Brain on Fire: My Month of Madness

Brain on Fire I just finished reading Brain on Fire: My Month of Madness which is a first-hand account of a young woman’s terrifying experience of an autoimmune disorder that attacks her brain. She is overtaken by seizures, hallucination, paranoia, and the realization that she is going mad.

Susannah Cahalan’s memoir raises issues around misdiagnosed illnesses, the importance of personal advocacy and the need for a second opinion. She shows us the unconditional love of a supportive network of family and friends, gratitude for medical advances and the sobering reality that there is still so much we don’t know about why and how our bodies fail us. Callahan says:

[My illness] is a good reminder about how fragile our hold on sanity and health is and how much we are at the utter whim of our Brutus bodies, which will inevitably, one day, turn on us for good. I am a prisoner, as we all are. And with that realization comes an aching sense of vulnerability.

This is a quick read that invites us to be sympathetic to all who struggle to find diagnoses for their mental and/or physical suffering. Every member of my book club, myself included, agreed that this is a book worth recommending to others.

Has anyone else read this? What did you think?

That Should Be An International Scandal

Today marks an important moment in history - the President of the United States publicly responded to the more than 73,000 of us who asked the White House to take a stand against modern-day slavery. (Huge thanks to IJM for taking the lead!)

Sheryl WuDunn, co-author of Half the Sky, spoke in Nashville last night. It's an important book and is deeply personal to me as it brings to light the horrific injustices that James and I see on a regular basis in our work in Africa. It's why we pour our work into educating girls, freeing girls from oppression and protecting them from HIV/AIDS. Here are direct highlights from Half the Sky.

21st Century Slavery

Far more women and girls are shipped into brothels each year in the early twenty-first century than African slaves were shipped into slave plantations each year in the eighteenth or nineteenth centuries—although the overall population was of course far smaller then.

Our own estimate is that there are 3 million women and girls (and a very small number of boys) worldwide who can be fairly termed enslaved in the sex trade.

Maternal Deaths

More women die in childbirth in a few days than terrorism kills people in a year.

In the United States, the lifetime risk of dying in childbirth is 1 in 4,800; in Italy, it’s 1 in 26,600; and in Ireland a woman has only 1 chance in 47,600 of dying in childbirth. Overall in sub-Saharan Africa, the lifetime risk of dying in childbirth is 1 in 22.

So lifetime risk of maternal death is one thousand times higher in a poor country than in the West. That should be an international scandal.


Being sold to a brothel was always a hideous fate, but not usually a death sentence. Now it often is. And because of the fear of AIDS, customers prefer younger girls whom they believe are less likely to be infected.

Women are about twice as likely to be infected during heterosexual sex with an HIV-positive partner as men are.

For women the lethal risk factor is often not promiscuity but marriage. Routinely in Africa and Asia, women stay safe until they marry, and then they contract AIDS from their husbands.

Female Genital Mutilation (FGM)

Worldwide, some 130 million women have been cut, and after new research, the UN now estimates that 3 million girls are cut annually in Africa alone (the previous estimate had been 2 million globally).

Domestic Violence

Surveys suggest that about one third of all women worldwide face beatings in the home. Women aged fifteen through forty-four are more likely to be maimed or die from male violence than from cancer, malaria, traffic accidents, and war combined.

Moving Forward

“Empowerment” is a cliché in the aid community, but it is truly what is needed. The first step toward greater justice is to transform that culture of female docility and subservience, so that women themselves become more assertive and demanding. As we said earlier, that is, of course, easy for outsiders like us to say: We’re not the ones who run horrible risks for speaking up. But when a woman does stand up, it’s imperative that outsiders champion her; we also must nurture institutions to protect such people.

In developing countries, tormenting the illiterate is usually risk-free; preying on the educated is more perilous.

The single most important way to encourage women and girls to stand up for their rights is education, and we can do far more to promote universal education in poor countries.

If there is to be a successful movement on behalf of women in poor countries, it will have to bridge the God Gulf. Secular bleeding hearts and religious bleeding hearts will have to forge a common cause. That’s what happened two centuries ago in the abolitionist movement, when liberal deists and conservative evangelicals joined forces to overthrow slavery. And it’s the only way to muster the political will to get now-invisible women onto the international agenda.

I want to be a part of this movement, don't you?


Contrary to more ambiguous titles in the book world, this one tells you exactly what you will read about.

