Remembering John Nash

Patient Expert

This past weekend, John Nash and his wife Alicia were killed in a traffic accident. Both were in their eighties.

As most of us are aware, John Nash achieved renown as the subject of Sylvia Nasar’s 1998 book, A Beautiful Mind. The book was made into an Oscar-winning movie of the same name, starring Russell Crowe.

The story is a compelling one: An eccentric math genius is derailed from his brilliant career by schizophrenia. Decades later, he receives the Nobel Prize in Economics.

Ms Nasar’s book is probably the best narrative I have ever read on mental illness. If you haven’t read it already, I strongly recommend you get your hands on a copy. In the popular imagination, however, a number of misconceptions have emerged, that need redressing.

First one …

In the movie version, a recovering John Nash mentions he is on newer medications. One memorable scene showed a younger Nash off his meds endangering his baby child. The message couldn’t be more clear: Stay on your meds, or else.

The book tells a different story: John Nash decided that the side effects of his meds were worse than the schizophrenia. With the support of Alicia, Nash chose to face his demons with no meds. Over time, he recovered.

Second one …

There is no shortage of commentary on how John Nash recovered without meds. The catch is it took at least two decades. In his Nobel biography, he refers to “25 years of partially deluded thinking providing a sort of vacation.”

Third one …

In the popular imagination, it is impossible to disentangle Nash’s genius from his schizophrenia. Depending on point of view, insight either emerged from madness or prevailed despite madness.

The chronology, however, gives us a few degrees of separation: Nash’s Nobel-worthy work came during his early career, before his first psychotic break, and during a short recovery period afterword. The recognition he received at age 66 was the product of a disciplined and rational mind operating at peak capacity four decades earlier.

Reconciling John Nash …

The story that emerges from Sylvia Nasar’s narrative is that of a man with a brain cohabited by genius and madness. In his early years, the madness showed up as merely odd or eccentric and occasionally inappropriate behavior.

That changed, however, when madness gained the upper hand and he began experiencing paranoid delusions and was no longer able to function in an academic environment. Both his career and marriage were derailed.

Over time, without meds, Nash’s condition stabilized to the point where he experienced only mild delusions. Although no longer married to Alicia, she provided him a place to stay, as well as moral and practical support.

In addition, although not employed, his intellectual peers at Princeton University made him feel welcome on the campus.

Nevertheless, these were lost years - decades - in his life.

It is fitting to wrap this up with an excerpt from an earlier piece of mine:

In 2007, I had the occasion to hear Dr Nash speak at a convocation at the American Psychiatric Association's annual meeting. He held a densely-worded typescript up to his face and proceeded to read in an interminably relentless monotone. …

Then something he said made my ears perk up. "My recovery began," he related, or words to that effect, "when my reputation finally started catching up with the acclaim I felt I deserved."

Complexity, nuance, in the end - simplicity.