Brain on Fire: My Month of Madness

by Susannah Cahalan

Paperback, 2013





Simon & Schuster (2013), Edition: Reprint, 288 pages


The story of twenty-four-year-old Susannah Cahalan and the life-saving discovery of the autoimmune disorder that nearly killed her -- and that could perhaps be the root of "demonic possessions" throughout history. One day in 2009, twenty-four-old Susannah Cahalan woke up alone in a strange hospital room, strapped to her bed, under guard, and unable to move or speak. A wristband marked her as a "flight risk," and her medical records, chronicling a monthlong hospital stay of which she had no memory at all, showed hallucinations, violence, and dangerous instability. Only weeks earlier, Susannah had been on the threshold of a new, adult life, a healthy, ambitious college grad a few months into her first serious relationship and a promising career as a cub reporter at a major New York newspaper. Who was the stranger who had taken over her body? What was happening to her mind? In this narrative, Susannah tells the astonishing true story of her inexplicable descent into madness and the lifesaving diagnosis that nearly didn't happen. A team of doctors would spend a month, and more than a million dollars, trying desperately to pin down a medical explanation for what had gone wrong. Meanwhile, as the days passed and her family, boyfriend, and friends helplessly stood watch by her bed, she began to move inexorably through psychosis into catatonia and, ultimately, toward death. Yet even as this period nearly tore her family apart, it offered an extraordinary testament to their faith in Susannah and their refusal to let her go. Then, neurologist Souhel Najjar joined her team and, with he help of a lucky, ingenious test, saved her life. He recognized the symptoms of a newly discovered autoimmune disorder in which the body attacks th brain, a disease now thought to be tied to both schizophrenia and autism, and perhaps the root of "demonic possessions" throughout history. This story is the powerful account of one woman's struggle to recapture her identity and to rediscover herself among the fragments left behind. Using all her considerable journalistic skills, and building from hospital records and surveillance video, interviews with family and friends, and excerpts from the deeply moving journal her father kept during her illness, Susannah pieces together the story of her "lost month" to write an unforgettable memoir about memory and identity, faith and love.… (more)


½ (822 ratings; 4)

Media reviews

"..a fascinating and compelling story told in a smart, succinct style.."

User reviews

LibraryThing member kidzdoc
In 2009, Susannah Cahalan had a rich and rewarding life, working as a respected reporter for The New York Post, living on her own in an apartment in Manhattan, and sharing her life with her handsome musician boyfriend. She was young, beautiful, and grew up in privilege and good health. One day she
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noticed two marks which appeared to be bedbug bites on one of her arms, and shortly afterward she experienced muscle weakness and headache, which she attributed to the flu. She then developed tingling and numbness in her left arm and foot, which led her to seek medical attention from her gynecologist, who referred her to a neurologist. Laboratory and radiographic tests were all normal, and she concluded that she had a bad viral illness, which was complicated by overwork. However her symptoms progressively worsened, as she developed anxiety, dizziness, nausea and memory loss, and after she had a seizure at her boyfriend's home it was clear that something was seriously wrong with her.

The next month for Susannah was a living hell, as she became manic and paranoiac, continued to have seizures, and went into a rapid physical and mental decline. She was hospitalized and watched closely by her parents and boyfriend, but her medical team could not figure out what was wrong with her, as all of her tests came back normal. Her loved ones became frantic as she continued to worsen, as they feared that the bright and brilliant Susannah that they knew and loved would never recover. Her neurologist that they had come to trust and respect turned her care over to a respected diagnostician, after he failed to discover what was wrong with her, and dismissed her and her family abruptly and brusquely. Her life then became a race against time: would the medical team diagnose this strange illness before it was too late to help Susannah?

