Tuesday, January 08, 2013

Brain on Fire

After reading my signed copy of Brain on Fire (Thanks, Lexi and Adam!), what impresses me more than anything is the work of a scientist.

Dr. Souhel Najjar, a Syrian-born neurologist, is now famous for identifying the disease that plagued Susannah Cahalan, a young reporter for the New York Post.  In the late winter of 2009, Cahalan began experiencing insomnia, headaches, and the onset of psychosis.  A few weeks and seizures later, she was admitted to NYU Medical Center's Epilepsy Unit.  It is there that Cahalan experiences a "month of madness," as she calls it, and she has no distinct memories from that period.  With symptoms such as hallucinations, paranoia, and a severe decrease in basic cognitive functions, doctors -- all kinds of talented doctors -- consistently misdiagnose her.  In the beginning, they think she has Schizophrenia.  Then Schizoaffective disorder.  Then encephalitis.  And on and on.  Doctors identified her with a range of diseases, but the test results for each disease were repeatedly shown to be negative.  As her condition worsened, it seemed that she would eventually retain that ambiguous label: "psychosis not otherwise identified."

But something happened to change the young reporter's fate.  An attentive doctor noticed details that others didn't.  Dr. Najjar listened to Cahalan recount her medical history and by connecting her symptoms to those of his Alzheimer's patients, he had the idea to administer the clock test.  With this simple test, Dr. Najjar determined that Cahalan was suffering from an autoimmune disease.  Specifically, he remembered a journal article he had read months earlier about anti-NMDA-receptor encephalitis and suspected that it was the cause of Cahalan's symptoms.  It turns out that he was right.

I marvel at this doctor's ability to think better than all the other doctors put together.  But maybe it's not that he thinks better.  Maybe it's that he thinks differently.  Or maybe he listens differently.

His example has been on my mind several times this week.  I think of him and other game changers:  Louis Pasteur, et al., who supported the germ theory of disease; Aristotle and Pythagoras, who knew the world could not be flat; Marie Curie, who hypothesized that radioactivity was a property of atoms, not interacting molecules.  These people impress me not because they are iconoclasts, attacking institutions or beliefs for the sake of subversion, but because they noticed details that others didn't.  Or as in the case of Pasteur, they couldn't see something small, but had an idea that it nevertheless existed.

Why?  Were they naturally brilliant?  Supremely confident?  I think the answer to both is no.  Dr. Najjar said, "Just because it seems like schizophrenia doesn't mean that it is.  We have to keep humble and keep our eyes open" (Cahalan, 226).  Pasteur stated that hard work is somewhere in the mix, too:  "In the fields of observation chance favors only the prepared mind" (1854 lecture, http://en.wikiquote.org/wiki/Louis_Pasteur).

So perhaps there is hope for us all to change the world.  To leave it better than we found it.  I think that's part of why we exist -- to leave something beautiful or useful in our earthly wake.


(Cahalan, Susannah.  Brain on Fire: My Month of Madness.  New York: Free Press, 2012.)


Thing I'm thankful for: immediate answers to prayer

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