A Beautiful Mind (64 page)

The syndrome we now call schizophrenia was once called “dementia praecox,” but, in fact, the delusional states typical of schizophrenia often have little in common with the dementia associated with, for example, Alzheimer’s disease.
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Rather than cloudiness, confusion, and meaninglessness, there is hyperawareness, over-acuity, and an uncanny wakefulness. Urgent preoccupations, elaborate rationales, and ingenious theories dominate. However literal, tangential, or self-contradictory, thought is not random but adheres to obscure and hard-to-understand rules. And the ability accurately to apprehend certain aspects of everyday reality remains curiously intact. Had anyone asked Nash what year it was or who was in the White House or where he was living, he could no doubt have answered perfect!}’ accurately, had he wished to.
Indeed, even as he entertained the most surreal notions, Nash displayed an ironic awareness that his insights were essentially private, unique to himself, and bound to seem strange or unbelievable to others. “This concept that I want to describe … will perhaps sound absurd,” is the sort of preface of which he was quite capable.
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His sentences were filled with phrases like “consider,” “as if,” “may be thought of as,” as if he were conducting a thought experiment or realizing that someone reading what he wrote would have to translate it into another language.

Like all other manifestations of the syndrome, delusions are not unique to schizophrenia; they can be present in a variety of mental disorders, including mania, depression, and a variety of somatic illnesses. But the types of delusions that Nash suffered from are particularly characteristic of schizophrenia, specifically of paranoid schizophrenia, the variant of the syndrome from which Nash apparently suffered.
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Their content was, as it often is, both grandiose and persecutory, often shifting from one to the other in the space of moments or even including both at the same time. At different times, as we know, Nash thought of himself as uniquely powerful, as a prince or an emperor; at other times he thought of himself as extraordinarily weak and vulnerable, as a refugee or a defendant in a trial. As is quite typical, his beliefs were what is called referential, in that he believed that a host of environmental clues — from newspaper passages to particular numbers — were specifically directed at him and that he alone was capable of appreciating their true meaning. And his delusions were multiple, a particularly common feature of paranoid schizophrenia, although all were organized, in subtle ways, around coherent themes.

Bizarreness is thought to be especially characteristic of schizophrenic delusions. Nash’s delusions were clearly implausible, difficult to penetrate, and not obviously derived from life experiences. Yet they were less bizarre, on the whole, than many delusions reported by other people with schizophrenia, and their connections to Nash’s life history and his immediate circumstances, though indirect, were often discernible (or would have been had anyone who knew him well been willing to study in the same spirit as the loyal wife of Balzac’s Louis Lambert). Many people with schizophrenia believe that their thoughts have been captured by outside forces, or that outside forces have inserted thoughts into their minds, but such beliefs did not seem to play a predominant role in Nash’s thinking. Occasionally, as in Rome, he might think that thoughts were being inserted directly into his mind via machines, or, as in Cambridge in early 1959, that his actions were being directed by God. But, by and large, Nash maintained a sense of himself, or selves, as the primary actor. And many of his beliefs — such as that he was a conscientious objector in danger of being drafted; that he was stateless; that mathematicians belonging to the American Mathematical Society were ruining his career; that various persons, posing as sympathizers, were conspiring, with malevolent intent, to have him incarcerated in a mental institution — were no more implausible than, say, a belief that one is being spied on by the police or the CIA. Thus, in a sense, the breakdown of reality and boundaries between self and outside world had limits for him, even in Roanoke.

In particular, although Nash later referred to his delusional states as “the time
of my irrationality,” he kept the role of the thinker, the theorist, the scholar trying to make sense of complicated phenomena. He was “perfecting the ideology of liberation from slavery,” finding “a simple method,” creating “a model” or “a theory.” The actions he referred to are mostly feats of mind, or involve language. At most, he was “negotiating” or “petitioning” or trying to persuade.

His letters were Joycean monologues, written in a private language of his own invention, full of dreamlike logic and subtle non sequiturs. His theories were astronomical, game theoretical, geopolitical, and religious. And while, years later, Nash often referred to pleasant aspects of the delusional state, it seems clear that these waking dreams were extremely unpleasant, full of anxiety and dread.

