‘Brain on Fire’ cases show benefits of dual-trained doctors

Successful businessman and father Glen Carter is in a very different place than he was a year ago today. Last holiday season, he was hearing voices, seeing visions, and sputtering thoughts about his imminent death. His condition was soon reversed, thanks to a correct diagnosis by a UT Southwestern physician of a rare disease first documented in the book and film ‘Brain on Fire.’ Read story

Summary:  Successful businessman and father Glen Carter is in a very different place than he was a year ago today. Last holiday season, he was hearing voices, seeing visions, and sputtering thoughts about his imminent death. His condition was soon reversed, thanks to a correct diagnosis by a UT Southwestern physician of a rare disease first documented in the book and film ‘Brain on Fire.’ 

Narrator: Just a few years ago, almost no one outside of medical circles had heard of a condition called autoimmune encephalitis. And then can the book and subsequent movie, ‘Brain on Fire’ – A New York Times best-selling memoir chronicling an up-and-coming journalist’s descent into what she called “a month of madness. 

Susannah Cahalan (HLN interview from Dec. 2012): “I started becoming psychotic and I started to hallucinate”

Narrator: The same rare autoimmune disease last year drove 58-year-old Glen Carter of Highland Park, Texas into his own living nightmare.

Janet Carter (Patient’s Wife):He was hearing things [and] seeing things.  I just knew there had to be something going on. I just didn’t know what.”

Narrator: Hallucinations, depression and crushing chest pain landed the faithful father of two in the emergency room three times over the course of just days. He fought off thoughts of hurting himself and others. Then, the dedicated husband and successful business disappeared from work shortly after Thanksgiving of 2017.      

Glen Carter:The day that I got here, I really have no recollection of it. I have no idea where I was or how I drove and why I chose UT Southwestern is still beyond us.”

Narrator: And it was here where Dr. Robert Weir discovered what others outside of UT Southwestern Medical Center had missed.    

Glen Carter: “It was just divine intervention that you happen to somebody like that.”

Narrator: The fourth-year resident had created a combined six-year neurology and psychiatry program – one of only a few across the country, and that program enabled Dr. Weir to more clearly see what was truly going on inside Carter.

Robert Weir, M.D:I’m already reaping the benefits of this program in my daily practice. It turns out that we’re thinking three or four percent of onset psychosis is due to autoimmune encephalitis.”

Narrator: It causes the body’s immune system to mistakenly attack healthy brain cells.

Weir: “It goes after it and attacks it and that can lead to a host of neuropsychiatric symptoms.”

Narrator: Dr. Weir’s dual training led him to suspect Carter was battling a debilitating neurological disease disguised as psychiatric.   

Janet Carter: “He was exactly where we needed him to be and thankfully so.”

Weir: “This guy had been previously healthy, a pillar of his family, very bright and efficient at work and all that fell apart within a matter of days and weeks. He began to do things that were very irrational and odd like taking his clothes off and putting them in the shower or telling us that he needed to look at a book of human anatomy because he was going to be dead in 12 hours and he needed to figure out what his body looked like inside.”

Narrator: Dr. Weir conducted a closer examination after Mr. Carter complained of shoulder pain and that’s when he discovered a bite mark on his patient’s tongue, a tell-tale sign of a seizure that likely contributed to a fall.

Weir: “At this point, I felt comfortable that something wasn’t adding up in our normal acute psychosis case and so I asked the neurology team, my other half, to get involved.  Rather than this kind of standard psychosis treatment with anti-psychotics, we ended up giving him high dose steroids which you would generally not want to be giving these to someone who is amped up and confused and hallucinating.”

Narrator: Within 24 hours, Carter was emerging from the depths of his condition and becoming himself again.

Carter: “At this point, I’m medicine free.  I would consider myself completely recovered. I’m just eternally grateful for the work that’s been done here for sure.” 

Narrator: Work that’s bridging the gap between neurology and psychiatry and helping to unravel the mysteries of the brain.

Carter: “If my case can spur that and motivate people to dig deeper into what’s going on and can help others who suffer what I’ve suffered from than of course Janet and I will do whatever we can to further that.”