Brain on Fire (2016)
10/10
From a Doctor who focuses on a related condition
24 June 2018
Warning: Spoilers
Let me preface by stating I am a doctor who has devoted the last 10 years of my career to a closely related condition called PANDAS/PANS, which produces symptoms like Susannah's but in school-aged children. I know the real Dr. Najjar well and we refer patients to one another.

I think the movie must be judged on the public service it provides as much as a work of cinematic art.

I think the movie does a good job trying to depict what is happening in the head of Susanna as the disease takes hold. It tries to depict auditory hallucinations and epileptic phenomena, which only a small percentage of viewers have experience with. Just imagine the terror a person walking the busy, noisy streets of Manhattan must experience while experiencing intense auditory and visual hallucinations. The sad truth is, there are many many homeless people in big cities who are experiencing this every day.

The particular condition Susannah has is "rare", but there are thousands of people with the category of disease to which it belongs - so called "autoimmune encephalopathy" (AE). I think the movie shows a sharp contrast between 20th century psychiatry (psychoanalysis, drugs) and 21st century psychiatry, where a few pioneers like Najaar are actually looking for root causes.

Just to give you an idea of the importance of this condition, Columbia University Vagelos School of Medicine held a two day conference this past March on AE and PANDAS/PANS. I can tell you that EVERY person with a sudden change in mental status, with no prior history of the same, and no simpler explanation MUST be evaluated for AE and, in children, for PANDAS/PANS.

It just might save them for a needless lifetime of visits to the Cuckoo's Nest.
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