This story immediately throws you into a scenario of a devastating predicament for a young soldier, Louis Zamperini. Stranded for weeks in the middle of the ocean on a failing raft, enemy fire from above and sharks looming below. The author then leaves you hanging there in the uncertainty of survival and takes you to Zamperini's early years - all the while knowing that somehow he will end up in this unfortunate introductory scene.

And there was more to come. Violence, isolation, starvation and disease.  It is a true story through and through, and all I could think was, unbelievable. As in, how could one man have endured such atrocity? And, are humans really capable of this kind of brutality toward one another? This is a captivating story, a page-turner that forces you to refer back to the front cover multiple times, simply as a reminder that, as suggested by the title, this man indeed survives.

Here a few take-aways for me in the story:

1. War

It's horrible. It's outrageous. This World War II account takes you into the underbelly of human beings at their worst. I wish it were a thing of the past, but it is not. It is an ever-present reality for our world today, and I fear, for as long as people inhabit this earth. There's an observation in the book about the cost of human dignity. We ought never to forget what war costs, for all of us, everywhere.

2. Resilience

The recent Olympics reminded me of the kind of physical, emotional, and psychological strength that some people are capable of drawing out of themselves. But what if it isn't voluntary or for sport? What if it is a matter of life and death, a test of survival? To be living off a few grains of rice, to be beaten to a pulp, to be force-fed a whopping dose of terror, to be ripped violently of human dignity - and to keep going? Un-freaking-believable. That is resilience.

3. Redemption

We are never too far gone for redemption. And we ought to remember what kind of influence we can have on others in extending grace, love and an opportunity for healing. This part of the story was a surprise for me. We simply wanted our protagonist to survive, and he did. But thrive? Again, unbelievable.

Thank you, Laura Hillenbrand, for working so diligently and writing so beautifully to accurately share this one man's story.

Who else has read this book? What were your impressions?

Why Dignity Matters

But on Kwajalein, the guards sought to deprive them of something that had sustained them even as all else had been lost: dignity. This self-respect and sense of self-worth, the innermost armament of the soul, lies at the heart of humanness; to be deprived of it is to be dehumanized, to be cleaved from, and cast below, mankind. Men subjected to dehumanizing treatment experience profound wretchedness and loneliness and find that hope is almost impossible to retain. Without dignity, identity is erased.

Laura Hillenbrand, Unbroken: A World War II Story of Survival, Resilience, and Redemption

When Atlas Shrugged, Compassion Crumbled

"I swear by my life and my love of it that I will never live for the sake of another man, nor ask another man to live for mine." This is the creed of Ayn Rand’s 1000+ page novel, Atlas Shrugged. It was written in the 1950’s from a woman who had grown up in communist Russia, and the story focuses on the negative consequences of regulating capitalism and individualism.

The book was a page-turner – at times because I was captivated by the mystery of the story and fascinated by Rand’s ability to take me into a world where I rooted for the characters that I would hesitate to endorse in my real life. The other way it became a page-turner was that I ended up skimming past several 30-page monologues (or rants) that were redundant and, quite frankly, self-indulgent. Rand’s arguments are compelling and worthy of consideration, but they were also disturbing – particularly reflecting a worldview that promotes selfish ambition for the sake of happiness and denies the responsibility that we have to one another.

Rand’s words state:

My philosophy, in essence, is the concept of man as a heroic being, with his own happiness as the moral purpose of his life, with productive achievement as his noblest activity, and reason as his only absolute.

Atlas Shrugged is an upside-down world where acts of mercy and compassion are deemed sinful, and where selfishness and self-promotion are virtues.

I read this book through the dirt roads of Africa where the desert people of Marsabit are at the mercy of strangers to partner with them in the provision of water. I read this book in western Kenya where a thousand HIV-positive mothers, fathers and children are alive because of the life-saving drugs provided by PEPFAR (The President’s Emergency Plan for AIDS Relief). I read this book in our nation’s capital as global forces gathered for the International AIDS Conference to protect those who dearly need it. And I read this book back in my inner-city neighborhood that is struggling through the implications of gentrification by the rich in the neighborhood of the poor.

I appreciate the novel’s warning against the destruction of society through communism. Yet, ultimately Ayn Rand’s story mocks the life I am committed to. She simplifies the world’s problems by suggesting that those who matter in the world are the ones who are the most intelligent, reasonable and powerful for their own sake. It is a “God helps those who help themselves” kind of worldview. I do believe in free markets and the rights of individuals. And I do not believe in handouts, and choose to model our work in Africa differently than traditional charity. But I do believe in the story of the Good Samaritan, and in the power of sacrificial love. Therefore, when Atlas shrugged, compassion crumbled.

