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Ziegler, Dewey K. MD

Book Review: Infobytes

Dr. Ziegler is Professor Emeritus of Neuro-logy at University of Kansas Medical Center in Kansas City.

A Beautiful Mind: The Life of Mathematical Genius and Nobel Laureate John Nash By Sylvia Nasar 464 pages • Touchstone Books

The life story of John Nash, the Nobel laureate in mathematics, is indeed the stuff of drama, and it is well documented in the biography, A Beautiful Mind by Sylvia Nasar. A precocious genius, Mr. Nash was producing innovative mathematical theorems and had achieved prestigious academic honors in his twenties. He then rapidly developed a devastating psychosis characterized by multiple delusions, auditory hallucinations, and complete disruption of his ability to relate normally to associates and family.

Insulin coma therapy may have induced a remission – thorazine definitely did – but for approximately 20 years he was, to varying degrees, a psychotic recluse. He then rather rapidly recovered and resumed his profession and normal relationships with friends and family.

There was no indication of Mr. Nash's illness at the Nobel ceremony at which he was awarded the prize for mathematics. In recent television interviews, he discusses most amazingly as a dispassionate observer, his delusions and hallucinations.

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A Beautiful Mind is well written in a somewhat journalistic style – including multiple quotes from interviews with family and associates of Mr. Nash, and careful assessments of the validity of other information given.

Ms. Nasar wisely does not attempt to provide the reader with details of her subject's mathematical accomplishments – she states their general nature and their importance. The discussion of psychiatric matters is particularly well done.

Mr. Nash almost definitely is schizophrenic, and the author provides a good discussion of the usual manifestations and course of that illness and the striking changes during the late 20th century of the conception of that disease – from that of a super-neurosis engendered by faulty parenting to that of a genetically influenced neurotransmitter disorder.



The book also accurately emphasizes the ways in which Nash's illness was a variant. Most unusual were the unpredictable remissions during his illness – particularly the terminal striking remission that did not seem related to treatment.

The difficult subjects, such as Nash's often callous treatment of his mistress Eleanor and their son, are presented in a straightforward objective fashion. Some discussion of ethical matters could not be totally avoided; such discussion and any subsequent value judgments are considerably brief and measured in tone.

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How could this complex life be made into a movie? Certainly it was impossible to do justice to all the facts given in the book – the mathematical achievements, the strange personality with its combination of emotional isolation and aggressiveness and the complex amalgam of psychiatric states from frank insanity to “normality.” The movie lasts two hours and confines itself more or less to the story of the psychosis.

There is a suggestion of the abnormality of the pre-psychotic personality, but it is more or less confined to an episode of the Nash character not responding to inviting glances from bar girls, and then inadvertently insulting one. The scenes of the young mathematicians in the bar are more reminiscent of high school students.

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The psychosis is presented as organized visual hallucinations with Mr. Nash seeing an imaginary roommate, a formidable, police-type spymaster, and a child. This makes for exciting theater, but it is remote from the reality where the hallucinations were primarily auditory, and where the delusions were not, as the movie indicates, solely about Nash being urged to combat Russian spying.

There is no hint of the actual disorganized fragmentary delusions – that is, that he had special relations to many heads of state, that he was “the left hand of God on earth” – or of their relation to the chaotic thought processes that led to the effort to resign American citizenship.

The actor Russell Crowe, as Mr. Nash, does convey some of the emotional flattening of the schizoid personality and its strange inappropriate responses. His reaction, however, during psychosis to the hallucinations (presented on the screen as actual individuals) is that of a “normal” person being confronted by violent hoodlums. I did not get, as noted above, the feeling of the intellect and personality disorganization that actually occurred.

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The movie has time limitations, but to omit completely the existence of major persons in the life – namely his mother, sister, mistress, and first son – makes for a massive over-simplification of the life. Nor are we made aware that the relationship with his wife, punctuated at one period by divorce, was not a simple one. Some abbreviated treatment of these subjects (in place of the prolonged depiction of insulin coma treatment and the cops-and-robbers treatment of the paranoid delusions) would have been preferable. The last scene – as the humbled elderly man returns quietly to his work and with dignity receives the Nobel Prize – is excellent.

©2002 American Academy of Neurology