Dr. Saul Bailey

Quick Facts

• Role: First neurologist consulted by Susannah Cahalan; an early, obstructive force in her diagnostic journey
• Occupation: Neurologist
• First appearance: Chapter 3
• Key relationships: Susannah; her parents Rhona Nack and Tom Cahalan; a professional foil to Dr. Souhel Najjar
• Thematic function: Embodies the pitfalls driving the Theme: The Diagnostic Mystery
• Physical impression: “Grandfatherly-looking,” with a “soft but strong,” “meaty, significant” handshake that initially signals trustworthiness

Who They Are

At first glance, Dr. Saul Bailey seems like the safe harbor Susannah needs: a calm, seasoned neurologist whose bearing and touch project competence. But the warmth of that first impression quickly curdles into a pattern of dismissal and certainty. Bailey’s character crystallizes the book’s critique of rushed, stereotype-driven medicine: he collapses complex neurological red flags into an easy lifestyle story, and his confidence—so reassuring at first—becomes the mechanism of danger. In the narrative, he’s less a villain than a cautionary figure: the doctor who stops asking questions because the first answer feels comfortable.

Personality & Traits

Bailey’s defining qualities—assured, reductive, and incurious—are not simply personal flaws; they are professional habits with life-or-death stakes. His reliance on “normal” test results, his readiness to pathologize a young woman’s behavior as partying, and his refusal to revisit his own conclusions reveal a mindset that privileges neat explanations over messy reality.

• Dismissive: He makes Susannah feel like a “burden” during her first visit, minimizing the urgency of her escalating symptoms even as seizures and paranoia emerge.
• Judgmental: He steers the interview toward alcohol, asking leading questions that frame her as an unreliable party girl rather than a patient in medical crisis.
• Overconfident: He assures her family that the case is “very simple,” insisting she’s “partying too hard,” a confidence that delays life-saving care.
• Uninquisitive: He treats “normal” EEG, MRI, and labs as end points rather than data points, closing the diagnostic door that a more curious physician later reopens.

Character Journey

Bailey is a deliberately static character—he does not grow, learn, or revise. His arc is the story of a closed loop: a swift, confident hypothesis (“stress and alcohol”) becomes a fixed narrative he defends against mounting evidence. Across Chapters 3, 9, and 14, he performs routine exams, prescribes Keppra, and resists hospitalization—each step reinforcing his initial frame. When Susannah reaches out in Chapter 47, he has still not learned about anti-NMDA-receptor encephalitis. This stasis serves the memoir’s argument: Bailey embodies the medical failure that occurs when certainty outruns curiosity.

Key Relationships

• Susannah Cahalan: As her neurologist, Bailey is positioned to catch the diagnosis early; instead, his certainty blinds him. By attributing seizures and psychosis to lifestyle, he transforms a cry for help into an administrative handoff, prolonging her crisis and increasing the danger she faces.

• Rhona Nack and Tom Cahalan: Bailey’s confident misdiagnosis initially soothes them—at last, a simple explanation. But as Susannah deteriorates, his assurance becomes an obstacle they must push against, compelling her parents to advocate fiercely for hospitalization and more thorough care.

Defining Moments

Bailey’s presence in the memoir is punctuated by scenes where his confidence collides with the complexity of Susannah’s illness.

• The First Consultation (Chapter 3): He performs a routine exam he deems “normal” and orders an MRI. The drab office and Miró’s unsettling Carota painting mirror Susannah’s unease, foreshadowing the mismatch between appearance (calm, artistic, orderly) and the chaos inside her brain. Why it matters: The scene establishes Bailey’s authority and the narrative’s central tension—trusting the expert versus trusting the symptoms.
• The Misdiagnosis (Chapter 9): After a major seizure, he attributes everything to stress and alcohol, prescribes Keppra, and refers her to psychiatry. Why it matters: This is the inflection point where a neurological emergency is rebranded as a behavioral problem—an error that shapes the next, most dangerous phase of Susannah’s illness.
• The Hospital Admission (Chapter 14): Even as Susannah’s condition worsens, he resists admitting her, repeating that all tests are “normal.” He concedes only under parental pressure, placing her on the NYU epilepsy floor. Why it matters: The scene spotlights the power and limits of medical gatekeeping—and the essential role of family advocacy when a clinician is wrong.
• The Follow-Up Call (Chapter 47): Years later, he still hasn’t heard of anti-NMDA-receptor encephalitis. Why it matters: His unchanged knowledge base underscores the memoir’s indictment of professional inertia and the risk of practicing medicine without humility.

Symbolism

Bailey symbolizes medical hubris and the structural rift between neurology and psychiatry—the impulse to slot symptoms into a simpler category when tests look clean. By labeling a physical illness as psychological, he embodies the peril of collapsing the The Mind-Body Connection into stereotype. As a figure, he exposes how gendered, youth-focused assumptions (“partying too hard”) can override careful inquiry, turning bedside manner into a barrier to care.

Essential Quotes

"I think this is very simple. Plain and simple. She’s partying too hard, not sleeping enough, and working too hard. Make sure she doesn’t drink and takes the Keppra I prescribed, and everything should be fine."

Analysis: The repetition of “plain and simple” performs certainty, not evidence. By reducing multifaceted neurological symptoms to lifestyle, Bailey converts a diagnostic challenge into moral advice—an abdication disguised as clarity.

"Tell me honestly," he said, as if preparing himself for me to let him in on a big secret. "There are no judgments here. How much alcohol are you drinking a day?"

Analysis: The question is framed as compassionate disclosure but functions as a funnel: it narrows possible causes to one preferred narrative. The promise of “no judgments” ironically ushers in the very judgment that derails the work-up.

"Her EEG was completely normal," Bailey protested, looking through my file. "MRI normal, exam normal, blood work normal. It’s all normal." "Well, she’s not normal," my mom snapped.

Analysis: Bailey’s mantra of “normal” reveals faith in tests over the patient in front of him. The mother’s retort re-centers clinical reality: normal results can coexist with a very abnormal patient—an insight Bailey’s approach cannot accommodate.