The Friday Five

Here are my most recent reads of non-fiction books that read like fiction:

1. The Immortal Life of Henrietta Lacks by Rebecca Skloot

A poor black woman named Henrietta Lacks gets a terrible case of cervical cancer and is treated at Johns Hopkins. Her cells uncharacteristically multiply, and end up serving as the source of some of the most significant medical advances in the last sixty years. The cells were taken without her knowledge or consent, and the story follows the author's research of the impact of the HeLa cells as well the woman behind them.

2. Nothing to Envy by Barbara Demick

It is nearly impossible to have access to the stories of those who live in North Korea. But those who have escaped have unbelievable stories to tell -- stories of fear, hunger, brainwashing and obedience. It is terrifying to realize that there is a place such as North Korea in the world today. It opened my eyes to an entire world unto itself. Truly riveting.

3. Devil in the White City by Erik Larson

The White City is Chicago. The Devil is a mass murderer. Dreamers and architects spend years planning and building the World's Fair at the turn of the century. Meanwhile a man utilizes the site of the World's Fair as a place to lure women and eventually murder them. One story shows man's desire to build; the other, a desire to destroy.

4. The Zookeeper's Wife by Diane Ackerman

A zoo in Warsaw becomes a place for refuge and hiding from the Nazis. People and animals share the spaces together, and the author explores the nature of both animals and humanity in the midst of inhumanity. Delightful coverage of a family's love of animals blended with their courage to house and care for as many people as possible. Fascinating to read about a zoo as a center for Polish resistance.

5. Bossypants by Tina Fey

An episodic autobiography of Tina Fey's awkward and hilarious "coming of age" and working on SNL. An honest female voice that says things about the world, especially as a career woman, that you wish you were brave enough to admit yourself. I bought this book on a whim at an airport on the west coast and caught myself laughing out loud by myself on the plane. Oh, and this is definitely at least a PG-13.

What are your favorite "non-fiction read like fiction" books?

On Why Women Still Can't Have it All

The Atlantic published an article last week titled "Why Women Still Can't Have it All." It has become a raving topic of conversations among many of my friends, both male and female. The article is written Anne-Marie Slaughter, a remarkable woman who has spent her life working in highly demanding leadership careers (as Dean of the Woodrow Wilson School and Director of Policy Planning for the US State Department) while raising two boys and maintaining a marriage. She speaks candidly about the real challenges for women who want to be successful both at home and at work. I really encourage you to read the article. It is a long read, but it is packed with relevant issues that we would all be better by engaging in and discussing.

Here are a few take-aways for me from the article:

Having it all, in general, is a first-world ambition.

There are women on my street here in East Nashville who are simply trying to make it to the next paycheck or trying to avoid being beaten by the men in their lives. Most of my female African friends are primarily concerned about survival - of their bodies, babies, and livelihood.  As a woman in today's world, it is a rare opportunity to have the freedom to make choices about work, life and self-actualization. It is specific to an elite population of privileged women, myself included. Before we go any further, I just want to acknowledge that asking the question of having it all is, in itself, a privilege.

We must be realistic about limitation.

While there are enormous societal challenges that make it very difficult for a woman to successfully serve in work and life (for instance, school schedules do not align with typical work schedules), there are also unrealistic expectations about what women (and men) are capable of managing. My priest, Becca Stevens, told me that life is a box, and in that box are various balloons representing the commitments of our life. If we want to fit more in the box, we may have to deflate some of the larger balloons to make room for the other ones. Or we may have to only have two really big balloons or a lot of really small balloons. The point is, pay attention to the balloons because the box isn't going to get bigger.  And we live in a culture of broken boxes and popped balloons.

We need a new paradigm shift. 

James and I are replacing work/life balance for something we are calling vocational rhythm. We mean vocation quite literally as “calling”, which includes work and life, business hours, vacation hours, children, family, friends, and job as pieces of an integrated pie, not diametrically opposing forces. In the vocational rhythm paradigm, all parts of our lives are working toward one mission, telling one story. I am interested in what it looks like to integrate the whole self into a vocational rhythm. I am curious if there will be a cultural shift to continue to encourage that for everyone.

What do you think? Can women have it all?