A Beautiful Mind (60 page)

The Carrier staff, well aware of such attitudes, defended itself by arguing that its approach was more practical and worked better. “McLean, Austin Riggs, Chestnut Lodge, Shepherd Pratt, and Institute for Living, these were all much fancier,” said William Otis, a psychiatrist on Carrier’s staff. “We were very clinical. None of us had any fancy training. None of us were stars. But the ironic thing is that if you were sick you were much better off at Carrier.”
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Garber said: “At Carrier we were proud of the fact that we set ourselves up as a short-term treatment center. That’s why we were so successful. We were able to treat the patients and get them out, in contrast to McLean and Chestnut Lodge, which were notorious for having schizophrenic patients there for four, five, and seven years.”
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It was Alicia who, despite the impending divorce, felt responsible for Nash, and therefore had to face the decision.
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It took a great deal of courage, as anyone who has had to make such a decision knows. As one psychiatrist at Carrier said, “Commitments always created terrible conflicts in the family. It was very hard to find somebody who wanted to take the responsibility.”
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Alicia, like everyone else around Nash, abhorred the idea of involuntary commitment and feared that treatment, besides being uncertain of success, carried the risks of irreparable harm. But she also knew that Nash was on a disastrous course and was convinced that failure to act would almost certainly lead to further deterioration. The psychoanalysts at McLean had failed, the effects of the shock treatments at Trenton had proved short-lived. She was prepared to try something new. She recognized that the most prestigious hospitals were unaffordable. At Carrier, patients’ families paid a flat fee of eighty dollars a day plus hourly fees for group and individual therapy; Virginia was able to pay that. Besides, it was important to Alicia that Nash be close by, so that she and his old acquaintances at Princeton could visit him.

So in the third week of April, after it had become all too clear that Nash was unprepared to enter treatment at Michigan, she went ahead with arrangements to have Nash taken to Carrier. Once again, she asked Martha and Virginia to come up to Princeton and sign the commitment papers.

From the outset, however, Alicia drew the line at electroshock.
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“We debated electroshock therapy,” Martha recalled. “But we didn’t want to mess with his memory.”
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At Carrier, electroshock was frequently used for schizophrenic patients, who generally got three times as many treatments — twenty-five versus eight — as patients suffering from depression.
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Garber said, “What we were trying to do was to gain control of that patient — to break through his excitement, panic, depression — in the shortest possible time.”
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Generally, psychotic patients were initially treated with Thorazine, and those whose disturbed behavior didn’t improve quickly were also treated with electroshock. Some of the psychiatrists at Carrier felt that the shock treatments were effective and produced fewer side effects than neuroleptic drugs. In any case, despite the nearly universal belief around Princeton that Nash received electroshock treatments at Carrier, he apparently did not.

Nash spent most of the next five months of 1963 in Kindred One, the only locked ward at Carrier. He said later that he made efforts to overturn his commitment; if so, they were not successful. Frank L. Scott recalled that Nash went AWOL from Carrier at least once — presumably after he got ground privileges — and that he had to track him down and return him to the hospital.
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Compared to Trenton, however, Carrier was, if no country club, at least more like a reform school than a prison. There were just eighty patients, the majority of whom came from comfortable middle-class homes, many from New York and
Philadelphia, and most of whom suffered from alcoholism, drug addiction, and depression rather than from psychotic illnesses.
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Carrier had a dozen psychiatrists on its staff, a more adequate nursing staff than at Trenton, and a reasonable complement of medical doctors, psychologists, and social workers.

Kindred One had single and double rooms. Nash, it seems, had a room to himself. He had access to a telephone. He was allowed to wear his own clothing. Patients were addressed by their titles and last names, so he was Dr. Nash, not Johnny as he was at Trenton. Nash’s wishes regarding his vegetarianism — which “doesn’t exclude animal products, for example, milk, but only the animal products which become available only at the death (execution of the animal)” — were apparently respected.
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Alicia visited regularly, as did a number of others from Princeton, among them Spencer, Tucker, and the Borels.
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Probably the best thing that happened to Nash at Carrier was that he met a psychiatrist, Howard S. Mele, who was to play an important and positive role in his life for the next two years.
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The psychiatrist, who happened to be on duty the night that Nash was brought to Carrier, was assigned to care for him. A short, soft-spoken, dapper man of Italian descent who got his medical degree at Long Island College of Medicine and did his residency at Mt. Sinai Hospital in New York City, Mele was quiet and careful.
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Described by his former colleagues as “conventional,” “cautious,” “not an exciting man,” Mele was, as later events showed, competent and caring.
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He was respected by the nursing staff. Belle Parmet, the institute’s social worker at the time, said of Mele and the other staff psychiatrists: “They weren’t just pill pushers or prescription writers. They were all humanistic.”
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Nash responded quite quickly to his initial treatment with Thorazine. If someone responds at all to what are now called “typical” neuroleptics, dramatic changes are usually evident within a week, and the full effect becomes apparent within six weeks. Two weeks after his commitment, Nash wrote a relatively lucid letter to Norbert Wiener, saying, among other things, “My problems seem to be essentially problems of communications. I don’t know how they can be resolved. Perhaps I shall be able to approach their solution as a result of begging for aid. (However, this isn’t a begging letter!)”
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At this point, Nash was seeing Mele for therapy sessions and also participating in group therapy, which Mele particularly favored.
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There was, however, no thought of releasing him quickly. As Garber said, “Paranoid schizophrenics are not that responsive. Once you do get them under control, you have to satisfy yourself that they’ve stabilized. You don’t want a relapse, especially if there’s been a commitment because then you and the family would have to start all over.”

