Brain On Fire: My Month Of Madness Part 1

Brain on Fire: my month of madness.

by Susannah Cahalan.

PREFACE

At first, there's just darkness and silence.

"Are my eyes open? h.e.l.lo?"

I can't tell if I'm moving my mouth or if there's even anyone to ask. It's too dark to see. I blink once, twice, three times. There is a dull foreboding in the pit of my stomach. That, I recognize. My thoughts translate only slowly into language, as if emerging from a pot of mola.s.ses. Word by word the questions come: Where am I? Why does my scalp itch? Where is everyone? Then the world around me comes gradually into view, beginning as a pinhole, its diameter steadily expanding. Objects emerge from the murk and sharpen into focus. After a moment I recognize them: TV, curtain, bed.

I know immediately that I need to get out of here. I lurch forward, but something snaps against me. My fingers find a thick mesh vest at my waist holding me to the bed like a-what's the word?-straitjacket. The vest connects to two cold metal side rails. I wrap my hands around the rails and pull up, but again the straps dig into my chest, yielding only a few inches. There's an unopened window to my right that looks onto a street. Cars, yellow cars. Taxis. I am in New York. Home.

Before the relief finishes washing over me, though, I see her. The purple lady. She is staring at me.

"Help!" I shout. Her expression never changes, as if I hadn't said a thing. I shove myself against the straps again.

"Don't you go doing that," she croons in a familiar Jamaican accent.

"Sybil?" But it couldn't be. Sybil was my childhood babysitter. I haven't seen her since I was a child. Why would she choose today to reenter my life? "Sybil? Where am I?"

"The hospital. You better calm down." It's not Sybil.

"It hurts."

The purple lady moves closer, her b.r.e.a.s.t.s brushing against my face as she bends across me to unhook the restraints, starting on the right and moving to the left. With my arms free, I instinctually raise my right hand to scratch my head. But instead of hair and scalp, I find a cotton hat. I rip it off, suddenly angry, and raise both hands to inspect my head further. I feel rows and rows of plastic wires. I pluck one out-which makes my scalp sting-and lower it to eye level; it's pink. On my wrist is an orange plastic band. I squint, unable to focus on the words, but after a few seconds, the block letters sharpen: FLIGHT RISK.

PART ONE

CRAZY

I have felt that odd whirr of wings in the head.

-VIRGINIA WOOLF, A Writer's Diary: Being Extracts from the Diary of Virginia Woolf A Writer's Diary: Being Extracts from the Diary of Virginia Woolf

CHAPTER 1

BEDBUG BLUES

Maybe it all began with a bug bite, from a bedbug that didn't exist.

One morning, I'd woken up to find two red dots on the main purplish-blue vein running down my left arm. It was early 2009, and New York City was awash in bedbug scares: they infested offices, clothing stores, movie theaters, and park benches. Though I wasn't naturally a worrier, my dreams had been occupied for two nights straight by finger-long bedbugs. It was a reasonable concern, though after carefully scouring the apartment, I couldn't find a single bug or any evidence of their presence. Except those two bites. I even called in an exterminator to check out my apartment, an overworked Hispanic man who combed the whole place, lifting up my sofa bed and shining a flashlight into places I had never before thought to clean. He proclaimed my studio bug free. That seemed unlikely, so I asked for a follow-up appointment for him to spray. To his credit, he urged me to wait before sh.e.l.ling out an astronomical sum to do battle against what he seemed to think was an imaginary infestation. But I pressed him to do it, convinced that my apartment, my bed, my body body had been overrun by bugs. He agreed to return and exterminate. had been overrun by bugs. He agreed to return and exterminate.

Concerned as I was, I tried to conceal my growing unease from my coworkers. Understandably, no one wanted to be a.s.sociated with a person with a bedbug problem. So at work the following day, I walked as nonchalantly as possible through the newsroom of the New York Post New York Post to my cubicle. I was careful to conceal my bites and tried to appear casual, normal. Not that "normal" means a lot at the to my cubicle. I was careful to conceal my bites and tried to appear casual, normal. Not that "normal" means a lot at the Post Post.