Brain on Fire is narrated in the first person, based on Susannah's own recollections and those which came from her family, boyfriend, medical staff and colleagues during the month in which she experienced the worst of her nightmarish symptoms. She uses her journalistic skills to create a compelling medical mystery, which I could hardly put down until the last page. In addition to a fascinating story it is also a wake up call to physicians who are quick to label or dismiss patients' symptoms that they cannot adequately explain, and a reminder that a good medical history, a perusal of the medical literature, a curious and inquisitive mind, and a willingness to seek help from colleagues for the most difficult cases will often uncover the right answer.
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LibraryThing member msf59
A young woman wakes up in a hospital, strapped to a bed. She cannot move or speak. She is wearing a wristband that says “flight risk”. She is confused and angry. How did she end up in this state?
In 2009, Susannah Cahalan was an energetic and healthy twenty-four year old. She was a cub reporter
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for the New York Post. One day, her mental health takes a scary turn and she begins to experience a meltdown, with hallucinations, psychosis and deep anxiety. She lands in the hospital a few days later, She stays here a month, while doctors scramble to figure out what is wrong with her. She nearly dies and remembers only fragments.
In a harrowing narrative style, Susannah tells the story, piecing it together from interviews with the hospital staff, family and friends, trying to reconstruct this nightmarish puzzle, of those few lost weeks. She ends up writing a very solid memoir, that will leave the reader shaken, but with a better insight into the many facets of mental health care and how the brain functions.
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LibraryThing member MsNick
At first glance, Brain on Fire by Susannah Cahalan might appear to be another (tired) psych ward stay memoir, but rest assured that it isn't. Cahalan chronicles her terrifying, mysterious life-threatening illness and her journey back to health, thanks to the brilliant doctor who was able to
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diagnose and treat her. Cahalan tells her story in an informative, matter-of-fact manner and never comes across as maudlin or cavalier. This was a very interesting read.
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LibraryThing member JaneSteen
Where I got the book: purchased on Kindle.

I devoured this one during a transatlantic flight; it's exactly the right kind of book for reading in one or two sittings. The true story of how Susannah Cahalan turned from a feisty young career journalist into a drooling madwoman with occasional lucid
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moments AND THEN BACK AGAIN. Because some very, very weird things can happen to the brain; I imagine quite a few people spent their lives in asylums when they could have been medicated back to normality if they'd had sufficiently persistent families, brilliant enough doctors and/or better health insurance.

I think the life lessons I drew from this memoir were: Keep Your Apartment Clean and Don't Believe Doctors When They Tell You You're Just Plain Nuts. An excellent read for those of us who are curious about weird mental illnesses, attracted to other people's suffering (oh come on, don't tell me otherwise) or just generally ghoulish. Lots of medical info for those who like that sort of thing or think they may have a similar condition.
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LibraryThing member thewanderingjew
Wow, once I started, I could not put it down. This book is excellent. I experienced Susannah’s confusion, fear, and incident by incident descent into the hell that followed the onset of her strange illness. A perfectly normal young woman, she is suddenly exhibiting some not so perfect behavior.
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The idea that medicine is in its infancy, and that we are sometimes at the mercy of its incompetence, hits home. Susannah’s odd assortment of symptoms eluded all of the professionals she visited. They could not offer an accurate diagnosis. Doctors, family and friends were at a loss to explain the changes in her physical and emotional health, in her work habits and in her behavior, yet she needed their support. Luckily, she is here to tell the tale.
This book will surely raise many questions about the state of our health care system.
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LibraryThing member LynnB
Wow! This memoir reads like a real-life episode of House. At 24, reporter Susannah Cahalan suffered a number of neurological and physical symptoms that teams of doctors were unable to diagnose. It seemed she would be destined to spend her life in a psychiatric facility, if she even survived. This
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is the story of her illness. It is told with honesty...and it's a scary story. One that makes me appreciate how much those who are ill need people to champion them and believe in them. Such a good story, told so well.
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LibraryThing member JLDobias
Brain on Fire:My Month of Madness by Susannah Cahalan

This book scared the daylights out of me.

There are so many parts of the breakdown here that read like regular parts of life.

I quickly come to a realization that this is the reason to surround ourselves with friends who know us(well). People who
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can constantly act as that check in life that asks "Are you okay?"

Sure we can ask ourselves that question as much as we want but it really helps to have someone around who can tell us that we are alright. Even so, it takes a true friend to not try to sugar coat things thinking that we might be having a bad day or over dramatic meltdown as opposed to an entire breakdown.

How and when do we define the line that has to be crossed before we realize that something proactive has to be done to get to the bottom of the overwhelming feeling of hopeless helplessness that's gripped us from out of nowhere?

In reading this I suddenly wondered how anyone can abuse drugs to an extent that they might experience something similar to what happened here. Yet it's so obvious that some people actually do just that, when one of the doctors makes that assumption right from the start.

