A Eulogy for a Beautiful Mind

[[{"type":"media","view_mode":"media_crop","fid":"38051","attributes":{"alt":"John Nash","class":"media-image","height":"193","id":"media_crop_4808015476296","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3776","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":" ","typeof":"foaf:Image","width":"263"}}]]COMMENTARY

Perhaps you recall the Beatles’ song from 1967, “A Day in the Life.” Apparently the inspiration for the song was the death of a British heir to the Guinness fortune, Tara Browne, in a car crash.

This song has a very unusual structure for a popular song. It is disjointed-some parts written by PaulMcCartney, others by John Lennon,although there is confusion and dispute about who wrote what. Then there are the electronically altered, unusual orchestral interludes by their producer, George Martin. Eerily, there seems to be some connection with this fragmented structure and some of the lyrics with another, recent death. I try to reflect some of the parallels in what follows.

“I read the news today oh boy”

It was Monday, Memorial Day 2015, when we read the news that John F. Nash Jr and his wife had died.

“And though the news was rather sad”

Of course, the news was sad. Even if Mr Nash was 86, in partial recovery from schizophrenia, he was still working on his economic game theories, for which he received a Nobel Prize in 1994. In one of life’s terrible ironies, he was returning from Norway, where he had just received yet another scientific award-the Abel Prize.

Most recently, he was working on cooperative, rather than competitive, game theory. Not that I really understood his work, but somehow it seemed to remind me of the interactions that psychiatrists have with patients who are cooperative with or resistant to therapy.

“He blew his mind out in a car”

Mr Nash and his wife died in a car crash when, for some reason, their taxi driver tried to pass another car. Tara Browne’s crash back in 1966 was apparently related to drugs.

“A crowd of people stood and stared,

They’d seen his face before”

So many know of Mr Nash and know his face, or at least the face of the actor Russell Crowe, who portrayed him in the movie A Beautiful Mind. So many had stared at him, for different reasons, at different times.

Those around the car crash stared. Those in the crowd in 1994, when he belatedly received the Nobel Prize, stared to see how much he had recovered. Those working at Princeton stared at him during the earlier, more paranoid times, when he walked the halls ghostlike. Those colleagues stared when he presented his groundbreaking economic game theories before age 30. His family and schoolmates stared at his odd behavior when he was younger. Now his own stare is frozen in time, challenging us to understand the meaning of the stares that he had received during his life.

“But I just had to look

Having read the book”

Yes, probably like many of you, I had read the biography that Sylvia Nasar wrote about him, A Beautiful Mind. The movie of the same name that followed in 2001 was a fictionalized account of the book. From the book I learned so much, including:

• The mixed history of psychiatric treatment from the 1950s to the 1970s, before my clinical time, from insulin coma treatment to the emergence of antipsychotic medications

• The possible connection between creativity and psychosis

• That recovery from schizophrenia can still occur very late in life

• That the loving support of another through thick and thin (in his case, his wife) can be so important over the long run of a severe, chronic psychiatric illness

“Now they know how many holes it takes to fill the Albert Hall”

After this last quote and the following line, “I’d love to turn you on,” there is a massive orchestral glissando, as if there is a disorienting break between nightmare and awakening, or between psychosis and reality. John Nash surely experienced those kinds of breaks, although they seemed to have been more gradual.

His fame filled many halls. His hole is unlikely to be replaced. Yet there are so many holes of others, many unknown, who experience similar mental states. They are just as important in their own lives and their-and our-shared humanity. Indeed, every life has its own lesson, and every death has a lesson. Although I’ve only eulogized psychiatrists in the past, it is just as important to eulogize patients, as well as any who made important contributions to mental health.

Perhaps Mr Nash could have averted much suffering and produced more work if he had access to our current treatments and recommendations for recovery. That includes the RAISE study that I reported on recently.¹ The best way we can carry on the legacy of Mr Nash in psychiatry is to do the best we can for those suffering from schizophrenia.

The Beatle song ends with a sustained piano chord, as if to try to sustain itself-as we must try to sustain our efforts. Consider listening to the song and contemplate what the life of Mr Nash means to you. I’d love to turn you on to that.

This article was originally posted on 5/27/2015 and has since been updated.

Note to readers: As with all of our blogs, the opinions expressed in this commentary are solely those of the author. Comments not followed by full names and academic titles will either be removed or heavily monitored. –Psychiatric Times

Disclosures:

Dr Moffic is an editorial board member of and regular contributor to Psychiatric Times. After an award-filled career focusing on the underserved, he retired from clinical work and his Tenured Professorship at the Medical College of Wisconsin in 2012. He continues to write, present, and serve on boards devoted to this-and related-ethical concerns. Dr Moffic’s book, The Ethical Way: Challenges and Solutions for Managed Behavioral Healthcare (1997), was the first on the subject.

References:

1. Moffic HS. Take-home lessons on schizophrenia. Psychiatr Times. May 21, 2015. http://www.psychiatrictimes.com/apa-2015-Schizophrenia/take-home-lessons-schizophrenia/page/0/2. Accessed June 2, 2015.