Brain on Fire: My Month of Madness

that eight-floor trip.

Finally we reached the bar floor. The rugs, which looked as if they belonged in an avant-garde production of Lawrence of Arabia, swirled before me. The harder I stared, the more the abstract patterns merged. I tried to ignore it. The hundred-plus-seat bar, which looked down over Times Square, was almost completely empty, with only a few groups of businessmen dotting the chairs around the entranceway. When we walked in, I was still bawling, and one group looked up from their cocktails and gawked at me, which made me feel worse and more pathetic. The tears kept coming, though I had no clue why. We positioned ourselves in the center of the room at seats with high chairs, far away from the other patrons. I didn’t know what I wanted, so Angela ordered a sauvignon blanc for me and an Anchor Steam for herself.

“So what’s really going on?” she asked, taking a small sip of her amber-colored beer.

“So many things. The job. I’m terrible at it. Stephen, he doesn’t love me. Everything is falling apart. Nothing makes sense,” I said, holding the wineglass like a comforting habit but not drinking.

“I understand. You’re young. You have this stressful job and a new boyfriend. It’s all up in the air. That’s scary. But is it really enough to make you feel this upset?”

She was right. I had been thinking about all of that, but it was a struggle to make one detail fit well enough to solve the entire problem, like jamming together pieces from incongruent sets of puzzles. “There’s something else,” I agreed. “But I don’t know what it is.”

When I got home at seven that night, Stephen was already waiting for me. Instead of telling him I’d been out with Angela, I lied and told him I had been at work, convinced that I needed to hide my perplexing behavior from him, even though Angela had urged me to just tell him the truth. But I did warn him that I wasn’t acting like myself and hadn’t been sleeping well.

“Don’t worry,” he responded. “I’ll open a bottle of wine. That will put you to sleep.”

I felt guilty as I watched Stephen methodically stir the sauce for shrimp fra diavolo with a kitchen towel tucked in his pant loops. Stephen was a naturally skilled and inventive cook, but I couldn’t enjoy the pampering tonight; instead, I stood up and paced. My thoughts were running wild from guilt to love to repulsion and then back again. I couldn’t keep them straight, so I moved my body to quiet my mind. Most of all, I didn’t want him to see me in this state.

“You know, I haven’t really slept in a while,” I announced. In fact, I couldn’t remember the last time I had slept. I had gone without real sleep for at least three days, and the insomnia had been plaguing me for weeks, on and off. “I might make it hard for you to sleep.”

He looked up from the pasta and smiled. “Don’t worry. You’ll sleep better with me around.”

He handed me a plate with pasta and a healthy helping of parmesan. My stomach turned at the sight, and when I tasted the shrimp, I almost gagged. I pushed the pasta around on my plate as he devoured his. I watched him, trying to hide my disgust.

“What? You don’t like it?” he asked, hurt.

“No, it’s not that. I’m just not hungry. Great leftovers,” I said cheerfully, while having to physically restrain myself from pacing around the apartment. I couldn’t stay with one thought; my mind was flooded with different desires, but especially the urge to escape. Eventually I relaxed enough to lie down on my couch bed with Stephen. He poured me a glass of wine, but I left it on the windowsill. Maybe I knew on some primal level that it would have been bad for my state of mind. Instead, I chain-smoked cigarettes, one after another, down to their nubs.

“You’re a smoking fiend tonight,” he said, putting his own cigarette out. “Maybe that’s why you’re not hungry.”

“Yeah, I should stop,” I said. “I feel like my heart is beating out of my chest.”

I handed Stephen the remote, and he flipped the channel to PBS. As his heavy breathing turned into all-out snores, Spain… on the Road Again came on, the reality show that followed actress Gwyneth Paltrow, chef Mario Batali, and New York Times food critic Mark Bittman through Spain. God, not Gwyneth Paltrow, I thought, but was too lazy to change the channel. As Batali ate luscious eggs and meat, she toyed with a thin goat’s-milk yogurt, and when he offered her a bite of his dish, she demurred.

“That’s nice to have at seven in the morning,” she said sarcastically.⁴ You could just tell how disgusted she was by his belly.

As I watched her nibble on her yogurt, my stomach turned. I thought about how little I had eaten in the past week.

“Hold on,” he retorted. “I can’t see you on that high horse of yours.”

I laughed right before everything went hazy.

Gwyneth Paltrow.

Eggs and meat.

Darkness.

CHAPTER 8 OUT-OF-BODY EXPERIENCE

As Stephen later described that nightmarish scene, I had woken him up with a strange series of low moans, resonating among the sounds from the TV. At first he thought I was grinding my teeth, but when the grinding noises became a high-pitched squeak, like sandpaper rubbed against metal, and then turned into deep, Sling Blade–like grunts, he knew something was wrong. He thought maybe I was having trouble sleeping, but when he turned over to face me, I was sitting upright, my eyes wide open, dilated but unseeing.

“Hey, what’s wrong?”

No response.

When he suggested I try to relax, I turned to face him, staring past him like I was possessed. My arms suddenly whipped straight out in front of me, like a mummy, as my eyes rolled back and my body stiffened. I was gasping for air. My body continued to stiffen as I inhaled repeatedly, with no exhale. Blood and foam began to spurt out of my mouth through clenched teeth. Terrified, Stephen stifled a panicked cry and for a second he stared, frozen, at my shaking body.

Finally, he jumped into action—though he’d never seen a seizure before, he knew what to do. He laid me down, moving my head to the side so that I wouldn’t choke, and raced for his phone to dial 911.

I would never regain any memories of this seizure, or the ones to come. This moment, my first serious blackout, marked the line between sanity and insanity. Though I would have moments of lucidity over the coming weeks, I would never again be the same person. This was the start of the dark period of my illness, as I began an existence in purgatory between the real world and a cloudy, fictitious realm made up of hallucinations and paranoia. From this point on, I would increasingly be forced to rely on outside sources to piece together this “lost time.”

As I later learned, this seizure was merely the most dramatic and recognizable of a series of seizures I’d been experiencing for days already. Everything that had been happening to me in recent weeks was part of a larger, fiercer battle taking place at the most basic level inside my brain.

The healthy brain is a symphony of 100 billion neurons, the actions of each individual brain cell harmonizing into a whole that enables thoughts, movements, memories, or even just a sneeze. But it takes only one dissonant instrument to mar the cohesion of a symphony. When neurons begin to play nonstop, out of tune, and all at once because of disease, trauma, tumor, lack of sleep, or even alcohol withdrawal, the cacophonous result can be a seizure.

For some people, the result is a “tonic-clonic” seizure like the one Stephen witnessed, characterized by loss of consciousness or muscle rigidity and a strange, often synchronized dance of involuntary movements—my terrifying zombie moves. Others may have more subtle seizures, which are characterized by staring episodes, foggy consciousness, and repetitive mouth or body movements. The long-term ramifications of untreated seizures can include cognitive defects and even death.