This book has altered the way I look at some things. I've never really had much recollection of my life before the age of five. The few memories I have had, which or only two that I recall, are now very suspect when coming to a more full understanding of how the memory works. Not to mention the rest of the parts that I do remember and that my siblings like to suggest I've remembered incorrectly.

I look at how fragile the mind is in respect to Susannah's experience and it makes me want to wear a crash helmet everywhere I go. That won't help much though when dealing with what happened here.

Reading this has been a true eye opener.

And just for the record Susannah:
You may have changed from this experience, but what you wrote here and how it touched me says that when you wrote this you were operating at 100 percent.

Mind boggling scary with some light at the end of the tunnel. Everyone needs to read this.

J.L. Dobias
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LibraryThing member Sean191
I heard an interview with Cahalan on NPR a couple of years back. The story sounded terrifying and fascinating, but it took me a while to pick up the book. Overall, I regret it. Somehow, the story didn't end up that interesting after all. The bigger problem was just the self-centered way the story
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was told. Obviously it was about an illness that she experienced directly, but the way she said things rang with such a sense of entitlement that it was incredibly off putting. She also didn't seem to worry too much about who she was writing about or who she hurt.

But then, she did and does write for the New York I should have took that as an early warning.
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LibraryThing member clamato
Excellent read! Just brutal what Susannah went through and so incredibly remarkable that she recovered and resumed her life. Her parents were her rocks and without them and her amazing boyfriend, I don't know if the outcome would have been the same. She's a very lucky girl. The book is well
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written, touching, alarming, and engrossing. All her research into what happened to her and to so many others was enlightening and educating. A very interesting book and I highly recommend it! Bravo to Susannah for sharing her difficult journey.
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LibraryThing member Carolee888
Brain on Fire by Susannah Cahalan is a true story of a horrifying descent into illness. Working as a journalist at the New York Post, she honed her investigative skills that are easily evident in this book. She has only bits and pieces of memory from her illness. She had to reconstruct what
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happened by interviewing doctors, family, friend and her supportive boyfriend.

One morning before going to work, she noticed two bite marks on her arm. She immediately thought bedbugs and was embarrassed about the possibility. She went to work and started to feel like she was coming down with something like the flu. That was the first time that she knew something was wrong.

Her parents stood by her and demanded to know what she had. She did too until the worst of the disease. She experienced seizures, strange sensory perceptions that lead to not eating, paranoia, schizophrenic like behavior and even catatonia. She forgot things, people, and seemed to be in a different world. She had the tests, blood tests, MRIs, you name it.

Why was she sick? Would she ever come back to being able to relate to people? What did she have? Was it an infection, a mental illness, epilepsy or an auto-immune disease? She was seen by many neurologists and other specialist. Finally a test that didn't cost a single cent was given to her by Dr. Souhel Najjir. He had listened to her carefully and noticed something that others had ignored. That made him want try this test. The results brought an important discovery and then more and more information about what she had or more correctly has. People do have relapses!

Susannah in the throes of this terrifying disease was not herself anymore, this disease made her lose weight, become weak, and have behavior that easily land her to be permanently locked up in a mental ward until she died from this disease. How many others with this disease have been locked away or had their family use an exorcist?

I cannot recommend this book high enough, it is amazing! It is a story of perseverance and not giving up hope. I hope that everyone with a disease that has still not been diagnosed or diagnosed incorrectly reads this book.
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LibraryThing member graffitimom
The surprising thing about this book is that it details a terrifying experience that can happen to anyone. Miss Cahalan's mind was trapped inside a brain gone haywire. The assumptions seemed to be alcohol abuse or a severe mental illness. What had actually happened was that her brain was inflamed
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and fighting for survival. As Miss Cahalan pointed out towards the end of the book, there could be many others who have been misdiagnosed, who actually have this newly discovered condition, but who are untreated because their doctors have not kept up to pace with developments in medical science. The author writes simply and tries to explain her experience and the disease. This was an interesting book to read and I wish Miss Cahalan all the best.
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LibraryThing member JerryColonna
Fascinating if at times inconsistent and somewhat choppy. At times poignant. A personal reminder of the tight relationship between biology and mind and the thin line between unhealthy brain functions and madness. In an age when it's easy to see all psychological manifestations only in terms of
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psychological character structure, an important reminder that we are, after all, a meat bag, made up of flesh and neurons and synaptic pulses.
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LibraryThing member charleneparsons
This book was amazing! There is a lot of technical terms used in this book in relation to what she had encountered. Overall it was interesting.
LibraryThing member TheLoopyLibrarian
“Sometimes, just when we need them, life wraps metaphors up in little bows for us. When you think all is lost, the things you need the most return unexpectedly (p. 206).”

