The dedication on the first page of this book reads: “… to those without a diagnosis.” I think it is that aspect of Susannah Cahalan’s story that I found the most frightening.
Imagine you are a young professional, just starting out in your chosen career, having met a partner whose company you truly enjoy. The world is your oyster. And then you start having visual hallucinations, suffering from paranoia, and generally feeling as though you have been possessed by the devil. You are at the mercy of your body and brain and the bureaucracy of a medical system that sees a young, single twenty-something and assumes you’ve been using drugs or drinking too much.
Cahalan’s career and, indeed, her life, was completely derailed by her unexplained symptoms and her story follows the murky trail of a near instant-onset mental illness and her efforts to get diagnosed. She benefitted from a health insurance plan that paid for testing and inpatient care and a family committed to finding answers. It is terrifyingly apparent how easy it would have been for her to fall through the cracks and live out the remainder of her days in a psychiatric ward. I found myself holding my breath more than once as I hoped against hope that some sort of breakthrough would come for her and her family.
Cahalan’s month of madness is testament to the power of perseverance, both on the part of Susannah’s advocates and the medical personnel who were willing to think outside the box. The story itself is unique in that the author herself didn’t recall much of the vital details of that month of her life and had to draw on her talents as a reporter for the New York Post in order to piece together information and reconstruct it. She does an admirable job of translating the complicated medical terms into an easily understandable language and clearly did extensive research into brain science and her own unique diagnosis in an effort to recount this incredible month of her life.
Her ultimate diagnosis of an incredibly rare disease begs two questions: first, how likely is she to have been diagnosed at all if she had not been in the right place at the right time with good health insurance and, second, how rare is this disease, actually, given that there could be a multitude of other people out there who are either misdiagnosed or unable to seek help at all? It is these two questions that kept me up at night as I made my way through Cahalan’s riveting story of madness and return to normalcy.