to show her my arm, but before I could get
into my tale of woe, my phone rang.
“You ready?” It was the new Sunday editor, Steve. He was just
barely in his midthirties, yet he had already been named head editor of the Sunday paper, the section I worked for, and despite his
friendliness, he intimidated me. Every Tuesday, each reporter had
a pitch meeting to showcase some of his or her ideas for that Sunday’s paper. At the sound of his voice, I realized with panic that I
was completely unprepared for this week’s meeting. Usually I had
at least three coherent ideas to pitch; they weren’t always great,
but I always had something. Now I had nothing, not even enough
to bluff my way through the next five minutes. How had I let that
happen? This meeting was impossible to forget, a weekly ritual
that we all fastidiously prepared for, even during days off.
Bedbugs forgotten, I widened my eyes at Angela as I stood
back up, gamely hoping it all would work out once I got to Steve’s
office.
6  BRAIN ONFIRE
Nervously,I walked back down “Pine Street” and into Steve’s
office. I sat down next to Paul, the Sunday news editor and close
friend who had mentored me since I was a sophomore in college,
giving him a nod but avoiding direct eye contact. I readjusted my
scratched-up wide-framed Annie Hallglasses, which a publicist
friend once described as my own form of birth control because
“no one will sleep with you with those on.”
We sat there in silence for a moment, as I tried to let myself be
comforted by Paul’s familiar, larger-than-life presence. With his
shock of prematurely white hair and his propensity to toss the
word fuckaround like a preposition, he is the essence of a throwback newsman and a brilliant editor.
He had given me a shot as a reporter during the summer of my
sophomore year of college after a family friend introduced us. After
a few years in which I worked as a runner, covering breaking news
and feeding information to another reporter to write the piece, Paul
offered me my first big assignment: an article on the debauchery at
a New York University fraternity house. When I returned with a
story and pictures of me playing beer pong, he was impressed with
my chutzpah; even though the exposé never ran, he assigned me
more stories until I had been hired on full time in 2008. Now, as I
sat in Steve’s office wholly unprepared, I couldn’t help but feel like
a work in progress, not worthy of Paul’s faith and respect.
The silence deepened until I looked up. Steve and Paul were
staring at me expectantly, so I just started talking, hoping something would come. “I saw this story on a blog . . . ,” I said, desperately plucking up wisps of half-formed ideas.
“That’s really just not good enough,” Steve interrupted. “You
need to be bringing in better stuff than this. Okay? Please don’t
come in with nothing again.” Paul nodded, his face blazing red.
For the first time since I’d started working on my high school
newspaper, journalism disagreed with me. I left the meeting furious at myself and bewildered by my own ineptitude.
“You okay?” Angela asked as I returned to my desk.
“Yeah, you know, I’m just bad at my job. No big deal,” I joked
grimly.
BEDBUG BLUES  7
She laughed, revealing a few charmingly crooked incisor teeth.
“Oh, come on, Susannah. What happened? Don’t take it seriously.
You’re a pro.”
“Thanks, Ang,” I said, sipping my lukewarm coffee. “Things
just aren’t going my way.”
I brooded over the day’s disasters that evening as I walked
west from the News Corp. building on Sixth Avenue, through the
tourist clusterfuck that is Times Square, toward my apartment
in Hell’s Kitchen. As if purposely living the cliché of a New York
writer, I rented a cramped one-room studio, where I slept on a
pullout sofa. The apartment, eerily quiet, overlooked the courtyard of several tenements, and I often awoke not to police sirens
and grumbling garbage trucks but to the sound of a neighbor
playing the accordion on his balcony.
Still obsessed with my bites, despite the exterminator’s assurance that I had nothing to worry about, I prepared for him to
spray the place and spent that night discarding things that could
be harboring bedbugs. Into the garbage went my beloved Post
clips, hundreds of articles reminding me of how bizarre my job
is: the victims and suspects, dangerous slums, prisons and hospitals, twelve-hour shifts spent shivering inside photographers’
cars waiting to photograph—or “pop”—celebrities. I had always
loved every minute of it. So why was I suddenly so terrible at it?
As I shoved these treasures into the trash bags, I paused on a
few headlines, among them the biggest story of my career to date:
the time I managed to land an exclusive jailhouse interview with
child kidnapper Michael Devlin. The national media were hot
on the story, and I was only a senior at Washington University
in St. Louis, yet Devlin spoke to me twice. But the story didn’t
end there. His lawyers went nuts after the article ran, launching a smear campaign against the Postand calling for a judicial
gag order, while the local and national media began debating my
methods on live TV and questioning the ethics of jailhouse interviews and tabloids in general. Paul fielded several tearful phone
calls from me during that time, which bound us together, and in
the end, both the paper and my editors stood by me. Though the
8  BRAIN ONFIRE
experience had rattled me, it also whetted my appetite,and from
then on, I became the resident “jailhouser.” Devlin was eventually
sentenced to three consecutive lifetimes in prison.
Then there was the butt implant story, “Rear and Present Danger,” a headline that still makes me laugh. I had to go undercover
as a stripper looking for cheap butt enhancements from a woman
who was illegally dispensing them out of a midtown hotel room.
As I stood there with my pants around my ankles, I tried not to
be insulted when she announced that she would need “a thousand
dollars per cheek,” twice the amount she charged the woman who
had come forward to the Post.
Journalism was thrilling; I had always loved living a reality
that was more fabulist than fiction, though little did I know that
my life was about to become so bizarre as to be worthy of coverage in my own beloved tabloid.
Even though the memory made me smile, I added this clip to
the growing trash pile—“where it belongs,” I scoffed, despite the
fact that those crazy stories had meant the world to me. Though
it felt necessary at the moment, this callous throwing away of
years’ worth of work was completely out of character for me. I
was a nostalgic pack rat, who held on to poems that I had written in fourth grade and twenty-some-odd diaries that dated back
to junior high. Though there didn’t seem to be much of a connection among my bedbug scare, my forgetfulness at work, and my
sudden instinct to purge my files, what I didn’t know then is that
bug obsession can be a sign of psychosis. It’s a little-known problem, since those suffering from parasitosis, or Ekbom syndrome,
as it’s called, are most likely to consult exterminators or dermatologists for their imaginary infestations instead of mental health
professionals, and as a result they frequently go undiagnosed. My
problem, it turns out, was far vaster than an itchy forearm and a
forgotten meeting.
After hours of packing everything away to ensure a bedbugfree zone, I still didn’t feel any better. As I knelt by the black
garbage bags, I was hit with a terrible ache in the pit of my stomach—that kind of free-floating dread that accompanies heart-
BEDBUG BLUES  9
break or death. When I got to my feet, a sharp pain lanced my
mind, like a white-hot flash of a migraine, though I had never
suffered from one before. As I stumbled to the bathroom, my
legs and body just wouldn’t react, and I felt as if I were slogging
through quicksand. I must be getting the flu,I thought.
This might not have been the flu, though, the same way there may
have been no bedbugs. But there likely was a pathogen of some
sort that had invaded my body, a little germ that set everything in
motion. Maybe it came from that businessman who had sneezed
on me in the subway a few days before, releasing millions of virus
particles onto the rest of us in that subway car? Or maybe it was
in something I ate or something that slipped inside me through a
tiny wound on my skin, maybe through one of those mysterious
bug bites?
There my mind goes again.
The doctors don’t actually know how it began for me. What’s
clear is that if that man had sneezed on you, you’d most likely just
get a cold. For me, it flipped my universe upside down and very
nearly sent me to an asylum for life.