Book Review: Uncontrollable

Reviewed by Erin Britton

How do you keep going when your own brain seems to be conspiring against you?

Epilepsy is a fairly common condition, affecting around 50 million people worldwide. It occurs as a result of abnormal electrical activity in the brain and causes seizures. The seizures can trigger a wide variety of symptoms, ranging from relatively minor to debilitating, which can have an adverse impact on the daily life of someone with epilepsy. While there are a number of treatment options available, they do not work for everyone, and there’s certainly no treatment for the thoughtless remarks and stigma that some people with epilepsy experience.

In her powerful debut novel Uncontrollable, Sara Staggs introduces us to Casey O’Connell, a young woman who has just led the Stanford University team to success in the 2006 American Mock Trial Association National Championship. With the team’s victory being in no small part due to her skillful cross-examination of the main witness and having been singled out for praise by the presiding judge, Casey feels on top of the world. However, even in her moment of triumph, her epilepsy diagnosis is lurking ominously in the back of her mind: “I paused as my head felt… something. You’ve taken your meds. You got enough sleep. It’s just stress. You can get through this.”

Fast-forwarding ten years finds Casey—now married to ad executive Jonah Scott and mother to five-year-old Sam and three-year-old Sadie—relishing the glittering legal career that she had both hoped for and expected. Of course, success always comes at a price, and Casey has recently celebrated winning a punishing week-long trial with a weekend visit to the ER following a tonic-clonic seizure. Still, she’s keen to advance her career even further and so jumps at the chance to lead the civil case stemming   from the criminal conviction of a prison guard for raping several inmates at the state women’s correctional facility: “it was just the type of case I was dying to sink my teeth into. High-profile. A challenge. Something that could really show off my expertise.”

Unfortunately, given the seriousness of the case and the far-reaching consequences that the eventual verdict will have for numerous people, the initial hearing places greater pressure on Casey than she has ever experienced professionally before, which triggers a massive seizure while she’s in the courtroom. When confronted by the possibility that, if it remains uncontrolled, her epilepsy may lead to her premature death, Casey has little choice but to agree to take a break from work and spend a couple of weeks being assessed at a hospital in Cleveland regarding the possibility of surgical treatment. Even then, the thought of losing the opportunity to become partner worries her just as much as the prospect of undergoing brain surgery.

Soon, Casey must make a decision that will have life-changing consequences for both herself and those closest to her. Will she risk losing everything that makes her who she is and wants to be, or will she accept having limitations placed on what she can do and achieve? 

Uncontrollable is told from the alternating perspectives of Casey and Jonah, which allows Staggs to show how one person’s illness has myriad consequences for both themselves and their loved ones. The pair clearly love each other deeply, but Staggs doesn’t sugar-coat their relationship, making it apparent that they still squabble and experience petty jealousies while jointly pursuing the best outcomes for their family. For instance, despite being abundantly aware of how much Jonah empathizes and supports her, Casey still sometimes finds herself frustrated that he doesn’t truly understand what she’s going through: “Jonah, you can’t understand. My perfectly healthy husband, who doesn’t have to walk around all day every day with a brain that might not cooperate, how can you.”

For his part, Jonah struggles with his fear regarding the possible consequences of Casey’s condition, especially when dealing with medical professionals: “I looked around helplessly, as if there might be a poster on the wall to explain what this nitwit had just said. One poster silently ordered, ‘Get a flu shot!’ Another showed a picture of the brain, its parts labeled. Nothing that announced ‘Hello! Your wife could die from SUDEP!’” He also finds it difficult to cope with family life while Casey is away at the hospital, which occasionally causes his temper to flare at his children. Staggs does a great job of portraying the strain that both he and Casey are under.

Interestingly, they both experience an unnecessary amount of work-related stress, which exacerbates the difficulties they are facing. Casey is single-minded in her pursuit of career success, being willing to put her health at risk to take on big cases and rise to a partnership role at her firm, but she also has to contend with an incredibly aggressive and demanding boss. While not the worst when it comes to underestimating the severity of her condition, her boss provides another example of how little people comprehend the struggle associated with living with a serious illness. The same is true of Jonah’s bosses, and their inherent sexism and focus on presenteeism also mean he has to fight hard for a promotion that should be his by right.

Uncontrollable is unflinching in its portrayal of epilepsy. The moments when Casey experiences not only the distressing seizures but when doctors utilize electrodes in her brain to interfere with her speech and movement are particularly affecting and upsetting. It’s impossible not to feel sympathy and empathy for her plight during such times, which highlights just how unreasonable many of the other characters are being in dismissing and minimizing her condition.

Uncontrollable is certainly an apt title for the novel, as Staggs demonstrates how the uncontrolled nature of Casey’s epilepsy leads to both her and Jonah feeling out of control in terms of their daily lives and options for the future. Given its complex and often difficult subject matter, it’s an emotional and thought-provoking novel about the fragility of health, life, and family, although it’s also an inherently hopeful story about perseverance in the face of adversity and the strength derived from human connections.

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