Imagine being a normal, healthy young adult with a promising journalism career until your body attacks your brain and you go
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mad. And, as your condition continues to deteriorate, no one can figure out why…not even the best doctors in the country. Brain on Fire tells the nightmarish experience of Susannah Cahalan as she struggled with just such a medical mystery and a frightening, nearly fatal experience.

Brain on Fire is based on Susannah’s award winning article, “My Mysterious Lost Month of Madness.” It is at once a fascinating and disturbing look at an experience that could happen to anyone. Right from the preface, Susannah draws the reader into her mysterious nightmare and her confusion. Because much of that month of illness is lost to her, she drew on her skills as a writer and journalist to piece together her experience. Not only is light shined on a relatively rare, but very disturbing medical condition, the story is a personal one. The entire family drops everything to save Susannah. In the end, no one is ever quite the same.

The devotion of Susannah’s family and friends, her honest and unflinching look at this devastating experience, her triumphs and her fears, and the brilliance and compassion of Dr. Souhel Najjar whose refusal to give up saved her life, all make for one of the most amazing stories I have ever read. Not only do I admire Susannah for looking her nightmare in the face and sharing it with the world, I see Brain on Fire as a work that will continue to have a profound effect on neurology and the study of the brain.

On a personal level, I was left with the feeling that I will never again take my brain for granted. The simplest tasks require complex actions from our brain. And damage, infection, or this newly discovered autoimmune disorder can take all of that away. As a person who has lived with bipolar disorder all of my adult life, I was particularly fascinated by Susannah’s story and her research. It hit very close to home. I’m so glad she was brave enough to write it, and I applaud all of the people that refused to give up on her. Because of her experience, many others have already been helped. Brain on Fire is more than a memoir of a hellish experience; it is a groundbreaking book in the field of medicine.

I highly recommend it. It will touch your heart; it will fascinate you, and it will forever change the way you look at mental illness.
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LibraryThing member dickmanikowski
Memoir of a young woman's battle with a seemingly inexplicable descent into madness. Through the patient persistence of her medical team at NYU Hospital, her condition was eventually diagnosed as an extremely rare autoimmune condition in which her body's self-defense mechanism was attacking her
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brain. Once the diagnosis had been made, medical treatments were provided which gradually permitted her to return to a condition closely approximating her old self
This well-written book also dips into the question of how many psychiatric patients may be suffering from undiagnosed organic diseases.
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LibraryThing member msbaba
The best thing about Brain on Fire, by Susannah Calalan, is that it puts you right in the mind and body of a bright young journalist succumbing to, and ultimately surviving, a horrifying neurological disorder. You get to feel—minute by minute, almost—what it is like to become a victim of a
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terrifying disease that in many ways mimicked demonic possession. This is not a clinical overview. The author doesn’t explain anything medically upfront. The reader is taken down all the same diagnostic blind alleys that Calalan and her parents experienced as they struggled to find an explanation for what was happening. Reading it is like being there. This is an ace first person journalistic description of the whole experience, from beginning to end…and it’s nearly impossible to put down.

Susannah Calalan’s body was attacking her brain and slowly, everything that she was as a person was disappearing. How frightening can that be? In its place were sudden burst of violence, hallucinations, seizures, extreme memory loss, schizophrenia-like symptoms, and ultimately catatonia.

The disorder is called anti-NMDA-receptor autoimmune encephalitis. And although the disease deprived the author of a great deal of memory about the events, she was able to reconstruct them and write about them by applying her journalist skills. She interviewed everyone who came into contact with her, studied all her medical reports in detail, and analyzed any videos that existed from her hospital stay.

Brain on Fire is a brilliant and eye-opening piece of first-person journalism. I recommend it highly…and I enjoyed it immensely.
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LibraryThing member TiffanyHickox
A young woman winds herself suddenly plagues by bizarre and uncontrollable behavior, and soon suffers from fullblown psychosis. What begins as a diseas diagnosed as a mental illness, she soon becomes catatonic. Her family never gives up hope and pushes for answers, resulting in a new diagnosis: her
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immune system is attacking her brain.