Before the 1967 Arab-Israeli war, he explained, he was a left-wing Palestinian Arab refugee, a member of the PLO, and a refugee making a “g-indent” in Israel’s border, petitioning Arab nations to protect him from “falling under the power of the Israeli state.”
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Soon afterward, he imagined that he was a go board whose four sides were labeled Los Angeles, Boston, Seattle, and Bluefield. He was covered with white stones representing Confucians and black stones representing Muhammadans. The “first-order” game was being played by his sons, John David and John Charles. The “second-order,” derivative game was “an ideological conflict between me, personally and the Jews collectively.”
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A few weeks later he was thinking of another go board whose four sides were labeled with cars that he had owned: Studebaker, Olds, Mercedes, Plymouth Belvedere. He thought it might be possible to construct “an elaborate oscilloscope display … a repentingness function.”
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It seemed to him also that certain truths were “visible in the stars.” He realized that Saturn is associated with Esau and Adam, with whom he identified, and that Titan, Saturn’s second moon, was Jacob as well as an enemy of Buddha, Iblis. “I’ve discovered a B theory of Saturn… . The B theory is simply that Jack Bricker is Satan. ’Iblisianism’ is a frightening problem connected to the Final day of Judgement.”
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At this point, the grandiose delusions in which Nash was a powerful figure, the Prince of Peace, the Left Foot of God, and the Emperor of Antarctica were no longer in evidence; instead, the theme became predominantly persecutory. He discerned that “the root of all evil, as far as my personal life is concerned (life history) are Jews, in particular Jack Bricker who is Hitler, a trinity of evil comprised of Mora, Iblis and Napoleon.” These were, he said, simply “Jack Bricker in relation to me.”
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At another point, he said, referring to Bricker, “Imagine if there would be a person who pats a guy on the back … with compliments and praises, while at the same time stabbing him in the abdomen with a deadly rabbit punch.”
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Seeing the picture so clearly, he concluded that he must petition the Jews and also mathematicians and Arabs “so that they have the opportunity for redress of wrongs,”
which must, however, “not be too openly revealed.” He also had the idea that he must turn to churches, foreign governments, and civil-rights organizations for help.

In the story of Jacob and Esau, told in Genesis, Nash saw a parable full of meaning for his own life.
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Jacob and Esau are brothers, the sons of Isaac and Rebekah, who love each other. Esau is the elder, and his father, Isaac, loves him, but Rebekah, their mother, loves Jacob more. As the story unfolds, Esau is twice supplanted by Jacob. First, Jacob tricks Esau into making a bad bargain and selling his birthright. Then, Jacob steals the blessing of the now blind Isaac, who had intended it for Esau. He does so by impersonating his brother. When Esau discovers Jacob’s deception, Isaac rejects his claim: “See, away from the fatness of the earth shall your home be/and away from the dew of heaven on high./By your sword you shall live,/and you shall serve your brother;/but when you break loose,/you shall break his yoke from your neck.” Esau, full of hatred for his brother, tells himself, “The days of mourning for my father are approaching; then I will kill my brother Jacob.”

Nash believed that he had been cast out (“I’ve been in a situation of loss of favor”) and ostracized. He was constantly threatened with bankruptcy and expropriation: “If accounts are held for a trustee, in effect, who is as good as defunct, through lack of ’rational consistency.’ … It’s as if accounts are held for persons suffering in an Inferno. They can never benefit from them because it’s as if they were supposed to come from the Inferno — to the bank offices — and collect, but they need, as it were, a revolutionary ending of the Inferno before having any sort of possibility of benefiting from their accounts.”
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There is a presumption of guilt. Punishment, penitence, contrition, atonement, confession, and repentance are constant themes — along with fears of exposure and the need for indirection and secrecy — and seem directly connected, but not limited, to his feelings about homosexuality. He refers to “the really dubious things that I have done in all the history of my personal life,” including “draft dodging, truancy.”
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Arrests, trials, and imprisonment were also recurring themes. Like Joseph K in Kafka’s novel
The Trial
Nash imagined that he was on trial “sufficiently complete in absentia.” He recognizes that “it is as if the accused is his own chief accuser … the road of self-accusation is a road that leads to death not redemption.”
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He thinks of a “court of inquiry” investigating “the life histories and … interactions” of Jacob and Esau, whom he identifies as Bricker and himself.
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These are guilty, fearful dreams. Nash’s state of imprisonment did not, it seems, refer to his illness, for he did not regard himself as ill except physically. It was existential. To Eleanor he wrote, “U see, U must sympathize more with the true needs of liberation, liberation from slavery, liberation from ’castration,’ liberation
from prison, liberation from isolation … I’m a refugee, in fact, from false symbols and dangerous symbols.”
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At times, he felt that he was in danger of crucifixion.