Though it's notoriously obsessed with what's new, the Post Post is nearly as old as the nation itself. Established by Alexander Hamilton in 1801, it is the longest continually run newspaper in the country. In its first century alone, the paper crusaded for the abolition movement and helped promote the creation of Central Park. Today the newsroom itself is cavernous yet airless, filled with rows of open cubicles and a glut of filing cabinets packed with decades of unused, forgotten doc.u.ments. The walls are freckled with clocks that don't run, dead flowers hung upside down to dry, a picture of a monkey riding a border collie, and a big foam Six Flags finger, all memorabilia from reporters' a.s.signments. The PCs are ancient, the copy machines the size of small ponies. A small utility closet that once served as a smoking room now holds supplies, and is marked by a weathered sign warning that the smoking room no longer exists, as if someone might accidentally wander in for a cigarette among the monitors and video equipment. This has been my eccentric little world for the past seven years, since I started here as a seventeen-year-old intern. is nearly as old as the nation itself. Established by Alexander Hamilton in 1801, it is the longest continually run newspaper in the country. In its first century alone, the paper crusaded for the abolition movement and helped promote the creation of Central Park. Today the newsroom itself is cavernous yet airless, filled with rows of open cubicles and a glut of filing cabinets packed with decades of unused, forgotten doc.u.ments. The walls are freckled with clocks that don't run, dead flowers hung upside down to dry, a picture of a monkey riding a border collie, and a big foam Six Flags finger, all memorabilia from reporters' a.s.signments. The PCs are ancient, the copy machines the size of small ponies. A small utility closet that once served as a smoking room now holds supplies, and is marked by a weathered sign warning that the smoking room no longer exists, as if someone might accidentally wander in for a cigarette among the monitors and video equipment. This has been my eccentric little world for the past seven years, since I started here as a seventeen-year-old intern.

Especially around deadline, the room buzzes with activity-keyboards clacking, editors yelling, reporters cackling-the perfect stereotype of a tabloid newsroom.

"Where's the f.u.c.king picture to go with this caption?"

"How is it that he didn't know she was a prost.i.tute?"

"What color were the socks of the guy who jumped off the bridge?"

It's like a bar without alcohol, filled with adrenaline-soaked news junkies. The cast of characters here is unique to the Post Post: the brightest headline writers in the business, the hardened newshounds hunting after exclusives, and type-A workaholics who possess the chameleon ability to either befriend or antagonize almost anyone. Still, on most days, the newsroom is subdued, as everyone silently combs through court doc.u.ments, interviews sources, or reads newspapers. Often, like today, the newsroom is as quiet as a morgue.

Heading toward my desk to start the day, I wove through the rows of cubicles marked by green Manhattan street signs: Liberty Street, Na.s.sau Street, Pine Street, and William Street, throwbacks to a time when the Post Post was actually flanked by those downtown streets in its previous home at the South Street Seaport. My desk is at Pine Street. Amid the silence, I slid into my seat beside Angela, my closest friend at the paper, and gave her a tense smile. Trying not to let my question echo too loudly across the noiseless room, I asked, "You know anything about bedbug bites?" was actually flanked by those downtown streets in its previous home at the South Street Seaport. My desk is at Pine Street. Amid the silence, I slid into my seat beside Angela, my closest friend at the paper, and gave her a tense smile. Trying not to let my question echo too loudly across the noiseless room, I asked, "You know anything about bedbug bites?"

I often joked that if I ever had a daughter, I'd want her to be like Angela. In many ways, she is my newsroom hero. When I first met her, three years before, she was a soft-spoken, shy young woman from Queens, only a few years older than me. She had arrived at the Post Post from a small weekly paper and since then had matured under the pressure of a big-city tabloid into one of the from a small weekly paper and since then had matured under the pressure of a big-city tabloid into one of the Post Post's most talented reporters, churning out reams of our best stories. Most late Friday nights, you'd find Angela writing four stories on split screens simultaneously. I couldn't help but look up to her. Now I really needed her advice.

Hearing that dreaded word, bedbugs, bedbugs, Angela scooted her chair away from mine. "Don't tell me you have them," she said with an impish smile. I started to show her my arm, but before I could get into my tale of woe, my phone rang. Angela scooted her chair away from mine. "Don't tell me you have them," she said with an impish smile. I started to show her my arm, but before I could get into my tale of woe, my phone rang.

