At the beginning of her book, Susannah Cahalan is a young and thriving journalist who works for the New York Post. The day of her bedbug scare, she finds herself in her routine Tuesday meeting with her boss and editor, Steve, without any new pitches for an upcoming news story. This incident somewhat sets Cahalan off, and she returns home that day to trash all of her beloved article clippings that she had saved. She recounts that "Though it felt necessary at the moment, this callous throwing away of years' worth of work was completely out of character for [her]" (Cahalan 8). At the time, what she didn't know was that bedbug scares can often be a sign of psychosis.
A few days later, while at her boyfriend Stephen's apartment, Cahalan experiences an overwhelming urge to read Stephen's emails and go through all of his belongings in order to find some sort of evidence that he is cheating on her. After this incidence, which she describes to be "wholly unlike [her]," she begins to feel what felt like pins and needles in her left hand and decides to visit a neurologist (11). Cahalan's exam and MRI results come back normal, but her doctor explains that she has an small amount of enlarged lymph nodes in her, which could possibly indicate mononucleosis.
Within the next few days, Cahalan receives word from her doctor that her blood results tested negative for mono, but she continues to experience mental highs and lows of extreme happiness and depression until she finally has what her coworkers believe to be a nervous breakdown. Her behavior becomes more erratic until one night, while with watching TV with Stephen, everything goes hazy.
"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 trough 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 call 911" (40).
(Cahalan's seizure was what is known as a "tonic-clonic seizure. This is characterized by loss of consciousness or muscle rigidity and strange, involuntary dance-like movements. This seizure was merely the largest and most dramatic of a series of seizures she had been experiencing for a while before this incident occurred. She had also been experiencing what are known as "complex partial seizure" that occur as a result of overstimulation of the temporal lobes and include side effects that range from a "'Christmas morning" feeling of euphoria to sexual arousal to religious experiences" (42).)
Cahalan explains that this blackout "marked the line between sanity and insanity," and that it was "the start of the dark period of [her] illness" (41).
