Dr. Souhel Najjar
Quick Facts
- Role: NYU Langone neurologist; the decisive diagnostician who solves Susannah’s case
- First appearance: Referenced for his reputation earlier (Chapter 23); appears in person during Susannah’s hospital crisis (Chapter 26)
- Key relationships: Patient Susannah Cahalan; her parents Rhona Nack and Tom Cahalan; collaborator Dr. Siegel
- Physical presence: A measured gait with a slight forward tilt of the head, a thick mustache he twists while thinking, and a rhythmic Syrian accent that quickens—and drops prepositions—when he’s excited (Chapter 26)
Who They Are
A brilliant, compassionate neurologist, Dr. Souhel Najjar arrives as the narrative’s clarifying force in the Diagnostic Mystery. Where others see a psychiatric breakdown, he sees a pattern—subtle neurological signs that point to inflammation and immune dysfunction. Najjar’s genius is not only intellectual; it’s ethical. He restores personhood to a patient lost in symptoms, translating baffling behavior into a coherent medical story. In a rushed, error-prone system, he models slow attention, creative testing, and a relentless insistence on treating the whole human.
Personality & Traits
Najjar’s authority comes from a rare blend of rigorous reasoning and radical empathy. He thinks like a scientist and behaves like a guardian, moving seamlessly from microscopic detail to big-picture meaning. He also reads the room: his calm confidence steadies a family on the brink, while his plainspoken metaphors build trust and comprehension.
- Brilliant and intuitive: Known as “the man to go to when nothing made sense” (Chapter 23), he sidesteps easy psychiatric labels and devises the simple, devastatingly effective clock test that reveals right-hemisphere dysfunction (Chapter 26).
- Compassionate and humane: He talks to Susannah even when she’s catatonic, treating her as a person first. He promises, “I will do my best to help you,” placing care before certainty (Chapters 16, 26).
- Determined and unyielding: “We will figure this out,” he tells her parents, then backs it with decisive steps—from biopsy to an aggressive, multi-pronged therapy (Chapters 16, 27).
- Confident yet reassuring: His recommendations (“If she were my child…”) balance clinical judgment with deep personal investment, making terrifying choices feel survivable (Chapter 27).
- Grounded presence: The forward-leaning posture, mustache-twisting habit, and quickening accent signal a mind in motion—physical cues that make his brilliance approachable (Chapter 26).
Character Journey
Najjar enters as a last-resort name passed between doctors and rapidly becomes the story’s lodestar. His clock test reframes chaos as neurology; his metaphor—“her brain is on fire”—translates the crisis for a family desperate to understand (Chapter 26). He pushes for a biopsy when answers remain elusive (Chapter 27), then orchestrates a rigorous regimen that begins to return Susannah to herself. Professionally, his Grand Rounds presentation (Chapter 46) and later recognition (Chapter 49) confirm his role as a pioneer. Personally, he remains steady and unchanged: a clinician whose humility, curiosity, and patient-first ethos transform everyone around him.
Key Relationships
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Susannah Cahalan: Najjar sees past the psychosis to the trapped self, using the clock test to locate neurological damage and speaking to her as if she can answer—even when she can’t. When she briefly hugs him in lucidity, he receives proof that “she is still in there,” validating his faith and guiding his treatment (Chapter 26).
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Rhona Nack and Tom Cahalan: To Susannah’s parents, Najjar’s calm confidence is oxygen after weeks of suffocation. Rhona dubs him a “real-life Dr. House,” while Tom is moved by the vow to help; Najjar earns their trust enough to secure consent for a frightening but necessary brain biopsy (Chapters 27).
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Dr. Siegel: A respected neurologist in his own right, Siegel’s decision to call in Najjar signals extraordinary professional regard. Their collaboration underscores that the breakthrough is not lone-wolf genius but expert teamwork oriented around the patient.
Defining Moments
Najjar’s pivotal actions reshape the narrative from mystery to medicine, from stigma to science.
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The Clock Test (Chapter 26): Asking Susannah to draw a clock yields numbers crammed on the right side—a concrete sign of right-hemisphere inflammation. Why it matters: It converts baffling behavior into a map of brain dysfunction, redirecting the team from psychiatry to neurology.
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“Her Brain Is on Fire” (Chapter 26): With one metaphor, he renders the invisible visible, helping the family grasp the disease’s inflammatory nature. Why it matters: The phrase affirms the illness’s physical basis and anchors the book’s exploration of the Mind-Body Connection.
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Recommending the Brain Biopsy (Chapter 27): He frames the decision as he would for his own child, marrying conviction with empathy. Why it matters: It shows leadership under uncertainty and clears the path to a definitive diagnosis and targeted treatment.
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The Grand Rounds Lecture (Chapter 46): Presenting Susannah’s case educates peers and validates the approach publicly. Why it matters: Najjar’s work becomes a template, expanding awareness of autoimmune encephalitis and changing future outcomes.
Essential Quotes
“Her brain is on fire.”
This metaphor is both diagnosis and translation: it names inflammation and makes it emotionally legible. It counters the psychiatric framing that has failed Susannah and reframes her behavior as the downstream effect of a physical storm (Chapter 26).
“I will do my best to help you. I will not hurt you.”
Najjar speaks to Susannah as a person, not a problem, even when she can’t respond. The promise establishes an ethical covenant—care without coercion—that earns the family’s trust and steadies the treatment journey (Chapters 16, 26).
“You have to look backward to see the future.”
A credo for differential diagnosis, this line captures Najjar’s method: trace present symptoms to hidden causes, then project recovery from that root. It elevates clinical reasoning into narrative reconstruction—medicine as detective work.
“We’re going to put her on an aggressive treatment of steroids, IVIG treatment, and plasmapheresis... It’s a three-pronged attack, no stone unturned.”
Here Najjar pairs clarity with urgency, outlining a plan that is methodical yet bold. The phrasing reassures the family that he will pursue every avenue while signaling the high stakes of inaction.
“Just because it seems like schizophrenia doesn’t mean that it is. We have to keep humble and keep our eyes open.”
This admonition critiques snap judgments and defends diagnostic humility. It insists on curiosity over certainty, a stance that ultimately saves Susannah by refusing to let a psychiatric label close the case.