"You ready?" It was the new Sunday editor, Steve. He was just barely in his midthirties, yet he had already been named head editor of the Sunday paper, the section I worked for, and despite his friendliness, he intimidated me. Every Tuesday, each reporter had a pitch meeting to showcase some of his or her ideas for that Sunday's paper. At the sound of his voice, I realized with panic that I was completely unprepared for this week's meeting. Usually I had at least three coherent ideas to pitch; they weren't always great, but I always had something. Now I had nothing, not even enough to bluff my way through the next five minutes. How had I let that happen? This meeting was impossible to forget, a weekly ritual that we all fastidiously prepared for, even during days off.

Bedbugs forgotten, I widened my eyes at Angela as I stood back up, gamely hoping it all would work out once I got to Steve's office.

Nervously, I walked back down "Pine Street" and into Steve's office. I sat down next to Paul, the Sunday news editor and close friend who had mentored me since I was a soph.o.m.ore in college, giving him a nod but avoiding direct eye contact. I readjusted my scratched-up wide-framed Annie Hall Annie Hall gla.s.ses, which a publicist friend once described as my own form of birth control because "no one will sleep with you with those on." gla.s.ses, which a publicist friend once described as my own form of birth control because "no one will sleep with you with those on."

We sat there in silence for a moment, as I tried to let myself be comforted by Paul's familiar, larger-than-life presence. With his shock of prematurely white hair and his propensity to toss the word f.u.c.k f.u.c.k around like a preposition, he is the essence of a throwback newsman and a brilliant editor. around like a preposition, he is the essence of a throwback newsman and a brilliant editor.

He had given me a shot as a reporter during the summer of my soph.o.m.ore year of college after a family friend introduced us. After a few years in which I worked as a runner, covering breaking news and feeding information to another reporter to write the piece, Paul offered me my first big a.s.signment: an article on the debauchery at a New York University fraternity house. When I returned with a story and pictures of me playing beer pong, he was impressed with my chutzpah; even though the expose never ran, he a.s.signed me more stories until I had been hired on full time in 2008. Now, as I sat in Steve's office wholly unprepared, I couldn't help but feel like a work in progress, not worthy of Paul's faith and respect.

The silence deepened until I looked up. Steve and Paul were staring at me expectantly, so I just started talking, hoping something would come. "I saw this story on a blog...," I said, desperately plucking up wisps of half-formed ideas.

"That's really just not good enough," Steve interrupted. "You need to be bringing in better stuff than this. Okay? Please don't come in with nothing again." Paul nodded, his face blazing red. For the first time since I'd started working on my high school newspaper, journalism disagreed with me. I left the meeting furious at myself and bewildered by my own inept.i.tude.

"You okay?" Angela asked as I returned to my desk.

"Yeah, you know, I'm just bad at my job. No big deal," I joked grimly.

She laughed, revealing a few charmingly crooked incisor teeth. "Oh, come on, Susannah. What happened? Don't take it seriously. You're a pro."

"Thanks, Ang," I said, sipping my lukewarm coffee. "Things just aren't going my way."

I brooded over the day's disasters that evening as I walked west from the News Corp. building on Sixth Avenue, through the tourist cl.u.s.terf.u.c.k that is Times Square, toward my apartment in h.e.l.l's Kitchen. As if purposely living the cliche of a New York writer, I rented a cramped one-room studio, where I slept on a pullout sofa. The apartment, eerily quiet, overlooked the courtyard of several tenements, and I often awoke not to police sirens and grumbling garbage trucks but to the sound of a neighbor playing the accordion on his balcony.

Still obsessed with my bites, despite the exterminator's a.s.surance that I had nothing to worry about, I prepared for him to spray the place and spent that night discarding things that could be harboring bedbugs. Into the garbage went my beloved Post Post clips, hundreds of articles reminding me of how bizarre my job is: the victims and suspects, dangerous slums, prisons and hospitals, twelve-hour shifts spent shivering inside photographers' cars waiting to photograph-or "pop"-celebrities. I had always loved every minute of it. So why was I suddenly so terrible at it? clips, hundreds of articles reminding me of how bizarre my job is: the victims and suspects, dangerous slums, prisons and hospitals, twelve-hour shifts spent shivering inside photographers' cars waiting to photograph-or "pop"-celebrities. I had always loved every minute of it. So why was I suddenly so terrible at it?