By August, Nash was beginning to look forward to getting out of Carrier. He wrote to Virginia that he was anticipating Alicia’s visit on the weekend and was “thinking of getting out.”
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He added that “Mele thinks it depends on having a
job.” Nash admitted that he was ill and in need of treatment but said that “Michigan might have been a better deal.” He asked Milnor for help in getting a job. On September 24, Nash wrote again saying that Sunday was “a sad day” because Alicia had to work overtime and couldn’t come to take him out. He said that the Institute for Advanced Study had decided to offer him a position.
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A week later, upbeat again, he wrote that he was thinking of buying a car and that there were “good propects for a reconciliation” with Alicia.
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It is a discouraging but well-documented fact that people who suffer from schizophrenia face an extremely high risk of suicide, comparable to those who suffer from severe depressions and one hundred times that of the general population.
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This risk is greatest not when the person is sickest, but shortly after a course of treatment has been declared a success. Though no one else can truly know the state of mind that leads someone to take his life, one can imagine that this is a time when the absence of delusions allows other feelings, including very painful ones, to emerge and that hopes that one has been nurturing for months collide with harsh reality.

Louisa Cauvin, who married Jean-Pierre Cauvin in the summer of 1963, has a haunting memory, which likely dates from that summer, the only time she ever talked with Nash.
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They met at a party. (Presumably he was home from Carrier on a pass.) Nash told Louisa that he didn’t feel life was worth living and saw no reason why he should not do away with himself. There is no evidence to show that Nash ever came close to acting on this thought. But he was certainly depressed. His hope for a reconciliation with Alicia, for example, proved overly optimistic. Alicia insisted that Nash live apart from her and Johnny (as John Charles was now called), so, instead of moving back to Spruce Street, Nash found himself in a rented room at 142 Mercer Street, a few doors down from the house occupied by Einstein during his Princeton years.

Once again, Borel and Selberg had arranged a one-year membership at the Institute for Advanced Study, although this time they did so with less hope.
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The 1963–64 membership was probably a rescue mission. Borel later said, “All members are voted by the whole school of people. I did the legwork. It was only to present the case to my colleagues.”
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” Oppenheimer decided this time to use the Institute’s own funds, saying in a note to Selberg, “This enterprise seems to me not too suitable for contract funds,” implying that, in contrast to the previous 1961–62 appointment, this one was more clearly a charitable exercise.
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Meanwhile, Nash’s old friends outside Princeton had not lost interest in his progress. A letter from David Gale to Deane Montgomery at the Institute, with copies to Milnor and Morgenstern, gives a flavor of the level of interest in and concern about Nash’s situation:

We got onto the subject of John Nash and wondered what his present situation was, in particular with regard to his state of his mind. It turned out that none of us knew what was going on medically nor did we know of any one else who knew. We had all heard rumors varying from “the doctors say there is no hope” to “he’s doing mathematics again.”

The thing that disturbed us was not our own lack of knowledge about Nash’s condition but the thought that perhaps everyone in the mathematical community was in the same position we were and that consequently Nash might not be getting the best possible medical attention. It is certainly true that the mathematical community has provided fellowships and jobs of various sorts for Nash whenever he has needed them. This is as much as we should be expected to do, provided some other competent, informed and adequately endowed person or persons are looking after the medical situation. Since Nash is now at the Institute, I thought you might be in a position to know whether such a person exists and to reassure us that everything that can be done is being taken care of. If it should turn out that for lack of money, for instance, Nash was not getting the care he ought to have, I’m confident that we could get together a friends of Nash group to see what could be done about it.
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To come out, to go through the motions of starting over, to see one’s old friends and colleagues again was not easy. Nash stayed out of sight at the Institute. Few of that year’s visitors recalled seeing him there. He complained in the fall of “feeling lonely.”
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He and Alicia still attended parties together, but she resisted any idea of their resuming their marriage. She was having difficulties at her job and found her son hard to handle. But when her mother took John Charles to El Salvador for several months that winter, she missed him terribly. Nash tried to be sympathetic, writing in March that “Alicia is seeing a psychiatrist. She is very depressed. She was crying.”
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Yet he also said that he was “learning new things” and then, in December, that Selberg was trying to arrange visiting positions for him either at MIT or Berkeley.
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He continued to hope for a reconciliation; he and Alicia continued to socialize as a couple. Nash seemed, as the fall unfolded, to be in far better shape than he had been during his previous interlude at the Institute. As he said in his Madrid lecture, he “had an idea which is referred to as Nash Blowing UP which I discussed with an eminent mathematician named Hironaka.”
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(Hironaka eventually wrote the conjecture up.)
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William Browder, who was also visiting at the Institute that year, recalled: “Nash was working on real algebraic varieties. Nobody else had been thinking about these problems.”
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During the winter, Milnor, by now chairman of the department, and his colleagues became greatly impressed by “some extremely interesting ideas [of Nash’s] in algebraic geometry.”
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The new work sparked a wave of optimism and renewed a desire to help Nash. There was a growing feeling, both at the institute and at the university, that Nash might well be able to resume his interrupted career.
Milnor decided to offer Nash a one-year post as research mathematician and lecturer. In April 1964, Milnor tentatively proposed that Nash teach one course the following fall and perhaps two in the spring.
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Milnor consulted Nash’s psychiatrist, Howard Mele, who confirmed on March 30 that Nash was seeing him regularly for psychotherapy, noting that this was the first time that Nash had agreed to seek outpatient treatment since the onset of his illness.
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Garber recalled: “[Mele] tried to keep him on medication. He also helped Nash initiate relationships with other people. In my experience, positive relationships plus medrcation does wonders. ’Someone likes me’: that’s an experience that’s almost impossible for a schizophrenic to have.”
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