Susannah Cahalan’s, Brain on Fire presents the author’s struggle with a health condition that made her paranoid and hallucinatory. Susannah Cahalan is a twenty-four years lady living in New York City who is also a reporter for the New York Post

Reflection paper: Novel – Brain on Fire: My Month of Madness
Institutional affiliation

Reflection paper: Novel – Brain on Fire: My Month of Madness
Background on Susannah
Susannah Cahalan’s, Brain on Fire presents the author’s struggle with a health condition that made her paranoid and hallucinatory. Susannah Cahalan is a twenty-four years lady living in New York City who is also a reporter for the New York Post. She has had a successful career at New York post for seven years since she joined the media station as an intern at seventeen years. However, things turn amiss all over of a sudden after she is bitten by two small insects on her arm. During this duration, there was panic across the New York of the possibility of bed bug infestation. She, therefore, consults an exterminator and though the exterminator does not notice any signs of the bedbugs, Cahalan insists that the apartment needs to be sprayed. After the bites, Cahalan always hid the insect bites on her arm from her colleagues at the workplace fearing that the workmates would conclude that she had bedbugs in her house. However, after of series of consultations and tests doctors later diagnosed Cahalan with a rare mental condition known as Dalmau’s disease.
Insights gained
From this novel, I have learned that health can affect anyone at any given point in his or her life. As such the human body needs continuous check up s to ascertain any form of health problem that may be slowly affecting an individual. In the case of Cahalan’s mental condition, it is clear that the situation was as a result of brain lesions. Lesions in the brain take a significant time to develop and therefore when detected at an early stage they can be easily suppressed. Such mental conditions can even result in depression and ultimately the death of the patient (Wilson, 2013). It is evident that the condition deprives an individual of his or her self-esteem. Self-esteem is equivalent to a person’s worth and once this is worth is deprived the person loses hope in life.
I have also learnt that Dalmau’s condition is a brain disorder whereby the antibodies begin to attack the brain particularly the right hemisphere of the brain. However, the causes of such a disease may not be ascertained, but the recovery journey can turn out to be successful.
Effective engagement
To engage effectively with a patient like Cahalan, I would strive to maintain a therapeutic alliance with the client. In this case, I would try to manage feelings, emotions and the stresses that the client may experience as a result of the condition. Most importantly I would employ motivational enhancement, relapse prevention and contingency management to ensure that there is a rapport with clients living with a condition such as Cahalan’s. A healthy relationship with the patients would mean that they will be able to disclose their feelings, fears, and experiences. I would, therefore, create a healthy relationship with clients with a condition such as Cahalan’s so that they acquire a sense of worthiness, hope and confidence to communicate their condition to enhance belonging and love from the society.
Avoiding/minimizing negative situations
One important negative situation that Cahalan experienced with the Healthcare system was the misdiagnosis. Notably, initial tests revealed that Cahalan was suffering from bipolar and schizophrenia disorders. However, the symptoms were not consistent with these ailments. It was until Dr Najjar was consulted that it became apparent that Cahalan’s situation was neither schizophrenia nor bipolar. As a social worker, I would encourage and advise Cahalan always to seek medication from specialized medical staff. In regards to misdiagnosis also I would inform her to seek further examination on bipolar and schizophrenia. Though Dalmau’s finally emerged as the significant disease that she was suffering from, she might as well be ailing from the earlier diagnosed disorders
Managing vicarious trauma
Dalmau‘s disease leads an individual to have a sense of low self-esteem. This is the main cause of all the traumatic experience that a client may undergo. To help the patient manage the vicarious trauma, I would provide guidance and counselling as well as engage them in activities that seek to promote their self-esteem. By having many people visit the patient will go a long way in making the patient realise that other people love him or her. The most important entity in the recovery process is a piece of mind. Peace is usually attained by building healthy interaction with the people in the society.
Notably, Dalmau’s disease is a treatable disorder that affects the patient’s immune system. Apparently, most of the patients who have schizophrenia end up suffering from Dalmau’s disease. Within the context of Cahalan therefore, it was evident that the doctors were not keen enough to detect Dalmaus disease and only recognised the presence of schizophrenia. The symptoms of Dalmau’s include hallucinations, agitation and paranoia. These symptoms are evident in schizophrenia, but in Dalmau’s disease, the symptoms are at their extreme levels. This is a rare condition, and therefore it is imperative that medical practitioners are keen when diagnosing a patient to ensure that the disorder is not confused with other similar conditions such as the bipolar and schizophrenia.

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Wilson, B. (2013). Brain on fire: My Month of madness. Neuropsychological Rehabilitation, 23(3), 463-464.
Cahalan, S.(2014).Brain on Fire – My Month of Madness2013 1 Susannah Cahalan Brain on Fire – My Month of Madness Particular Books November 2012 288 pp., Hardcover ISBN-10:11846147395/13:9781846147395. (2013). Social Care and Neurodisability, 4(3/4), 149-149.

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