As I shoved these treasures into the trash bags, I paused on a few headlines, among them the biggest story of my career to date: the time I managed to land an exclusive jailhouse interview with child kidnapper Michael Devlin. The national media were hot on the story, and I was only a senior at Washington University in St. Louis, yet Devlin spoke to me twice. But the story didn't end there. His lawyers went nuts after the article ran, launching a smear campaign against the Post Post and calling for a judicial gag order, while the local and national media began debating my methods on live TV and questioning the ethics of jailhouse interviews and tabloids in general. Paul fielded several tearful phone calls from me during that time, which bound us together, and in the end, both the paper and my editors stood by me. Though the experience had rattled me, it also whetted my appet.i.te, and from then on, I became the resident "jailhouser." Devlin was eventually sentenced to three consecutive lifetimes in prison. and calling for a judicial gag order, while the local and national media began debating my methods on live TV and questioning the ethics of jailhouse interviews and tabloids in general. Paul fielded several tearful phone calls from me during that time, which bound us together, and in the end, both the paper and my editors stood by me. Though the experience had rattled me, it also whetted my appet.i.te, and from then on, I became the resident "jailhouser." Devlin was eventually sentenced to three consecutive lifetimes in prison.

Then there was the b.u.t.t implant story, "Rear and Present Danger," a headline that still makes me laugh. I had to go undercover as a stripper looking for cheap b.u.t.t enhancements from a woman who was illegally dispensing them out of a midtown hotel room. As I stood there with my pants around my ankles, I tried not to be insulted when she announced that she would need "a thousand dollars per cheek," twice the amount she charged the woman who had come forward to the Post Post.

Journalism was thrilling; I had always loved living a reality that was more fabulist than fiction, though little did I know that my life was about to become so bizarre as to be worthy of coverage in my own beloved tabloid.

Even though the memory made me smile, I added this clip to the growing trash pile-"where it belongs," I scoffed, despite the fact that those crazy stories had meant the world to me. Though it felt necessary at the moment, this callous throwing away of years' worth of work was completely out of character for me. I was a nostalgic pack rat, who held on to poems that I had written in fourth grade and twenty-some-odd diaries that dated back to junior high. Though there didn't seem to be much of a connection among my bedbug scare, my forgetfulness at work, and my sudden instinct to purge my files, what I didn't know then is that bug obsession can be a sign of psychosis. It's a little-known problem, since those suffering from parasitosis, or Ekbom syndrome, as it's called, are most likely to consult exterminators or dermatologists for their imaginary infestations instead of mental health professionals, and as a result they frequently go undiagnosed.1 My problem, it turns out, was far vaster than an itchy forearm and a forgotten meeting. My problem, it turns out, was far vaster than an itchy forearm and a forgotten meeting.

After hours of packing everything away to ensure a bedbug-free zone, I still didn't feel any better. As I knelt by the black garbage bags, I was. .h.i.t with a terrible ache in the pit of my stomach-that kind of free-floating dread that accompanies heartbreak or death. When I got to my feet, a sharp pain lanced my mind, like a white-hot flash of a migraine, though I had never suffered from one before. As I stumbled to the bathroom, my legs and body just wouldn't react, and I felt as if I were slogging through quicksand. I must be getting the flu, I must be getting the flu, I thought. I thought.

This might not have been the flu, though, the same way there may have been no bedbugs. But there likely was a pathogen of some sort that had invaded my body, a little germ that set everything in motion. Maybe it came from that businessman who had sneezed on me in the subway a few days before, releasing millions of virus particles onto the rest of us in that subway car? Or maybe it was in something I ate or something that slipped inside me through a tiny wound on my skin, maybe through one of those mysterious bug bites?

There my mind goes again.2 The doctors don't actually know how it began for me. What's clear is that if that man had sneezed on you, you'd most likely just get a cold. For me, it flipped my universe upside down and very nearly sent me to an asylum for life.