Great for those interested in medical and psychological memoirs.
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LibraryThing member brianinbuffalo
Cahalan's account of her harrowing medical odyssey reinforced two things in my mind. The book verifies an observation from an expert who is quoted as saying that the human brain is a "beautiful mess." On a personal level, this book was further evidence that I would have never made it through med
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school. While the author's account of efforts to pinpoint her mysterious illness is filled with many insightful and touching moments, the book is crammed with a lot tedious technical jargon that becomes a bit much for folks who are not into the medical scene. At one point, this journalist notes that a newspaper editor encouraged her to write an article about her ordeal. In all candor, I think a long-form article would be a more suitable venue for this interesting case study. Having said that, the most riveting section of the book comes near the end where Cahalan cites cases involving exorcisms and other likely botched diagnoses of this baffling medical condition. The author must also be given credit for creating a tome that is a blend of memoir and reportage. Given the fact that she couldn't remember large chunks of her terrifying ordeal, she skillfully used a variety of sources that ranged from her father's diary to her medical records.
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LibraryThing member JLsBibliomania
Both utterly compelling, and lacking at the same time. I couldn't put down Susannah Cahalan's look into her own illness and finished it in an afternoon, but at the same time, I found myself skimming a lot.

With PANDAS causing OCD through autoimmune response to infection and Susannah's story of
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mental illness from autoimmune overreaction, it makes me hope that scientists and doctors take a good serious look into the currently unfounded theories that link the rise in allergies and other autoimmune disorders with the increase in Autism. Even if autoimmune illness only plays a factor in a percentage of the cases, it's worth the time to investigate.
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LibraryThing member Anna_Erishkigal
I got sucked into this story as though it was a crime thriller. Towards the middle of the book, I found myself referring to the authors picture on the back cover just to remind myself she SURVIVED this harrowing tale of a mystery illness that defied diagnosis. This book felt more like watching an
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episode of House, with a bit of Fringe thrown in (all in a good way) than a biographical about dealing with mental illness.

I enjoyed this book immensely.
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LibraryThing member MyChristineHobbs
Fantastic Book. If you are one of the many people that have ever wondered if you were losing your mind, then here is a book for you. This is the story of a young reporter who is slowing losing her mind. None of the doctors can deterimne what is wrong with her. It is not only a look into how the
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mind works but also in how the medical system treats those with illnesses that they cannot explain.
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LibraryThing member abbylibrarian
This book starts with a bang and had me tearing through the first 2/3 as Susannah Cahalan pieces together her month of madness - documenting her psychosis and catatonia as she was treated for an unknown illness in a New York hospital. The last third of the book slows down a little as Susannah
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gradually recovers and discusses doctors' quest to identify this disease and improve diagnostics to help more people. The fast pace and short chapters had me turning the pages. It's all the more terrifying knowing that this disease attacked Susannah out of the blue... could it happen to me, too?

Recommended for fans of medical memoirs and medical thrillers.
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LibraryThing member c.archer
What a fascinating book! I really enjoyed reading about Susannah and her experience with this particular encephalitis. I found both her story and the story of her diagnosis and treatment to be well written and very interesting. It certainly does appear that she was quite lucky to be alive and to
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have recovered as significantly as she did. I very much admired the part her family and Stephen played in pursuing someone who could diagnose her as well as providing the care and patience to see her through her long recovery. It is interesting to note how many more cases of this disorder have been diagnosed since hers. I expect that her story has and will continue to bring a spotlight on this very scary disease but at the same time provide answers and insight to others who might be suffering from it as well.
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LibraryThing member gkonopas
Fascinating account from the inside on what it's like to be manic, depressed, and psychotic. I found it especially interesting on how Ms. Cahalan's family initially responded to the obvious and rapid disintegration of her mind. It also raises the chilling issue of how many persons with chronic
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schizophrenia really have an undiagnosed auto-immune disorder.
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LibraryThing member mahallett
great,scary story. i wonder how many people are suffering from this. she's so lucky to have been diagnosed and cured. great reader.


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288 p.; 5.5 inches


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