Brain on Fire: My Month of Madness

by

Susannah Cahalan

Brain on Fire: My Month of Madness: Chapter 26 Summary & Analysis

Summary
Analysis
A few days later, Dr. Najjar is finally scheduled to arrive. Susannah drools and smacks her lips, habits that are now constant. Mom is excited to meet Dr. Najjar, but Dad is much less enthusiastic. When Dr. Najjar enters Susannah's room, he warmly greets Mom and Dad and then goes through Susannah's medical history. He's the first doctor to express interest in seemingly disconnected symptoms, such as the bedbug scare and the numbness. Then, he turns to Susannah and speaks to her directly.
From the very beginning, Dr. Najjar sets himself apart from all the other doctors who have seen Susannah by taking her seriously and speaking to her directly during her time in the hospital. In this way, he acts as a model for how a doctor should act with patients: kind, curious, and most of all, interested.
Themes
Identity and Illness Theme Icon
Responsibility and the Medical System Theme Icon
Susannah explains to the reader that Dr. Najjar is personal and heartfelt, and he loves to help the weak and powerless. This is because as a boy in Syria, he'd done very poorly in his private Catholic school. His father had moved him to public school, where a kind teacher took him under her wing. By the end of the year, Najjar was getting straight As. When his parents confronted the teacher about the possibility that Najjar was cheating, the teacher suggested that Najjar was actually smart. Eventually, Dr. Najjar graduated at the top of his class, immigrated to the US, and became an esteemed neurologist. He never gives up on his patients.
By offering the reader a very personal and intimate look into why Dr. Najjar is the way he is, Cahalan illustrates how a person's identity is shaped largely by their memories. Cahalan also creates an equivalency here between Dr. Najjar and this teacher, as Dr. Najjar takes on a similar role for her as the teacher did for him. He's the first doctor to truly express interest and the possibility of a cure for Susannah; he'll be the reason she lives.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Responsibility and the Medical System Theme Icon
Dr. Najjar asks Susannah for her name, the date, and the president, which she can answer with some delay. He leads her through several movement exercises, which Susannah can perform with extreme delay and difficulty. Finally, he decides to try the "clock test," a test designed to diagnose problem areas of the brain in patients with Alzheimer's and strokes. He hands Susannah a piece of paper and asks her to draw a clock face with numbers. On her second try, Susannah manages to draw a circle. Slowly, she writes in the numbers--all on the right side of the clock. Dr. Najjar is ecstatic, and explains that this means the right side of Susannah's brain is inflamed.
The fact that Dr. Najjar can come up with such an important answer from a test designed for diseases that Susannah doesn't have reinforces the idea that the parts of the brain are extremely interconnected. It also makes it clear that Susannah's doctors have been neglecting some of the tools available to them, which illustrates the need for more education and intercommunication within the medical community.
Themes
Responsibility and the Medical System Theme Icon
Susannah tells the reader that both sides of the brain must work to see: information that the eye sees in its left field of vision is processed in the right side of the brain and vice versa. Susannah's clock is an example of "visual neglect," or evidence that the brain isn't processing things on one side. This also explains the numbness on one side of her body as well as the paranoia, seizures, and hallucinations. Dr. Najjar figures that the inflammation is likely the cause of an autoimmune reaction and remembers a rare autoimmune disease. The diagnosis requires a brain biopsy, but Dr. Najjar doesn't tell Mom and Dad that.
When Cahalan describes the concept of visual neglect, she begins to piece together how the Susannah in the hospital saw the world and how she constructed her sense of self in space. In this way, she can begin to understand better why she did the things she did in the hospital, and can approach learning about this version of herself with more compassion and understanding.
Themes
Identity and Illness Theme Icon
Storytelling, Memory, and Emotion Theme Icon
Responsibility and the Medical System Theme Icon
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Brain on Fire: My Month of Madness PDF
Dr. Najjar paces as he thinks all this through and then sits down next to Susannah. He tells Mom and Dad that Susannah's brain is on fire, takes Susannah's hands in his, and tells her that he'll do everything he can. Susannah begins to cry and throws her arms around him.
Here, Dr. Najjar shows that he's truly willing to become part of Susannah's support team. By treating her like a person, not a medical curiosity, he makes her feel safe and welcome.
Themes
Identity and Illness Theme Icon
Love and Family Theme Icon
Responsibility and the Medical System Theme Icon