CHAPTER 2

THE GIRL IN THE BLACK LACE BRA

A few days later, the migraine, the pitch meeting, and the bedbugs all seemed like a distant memory as I awoke, relaxed and content, in my boyfriend's bed. The night before, I had taken Stephen to meet my father and stepmother, Giselle, for the first time, in their magnificent Brooklyn Heights brownstone. It was a big step in our four-month-old relationship. Stephen had met my mom already-my parents had divorced when I was sixteen, and I had always been closer to her, so we saw her more often-but my dad can be intimidating, I know, and he and I had never had a very open relationship. (Though they'd been married for more than a year, Dad and Giselle had only recently told my brother and me about their marriage.) But it had been a warm and pleasant dinner with wine and good food. Stephen and I had left believing that the evening was a success. few days later, the migraine, the pitch meeting, and the bedbugs all seemed like a distant memory as I awoke, relaxed and content, in my boyfriend's bed. The night before, I had taken Stephen to meet my father and stepmother, Giselle, for the first time, in their magnificent Brooklyn Heights brownstone. It was a big step in our four-month-old relationship. Stephen had met my mom already-my parents had divorced when I was sixteen, and I had always been closer to her, so we saw her more often-but my dad can be intimidating, I know, and he and I had never had a very open relationship. (Though they'd been married for more than a year, Dad and Giselle had only recently told my brother and me about their marriage.) But it had been a warm and pleasant dinner with wine and good food. Stephen and I had left believing that the evening was a success.

Although my dad would later confess that during that first meeting, he had thought of Stephen as more of a placeholder than a long-term boyfriend, I didn't agree at all. We'd only recently begun dating, but Stephen and I had first met six years earlier, when I was eighteen and we worked together at the same record store in Summit, New Jersey. Back then, we pa.s.sed the workdays with polite banter, but the relationship never went any deeper, mainly because he is seven years my senior (an unthinkable gap for a teenager). Then one night the previous fall, we had run into each other at a mutual friend's party at a bar in the East Village. Clinking our bottles of Sierra Nevada, we bonded over our shared dislike for shorts and our pa.s.sion for Dylan's Nashville Skyline Nashville Skyline. Stephen was alluring in that languid, stay-out-all-night kind of way: a musician with long, unkempt hair, a skinny smoker's frame, and an encyclopedic knowledge of music. But his eyes, trusting and honest, have always been his most attractive trait. Those eyes, with nothing to hide, made me feel as if I had dated him forever.

That morning, stretched out in his bed in his enormous (by comparison) studio apartment in Jersey City, I realized I had the place to myself. Stephen had already left for band practice and would be gone for the rest of the day, leaving me free to either spend the day there or let myself out. We had exchanged keys about a month earlier. It was the first time I had taken such a step with a boyfriend, but I had no doubt it was right. We felt deeply comfortable together, generally happy, safe, and trusting. As I lay there, however, I was suddenly, unexpectedly, hit with one overpowering thought: Read his e-mails Read his e-mails.

This irrational jealousy was wholly unlike me; I had never even been tempted to intellectually trespa.s.s like this. But without really considering what I was doing, I opened up his MacBook and began to scroll down his inbox. I sorted through months of mundane e-mails until I triumphantly unearthed a recent one from his ex-girlfriend. The subject line was "Do You Like It?" I clicked, my heart pounding furiously in my chest. She had sent him a picture of herself, posing seductively with her lips pursed, showing off a new auburn hairstyle. It didn't look as if Stephen had ever responded. Still, I fought the urge to punch the computer or throw it across the room. Instead of stopping there, though, I indulged my fury and continued digging until I'd dredged up the correspondence that chronicled their yearlong relationship. Most of these e-mails ended with three words: "I love you." Stephen and I hadn't yet said that to each other. I slammed down the laptop screen, enraged, though I couldn't say exactly why. I knew he hadn't talked to her since we started dating, and he had done nothing inappropriate. But now I felt compelled to go look elsewhere for signs of betrayal.