His own needs, he said, were “to be free, and to be safe and for friends.”
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He was always, he said, “in fear of ’death’ (Indian style) through an Armageddon with Iblis … at the Day of Judgement.” Even in these very dark hours he clung to a vision of liberation — which later became, more concretely, a wish for sexual liberation. “I’m hoping fervently to be saved (delivered) before reaching 40 in age,” he had written a few weeks before his birthday. “One cannot substitute free life and love of the 40s for the lost possibilities of the 20s and 30s and also teens.”
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Nash was acutely aware of the passage of time. “It does seem to me that I’ve been as if the victim of an excessively long wait for liberation… . It’s as if there wasn’t a ransom forthcoming, as if from Kuwait, which would have really substantially shortened the time of waiting for me.”
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He was waiting for deliverance: “I see, it seems surprisingly clearly, how there’s as it were, a time of grace before that time, a precious time of grace which is forever lost if not seized carpe diem and fully effective in its significance.”
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Nash was also hearing voices, voices that frightened him: “My head is as if a bloated windbag, with Voices which dispute within.”
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Hallucinations can involve any of the senses — hearing, smell, taste, touch, sight — but voices, one or several, familiar or strange but distinct from one’s own thoughts, are the most characteristic of schizophrenia.
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These are quite distinct from the hallucinations that are part of religious experience, or the humming inside one’s head, hearing one’s name called occasionally, or hallucinations that occur while falling asleep or waking up. The content of schizophrenic hallucinations can be benign, but they usually involve ridicule, criticism, and threats, typically related to the content of the delusional theme. The integration of voices with thought can produce an acute sense of reality.

The so-called negative symptoms of schizophrenia are, most clinicians agree, even more crippling than the delusions and hallucinations. The terms used to describe them are derived from the Greek: affective flattening, alogia, and avolition. There was no trace of the sharp looks, the enthusiastic gesturing, the brash body language that announced, “I’m Nash with a capital
N.”
His face was blank, his eyes empty, as if the fires of delusion had consumed everything that was once alive and left an empty husk.

One would feel comforted if one could believe that Nash, at this terrible time in his life, was at least spared the sight of his own condition. One of the consequences of chronic schizophrenia, noted long ago and verified since by numerous studies, is a curious insensitivity to physical pain. This insensitivity is often so great that there are high rates of premature deaths from physical illnesses among
schizophrenics, at least in the era when such people spent most of their lives in institutions. Might there not be a similar dulling that would anesthetize one to psychic pain? Possibly. But for Nash there were moments of lucid self-knowledge, unbearable in their sadness: “So long a time has passed. I feel there are many sad tragedies. Today I feel very sad and depressed.”
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It is often difficult to distinguish the effects of disease from those of its treatment. But Nash’s condition during the two and a half years he spent in Roanoke was probably almost purely the consequence of his disease. Six years had passed since Nash had received insulin treatments and well over a year since he had been taking neuroleptics regularly. While some of his memory loss was, no doubt, a result of the insulin treatments of the first half of 1961 and some of his extreme quietness in the early months following his return to Cambridge no doubt reflected the side effects of Stelazine, his condition in Roanoke is a strong testament that lassitude, indifference, and the peculiarities of his thought were primarily the consequences of his illness and not of the early attempts to treat it. The popular view that antipsychotics were chemical straitjackets that suppressed clear thinking and voluntary activity seems not to be borne out in Nash’s case. If anything, the only periods when he was relatively free of hallucinations, delusions, and the erosion of will were the periods following either insulin treatment or the use of antipsychotics. In other words, rather than reducing Nash to a zombie, medication seemed to have reduced zombielike behavior.