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Butting Heads over 'A Beautiful Mind'

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March 15, 2002 -- Things are getting ugly in Hollywood over the facts behind the Oscar-nominated biopic A Beautiful Mind. Starring Russell Crowe and Jennifer Connelly, the movie tells the life story of John Nash, a mathematical genius who suffered from schizophrenia for much of his life but who in his later years received the Nobel Prize for work he'd done decades earlier.

Representatives of the movie's distributor, Dreamworks SKG, charge that someone is going to great pains to plant stories in the media about Nash's dark side. They say distributors of other movies nominated in the same Oscar categories as "A Beautiful Mind" are working behind the scenes to expose Nash as being anti-Semitic, among other things, in order to hurt the film's chances of winning awards.

No doubt, the on-screen version of Nash is a simplified and cleaned-up version of the actual Nash. And the medical accuracy of how the on-screen Nash gains some measure of control over his mental illness, some mental-health experts say, is similarly softened and simplified.

Drama Is Not Reality

"The portrayal of Nash in the film is realistic for someone who has a great deal of intelligence and insight, but unfortunately, most patients don't have that," says David Garver, MD, professor in the department of psychiatry and behavioral science at the University of Louisville in Kentucky and a spokesman for the American Psychiatric Association.

"Nash had both visual and auditory hallucinations, and these become what seem to him like real people, and that is exceptionally rare in schizophrenia, which usually involves only auditory hallucinations or voices telling them to do something or severely criticizing them," Garver says. "Then [Nash] realizes that one of the people, a little girl, never ages. He uses that insight -- what he sees as reality isn't real -- to control his symptoms."

Although Nash's intelligence sets him apart from others with the same illness, it's true that self-awareness can play a role in the treatment of schizophrenia.

"In very rough terms, you see that about a third of patients have a milder form of the disease, and in those patients their awareness that they have a disease can help them stay on medication," says Vishwajt L. Nimogaonkar, MD, a specialist in schizophrenia research at the University of Pittsburgh in Pennsylvania. "Another third have lapsing illness, meaning that for some of the time their symptoms are not under control. A final third will never understand what is happening."

The Side-Effect Problem

In the movie, after Nash is hospitalized for his illness, he receives insulin-shock therapy and begins taking one of the first-generation antipsychotic medications. The side effects of the drugs are too much for him, though, and before long, he stops taking the medication.

"What is true of Nash's side effects in the movie is true of nearly every schizophrenia patient, but some have far worse side effects than others," says Garver.

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