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Chapter 24
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
The doctors perform the second spinal tap at the beginning of Susannah’s third week in the hospital. Susannah describes an EEG video in which she lies in bed with Stephen, asleep. Susannah wakes and starts inhaling rapidly, but never exhales. She bends her hands to her face slowly. A nurse arrives and Stephen tries to explain what happened, and then Susannah continues to move her arms slowly, as though they're made of lead. A neurologist arrives and Susannah throws a stuffed animal and begins batting the air. She can't answer the neurologist's questions. Stephen worries that Susannah is having more seizures, but nobody is ever able to explain these attacks. They happen almost nightly.
By including an explanation of a medical event that is still a mystery, Cahalan reminds the reader that just because her story had a happy ending, that doesn't mean that all the mysteries were solved—the brain is far too complicated, and medicine is still advancing. Medicine doesn’t always have a miraculous cure or explanation for everything.
Themes
Susannah's family begins to worry that if no answers surface, Susannah will end up in a nursing home or a mental institution. The day after the second spinal tap, Dr. Russo arrives to tell Dad that Susannah's white blood cell count is four times what it was after the first spinal tap. This indicates that Susannah's brain is inflamed, though they still don't know why. Dad writes this down in the journal he shares with Mom, and then tries to help Susannah write the news down in her own journal so she can share it with visitors.
As Dad writes this down for Mom and helps Susannah write it down herself, he attempts to make sense of and control this new information. Though writing something is a simple way to remember it, it's also important to keep in mind that in writing it down themselves, Dad and Susannah inject their own emotions and experiences into the words—these notes aren't entirely impartial.
Themes
Susannah promptly loses the journal and when Hannah arrives the next day, Susannah struggles to explain what's going on. Hannah distracts Susannah by reading to her. Susannah suddenly begins emphatically repeating an unintelligible word over and over, yelling until Hannah finally understands that she's asking for Stephen. When she calls Stephen into the room, Susannah quiets immediately.
As Susannah and Stephen's relationship develops during this time in the hospital, the question arises of whether or not it will continue once she's "back" after healing. This speaks to the changeable nature of identity and how it interacts with one's relationships with others.
Themes
The next day, a nurse arrives to draw Susannah's blood for the tests that will attempt to determine where her brain swelling is coming from. As the nurse begins to draw blood, Susannah jumps and slaps the needle away. Stephen recognizes that this is the psychosis resurfacing. The nurse reprimands Susannah and draws blood without incident.
Susannah's unpredictability reinforces the idea that her identity is constantly changing as the disease ravages her brain. At this point, everyone else has to navigate this alone, since Susannah isn't truly "there" to think about how she relates to her disease.
Themes
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