I tiptoed over to his yellow IKEA dresser-and froze. What if he has cameras going? What if he has cameras going? Nah. Who secretly videotapes their home while they're away besides overzealous parents spying on new nannies? But the thought persisted: Nah. Who secretly videotapes their home while they're away besides overzealous parents spying on new nannies? But the thought persisted: What if he's watching me? What if this is a test? What if he's watching me? What if this is a test? Although I was frightened by this foreign paranoia, it didn't stop me from pulling open the drawers and rifling through his clothes, flinging them on the floor, until I found the jackpot: a cardboard box decorated with band stickers and filled with hundreds of letters and pictures, most of them from exes. There was one long framed photo-booth series with his most recent ex-girlfriend: they pouted, looked longingly at each other, laughed, and then kissed. I could see it happening right in front of me, unfolding like a child's flipbook: I was witnessing them falling in love. Next there was a picture of the same girl in a see-through lace bra with her hands on her bony hips. Her hair was bleached blond, but it looked attractive, not whorish. Below that were the letters, a fistful of handwritten notes that went as far back as Stephen's teens. At the top, the same girlfriend gushed about how much she missed him while she was staying in France. She misused the word Although I was frightened by this foreign paranoia, it didn't stop me from pulling open the drawers and rifling through his clothes, flinging them on the floor, until I found the jackpot: a cardboard box decorated with band stickers and filled with hundreds of letters and pictures, most of them from exes. There was one long framed photo-booth series with his most recent ex-girlfriend: they pouted, looked longingly at each other, laughed, and then kissed. I could see it happening right in front of me, unfolding like a child's flipbook: I was witnessing them falling in love. Next there was a picture of the same girl in a see-through lace bra with her hands on her bony hips. Her hair was bleached blond, but it looked attractive, not whorish. Below that were the letters, a fistful of handwritten notes that went as far back as Stephen's teens. At the top, the same girlfriend gushed about how much she missed him while she was staying in France. She misused the word their their and spelled and spelled definitely definitely as as defiantely defiantely, which thrilled me so much that I laughed out loud, a kind of cackle.

Then, as I reached for the next letter, I caught sight of myself in the mirror of the armoire, wearing only a bra and underwear, clutching Stephen's private love letters between my thighs. A stranger stared back from my reflection; my hair was wild and my face distorted and unfamiliar. I never act like this, I never act like this, I thought, disgusted. I thought, disgusted. What is wrong with me? I have never in my life snooped through a boyfriend's things. What is wrong with me? I have never in my life snooped through a boyfriend's things.

I ran to the bed and opened my cell phone: I had lost two hours. It felt like five minutes. Moments later, the migraine returned, as did the nausea. It was then that I first noticed my left hand felt funny, like an extreme case of pins and needles. I clenched and unclenched my hand, trying to stop the tingling, but it got worse. I raced to the dresser to put away his things so that he wouldn't notice my pilfering, trying to ignore the uncomfortable tingling sensation. Soon though, my left hand went completely numb.

CHAPTER 3

CAROTA

The pins and needles, which persisted unabated over many days, didn't concern me nearly as much as the guilt and bewilderment I felt over my behavior in Stephen's room that Sunday morning. At work the next day, I commissioned the help of the features editor, Mackenzie, a friend who is as prim and put together as a character out of Mad Men Mad Men.

"I did a really bad thing," I confessed to her outside the News Corp. building, huddling under an overhang in an ill-fitting winter coat. "I snooped at Stephen's house. I found all these pictures of his ex-girlfriend. I went through all of his stuff. It was like I was possessed."

She shot me a knowing half-smile, flipping her hair off her shoulders. "That's all? That's really not so bad."

"Mackenzie, it's psycho. Do you think my birth control is causing hormonal changes?" I had recently started using the patch.

"Oh, come on," she countered. "All women, especially New Yorkers, do that, Susannah. We're compet.i.tive. Seriously, don't be so hard on yourself. Just try not to do it again." Mackenzie would later admit she was concerned not by the act of snooping itself but by my overreaction to having done it.

I spotted Paul smoking nearby and posed the same question. I could depend on him to tell it to me straight. "No, you're not crazy," he a.s.sured me. "And you shouldn't be worried. Every guy keeps pictures or something from their exes. It's the spoils of war," he explained helpfully. Paul could always be counted on for a man's perspective, because he is so singularly male: eats hard (a double cheeseburger with bacon and a side of gravy), gambles hard (he once lost $12,000 on a single hand at the blackjack table at the Borgata in Atlantic City), and parties hard (Johnnie Walker Blue when he's winning, Macallan 12 when he isn't).

When I got to my desk, I noticed that the numbness in my left hand had returned-or maybe it had never left?-and had moved down the left side of my body to my toes. This was perplexing; I couldn't decide if I should be worried, so I called Stephen.

"I can't explain; it just feels numb," I said on the phone, holding my head parallel to my desk because my landline cord was so tangled.

"Is it like pins and needles?" he asked. I heard him strum a few chords on his guitar in the background.

"Maybe? I don't know. It's weird. It's like nothing I've felt before," I said.