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Chapter 21
Themes
Key
LitCharts assigns a color and icon to each theme in Brain on Fire: My Month of Madness, which you can use to track the themes throughout the work.
Identity and Illness
Storytelling, Memory, and Emotion
Love and Family
Responsibility and the Medical System
Summary
Analysis
As Susannah's second week in the hospital begins, she starts showing new and horrific symptoms. She begins slurring her words, her tongue twists, and when she's tired, she lets her tongue hang out. This terrifies Mom. When Dr. Russo tries to lead Susannah through tests, Susannah cannot repeat "ca, ca, ca," or puff out her cheeks. Later in the day, Dr. Arslan observes that Susannah is making chewing motions, grimacing, and holding her arms out stiffly. The doctors suspect that Susannah's high blood pressure may be to blame, and fear a problem with her brain stem. The brain stem controls basic functions like heart rate and breathing, but Susannah tells the reader that it's difficult to pinpoint one area when the parts of the brain are so interconnected.
Again, Cahalan makes it very clear that though these are highly acclaimed doctors, the brain is still a relatively unknown entity, and little is known about how it actually works. However, these new suspicions do show that Susannah's doctors now believe that this isn't just a mental health issue, given that they suspect particular parts of her brain are malfunctioning. This shows them beginning to bridge the gap between mental health and physical health.
Themes
In the afternoon, Dr. Siegel arrives with news: Susannah's spinal tap showed an elevated level of white blood cells, which is a sign of infection. He explains that they have a number of other tests in process to discover why the white blood cells are elevated. Mom is relieved and goes home that evening to research the frightening possibilities, which include meningitis or a stroke. Late at night, Susannah calls Mom and tells her that she peed and the nurses are yelling. Mom assures Susannah that the nurses aren't mad. Susannah tells the reader that the reason for the phone call could've been entirely made up, and Mom never heard anything more about it.
Mom's frantic internet searching illustrates why researching one's symptoms is almost never a good idea: though she does come up with some possible answers, they're terrifying (and, incidentally, wrong). Though the memoir overwhelmingly supports patients taking control of their health and advocating for care given what they know, at this point Cahalan points out that there are downsides and consequences to trying to learn too much from the uncensored mass of the internet.
Themes
On Tuesday of the second week, Susannah's friend Katie comes to visit. Though she works with children with learning difficulties, she's shocked by Susannah's appearance and inability to hold a conversation. Katie suggests they take a walk, and Susannah agrees. They rest in a waiting area and when Katie comments on Susannah's baggy leggings, Susannah laughs. She gets up, slurs the phrase "these are my legs," and dances.
Much of Katie's shock comes from the fact that the Susannah she sees in the hospital doesn't at all match up with the Susannah she knows. This reinforces how important one's performed identity is, and shows again that other people are very much responsible for promoting this identity.
Themes
Next, Angela and Julie come to visit. Hannah is already there, and Julie hops onto the bed with Susannah. She pulls out her phone and finds a photo of the bowel movement the doctors insisted she take before she leave the hospital after delivering her son. Everyone but Susannah gasps and then starts laughing. Susannah grabs the phone and then begins laughing, which sends the others into hysterics again.
Susannah's delays are certainly signs that not all is well in her brain, but this heartwarming visit shows too that Susannah is still capable of warm and friendly relationships. At this moment he can accept support from friends and family, which makes her in turn easier to support.
Themes
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Angela begins asking Susannah questions. Susannah is very concerned about what people at work are saying about her, and mentions that the gossip blog Gawker has been saying bad things about her. Angela talks Susannah out of contacting Gawker. As Angela and Julie walk to the elevator later, they wonder whether Susannah will ever be the same. Susannah explains that it was a fair question. She says that at about this time, Dad gave her a notebook to record her difficulties and to use for writing thank you notes, though she never got to send them.
Again, when Susannah expresses fear that others are conspiring against her, it demonstrates a fear that other people are controlling her story, image, and identity. It's worth noting that at this point, all three of those things are entirely outside Susannah's control, even if she is capable of writing in the notebook from Dad.
Themes
