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How soloists who lose their way can recover: Some recommended movies and books

May 6, 2011
by H. Steven Moffic, MD
| Reprints

Over the last Christmas holiday on our annual family vacation, my wife and I found ourselves alone in our hotel room. The kids and grandkids were asleep. Usually, we don’t channel surf, but there wasn’t much else to do late on Christmas night, and we were too wound up to sleep.

Suddenly, a certain look grabbed my attention. It was one I had seen many, many times before: that fearful, penetrating stare of someone dressed in a bizarre style. Then an apparent flashback to a child looking a little like the adult, practicing over and over on his cello. Little social interaction. A brief vision of a car on fire. Real or imagined?

A pan then to a freeway underpass in downtown Los Angeles. An association in my mind started to make some sense of these images. This must be the African-American musician who developed a severe mental illness, whose story was captured by a Los Angeles Times reporter in a book and movie.

As the movie continued, my wife joined me. As the reporter struggled and spent more and more time trying to help this homeless man, each step forward seemed to lead to some sort of precipice. At one point, Nathaniel (later to be called Mr. Ayers) attacks the reporter. My wife felt the reporter had no business trying so hard to get him help. Given my interest in ethics, I wondered about the conflict of interests of this reporter getting so involved in the personal life of the subject of his story. In our field, such intense personal involvement often is considered ethically controversial and often, but not always, leads to problems.

These issues seemed to strike at the heart of the recovery movement. How much to try to persuade someone with mental illness to get the help you feel is needed, and how much to let one decide for themselves, even in such a dangerous, homeless situation like this?

Related questions and challenges had been raised in an earlier movie you may recall: Shine, from 1996. In that one, the pianist David Helfgott from Australia also had a psychotic break in music school and seemed to develop Schizophrenia. He was hospitalized for a long time, and, like Mr. Ayers, was also treated with ECT and antipsychotics. After release, he played piano at a restaurant, is seen by an astrologer named Gillian, and they fall in love and are married. He then was able to concertize again with mixed musical success.

Intrigued by these similarities, I vowed to read the book that was the basis of the movie, The Soloist: A Lost Dream, an Unlikely Friendship, and the Redemptive Power of Music, by the reported Steve Lopez (G.P. Putnam’s Sons, 2008). I read there that Mr. Lopez did get advice from administrators and psychiatrists. There was a failed attempt of one psychiatrist to pose as a friend of Mr. Lopez, only to be quickly sized up (as those with schizophrenia can be exquisitely sensitive to) and aggressively rejected by Mr. Ayers. Another psychiatrist, Mark Ragins, from the well-known and admired (but little replicated) Village Program in nearby Long Beach, acted as a kind of consultant to the reporter, emphasizing over and over the importance of the relationship in improving brain chemistry.

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H. Steven Moffic

H. Steven Moffic

H. Steven Moffic, M.D. retired from the clinical practice of psychiatry and his tenured...