47 pages • 1 hour read
Susannah CahalanBrain On Fire
Nonfiction | Autobiography / Memoir | Adult | Published in 2012A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Symbols & Motifs
The Lucky Ring
The first time Cahalan seeks medical advice about the symptoms she experiences, her doctor is Dr. Bailey. As part of her examination, she is required to change into a cotton gown and place her jewelry in a lock box, so there is no interference with her MRI. The ring is a graduation gift from Allen, her stepfather, and “it was 14K gold with a black hematite cat’s eye, which some cultures believe can ward off evil spirits” (17). Cahalan is very uncomfortable during the examination and the MRI. After the MRI, Cahalan rushes to change and leave Dr. Bailey’s office quickly. In her haste, she leaves her jewelry, including this special ring, in the lock box with Dr. Bailey’s staff.
It is not until Cahalan is months into recovering from her illness that she discovers her ring in a pile of unopened mail from her Manhattan apartment. When Cahalan is reunited with her ring, she has been through a life-changing experience. Cahalan is relieved and happy to have her ring again. Cahalan had the ring when she was her former self. Cahalan has the ring again as a new version of herself. She believes the ring protects her and is able to return her to something like her old self.
Music
Cahalan’s boyfriend, Stephen, is a musician. Before Cahalan’s illness, she and Stephen participated in activities that involved music, such as listening to music together and attending concerts. During Cahalan’s illness and recovery, there are many times when Cahalan is despondent or catatonic. There are several times in her treatment and recovery when doctors, family and friends are uncertain as to whether any part of the old Cahalan remains. Cahalan’s responses to music repeatedly show her family and friends that something of her old self still remains, and these responses give them hope that Cahalan can make a full recovery.
After Cahalan’s first round of IVIG treatment from Dr. Najjar, Cahalan is discharged from the hospital. Her family, her boyfriend, and her friend Lindsey pack Cahalan’s belongings and return to Summit, New Jersey:
Lindsey looked over at me to see if I recognized the song. […] Lindsey doubted I would remember it. I began bopping my head out of rhythm, my arms at rigid right angles. I swung my elbows front to back like I was awkwardly cross-country skiing (164).
Although Cahalan’s response to the song is not completely normal, hearing the song does conjure a more energetic response than in the recent past. Following a subsequent hospital visit, Stephen takes Cahalan on a drive around Summit in an effort to help her relax:
As if on cue, Stephen and I together belted out the chorus, ‘California dreamin’ on such a winter’s day!’ For a moment, Stephen took his eyes off the road and glanced at me in astonishment and joy. […] I was still in there (171).
Cahalan’s ability to recall and enjoy music with her boyfriend gives him hope that someday, Cahalan will be an independent woman with a dynamic personality again, as she had been before the illness. Despite Cahalan’s physical and emotional states after her hospital visit, the music reaches a part of her that her family and friends remember.
While attending her stepbrother’s wedding, Cahalan struggles to act normally. She drinks champagne, and dances with her boyfriend: “When the song ‘Build Me Up Buttercup’ came on, I even did the twist with Stephen” (187). Cahalan and her family feel nervous about how much of a strain the wedding might put on Cahalan, and Cahalan worries about how others perceive her. When a familiar song comes on, she dances with Stephen and is happy.
Collage
Brain on Fire includes narration by Cahalan before, during, and after experiencing her illness. The narration is sometimes hallucinations and paranoid delusions that she partially remembers and may have had assistance in reconstructing. The narration includes transcribed video footage of her strange behavior while at NYU. There are scanned pieces of doctor’s reports, diagrams, journal entries, and the drawing that inspired Dr. Najjar’s life-saving diagnosis as part of the text. Combining different types of writing from different moments in time create a unique quality to the text and to the storytelling. This type of collage-style writing provides a different experience for the reader. All of the elements together create a vivid picture of Cahalan’s ordeal and support her narrative.
