Rhona Nack

Quick Facts

Rhona Nack is the mother of Susannah Cahalan, a senior professional at the Manhattan district attorney’s office, and the book’s fiercest lay advocate in the medical maze. First seen as Susannah’s symptoms escalate toward her first seizure (Chapter 9), she co-parents with her ex-husband, Tom Cahalan, while relying on her husband Allen’s steady presence. Her role crystallizes around vigilance, record-keeping, and unrelenting advocacy during crisis.

Who They Are

At her core, Rhona is a high-functioning professional who transfers her courtroom discipline to hospital corridors. She channels fear into action: asking hard questions, keeping meticulous logs, and refusing to accept reductive explanations for her daughter’s rapidly worsening condition. Her “frenetic energy” and “sharp” presentation are not vanity so much as armor—visible proof that she will not be outworked or outmaneuvered by a chaotic system. Even small details, like her “beautifully shaped hands” that soothe by brushing Susannah’s hair, fuse competence with tenderness. As a figure, she embodies the sustaining force of Love and Family Support when institutions falter.

Personality & Traits

Rhona’s traits read as survival tools repurposed for crisis. Her baseline anxiety becomes radar for danger; her legal precision becomes medical strategy; her composure hides a well of fear she rarely permits to surface. The tension between her outward control and inner panic shapes both her advocacy and her temporary blind spots during recovery.

• Worrier with purpose: “Mom was a worrier by nature” (Chapter 9). Her uncontrollable crying after the first seizure shows raw terror, but that worry quickly hardens into vigilance, propelling her from panic to plan.
• Determined advocate: She rejects dismissive narratives, pushing back on Dr. Saul Bailey’s suggestion Susannah is just “partying too hard,” arriving with a symptom list and a demand for hospitalization (Chapter 14). Her relentless questioning reframes her from “concerned mom” to de facto case manager.
• Organized and meticulous: She runs multiple question lists, compiles detailed notes, and creates a shared logbook with Tom (Chapter 19). The paperwork is more than paperwork—it’s an effort to impose logic on the illogic of disease.
• Emotionally resilient: After an initial collapse, she “rarely” allows herself to fully break down (Chapter 9). Setbacks—like Dr. Siegel’s departure—shake her, but she reconstitutes quickly and refocuses.
• Protective to the point of combativeness: When a wedding guest comments that Susannah has “lost her spark,” Rhona slices the remark short—“She’s doing very well” (Chapter 38). Protection here means curating the narrative to shield Susannah’s dignity.

Character Journey

Rhona’s arc is a conversion narrative from fear to agency. The early days show a mother overwhelmed by a mysterious deterioration she cannot stop. But the same fear catalyzes her transformation: she becomes the primary interrogator, a meticulous archivist of symptoms, and the immovable force who forces hospitalization when others minimize. Parallel to this is a quiet, difficult evolution in co-parenting with Tom; despite a fractured past, they build a functional alliance via the shared logbook (Chapter 19). Mid-crisis blows—like the demoralizing exit of Dr. Siegel—reveal how precarious hope can be. Later, as Susannah improves, Rhona’s protectiveness morphs into minimizing: insisting Susannah was “never really that bad” (Chapter 41) becomes its own form of denial, an attempt to soften trauma by rewriting it. Only when she breaks down at dinner (Chapter 41), admitting the depth of her fear, can mother and daughter meet honestly in the aftermath and rebuild their closeness.

Key Relationships

• Susannah Cahalan: This is Rhona’s defining bond—love expressed as ferocious advocacy. The dynamic strains when protection shades into denial during recovery, but their connection stabilizes once Rhona acknowledges her terror, allowing genuine empathy to replace self-protective minimization.
• Tom Cahalan: Once “barely on speaking terms” (Chapter 19), they craft a functional partnership under pressure. The shared logbook becomes both a communication tool and a symbolic truce, proof that shared purpose can supersede old grievances.
• Allen: As Rhona’s husband, he provides ballast—gentle, calm, and informed by his experience caring for a schizophrenic brother. He tempers Rhona’s “frenetic energy,” grounding her at moments when fear threatens to spill over.
• Dr. Souhel Najjar: To Rhona, Najjar is the long-sought expert who listens, hypothesizes, and acts—the “real-life Dr. House” (Chapter 27). Her faith in him reflects her hunger for competence after a string of dismissals.

Defining Moments

Rhona’s story is punctuated by decisions and confrontations where her identity as mother-advocate crystallizes.

• Confronting Dr. Bailey (Chapter 14): She rebuts the alcohol-withdrawal narrative with a prepared symptom list and refuses to leave without admission. Why it matters: It marks the pivot from reactive parent to proactive strategist, changing the trajectory of care.
• Dr. Siegel’s departure (Chapter 23): When a previously optimistic physician abruptly exits, her “lowest” moment captures the vertigo of the Diagnostic Mystery. Why it matters: It exposes the fragility of hope in a system where experts can vanish, deepening her resolve to keep driving.
• The brain biopsy decision (Chapter 27): Overwhelmed by the prospect of surgery, she breaks down with Dr. Russo, then seeks solace in prayer with coworkers. Why it matters: It reveals the cost of sustained control—and how communal support supplements her private resilience.
• Dinner at J.B. Winberie’s (Chapter 41): During recovery, she finally cries and confesses how terrified she’d been. Why it matters: Vulnerability replaces denial, repairing the mother-daughter bond and acknowledging the trauma both carried.

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.”
— Dr. Bailey’s assessment to Rhona (Chapter 9)

This dismissal is the foil against which Rhona’s advocacy defines itself. The quote exposes how misogynistic or reductive tropes can mask serious illness, and it explains why Rhona refuses to accept neat answers for messy symptoms.

“Well, she’s not normal,” my mom snapped as I sat there, quiet and polite with my hands folded in my lap. She and Allen had made a pact that they would not leave Dr. Bailey’s office without getting me admitted to a hospital.
— (Chapter 14)

Rhona’s bluntness cuts through institutional politeness. Her pact with Allen reframes “family” as a tactical unit, showing premeditated resolve rather than impulsive panic.

He stared back without his familiar warmth and optimism. “I’m not on the case anymore,” he said flatly and turned to leave.
“What, what?” she stammered, her lower lip quivering. “What do we do?”
— Rhona’s reaction to Dr. Siegel leaving the case (Chapter 23)

This rupture exposes the emotional whiplash built into the diagnostic process. Rhona’s quivering response humanizes the iron-willed advocate, reminding us that tenacity coexists with fear.

As Dr. Najjar walked away, my mother whispered, “He’s a real-life Dr. House.”
— (Chapter 27)

The line crystallizes her need for an authoritative problem-solver who both sees and explains. It also marks a turning point: hope shifts from wishful to earned as expertise enters the room.