University Seminar 101

Medications such as risperidone, olanzapine, clozapine, haloperidol, chlorpromazine, and fluphenazine are approved to treat the psychotic symptoms of this mental illness. These medications typically work by balancing out the chemicals found naturally in the brain, and must be taken continuously for the rest of the affected person’s life (pysweb.com). Even though there is no guarantee that the drugs will work, they are FDA approved to treat schizophrenia and the success rate is quite high. However, many people with this mental illness refuse to take medications for one reason or another. As with Ayers in The Soloist, schizophrenics can experience paranoia, which causes them to mistrust other people and their motives. Some have had bad experiences in the past with doctors or institutions, and that may affect their willingness to try a medication. Also, medications have side effects, and the side effects can be enough to make a schizophrenic person stop taking the medication (psyweb.com).
Antipsychotic drugs are only approved to treat the psychosis element of schizophrenia. However, people with this mental illness also experience social withdrawal and other social oddities that also greatly affect their ability to blend into society. Treatment for these issues is not always as easy as popping a pill. Programs include social skills training, which can help the individual learn commonly accepted behaviors and how to act around other members of society. Therapy may be suggested to help deal with depression and uncover some unfounded or unrealistic fears. Since many patients are unable to stay employed, assistance is offered in the form of supported employment. This can help the affected person retain a job for longer, which in turn augments their overall recovery (psyweb.com).

Music may not be the most obvious cure, however when a person is in need of their spirits being lifted up, it is the first thing a person surrenders to. Music will not judge, it will not fade, and it will not leave their side. In time of need children, adults, and elderly individuals need something to resort to. Music is their cure. They are able to use the power of expression, whether they are making it, singing it, or listening to it. It may not take away their physical pain, but it can take away their mental pain. It allows them to fall into their own thoughts, where no one but them is able to hear it. It has no need for explanations, and no need for questions. It will undoubtedly lift people’s spirits in times of need. Music has a release where people can be free to express themselves.
Expression and music plays hand in hand to each other. A person may have an illness, where they cannot hear, speak, or even see. Their personal expression is challenged, as they may struggle with their weaknesses. Music can allow them to show, feel, and imagine the things they aspire to. They may even be able to use their talents like Nathanial played his instruments, to share the gift that they are passionate about. Music is another language that all people can understand. It is a common line of all people no matter what genre or style is preferred. Music is the past and it can help refresh the memories that were once and may still be cherished.

The definition of homeless differs with each individual. Some people, such as Nathaniel, prefer to sleep on the streets due to paranoia and the anxiety of having neighbors, or to have social contact. Even by having the availability of free housing, such as hostels and many organizations that take in the homeless, people will still prefer to be homeless without proper healthcare because of their extreme mistrust of people. According to the article “Access to primary care services for homeless mentally ill people,:(art & science: healthcare policy) by Madeleine Woollcott, “Many receive help from voluntary services but some–the ‘hidden homeless’–do not request help or contact such services. Little is known about these people and it is difficult to estimate their number reliably” (Warnes et al 2003, Office of the Deputy Prime Minister (ODPM) 2005). There is no way people can be forced into being helped. The only way they can be reached is through gaining their trust.

Not everyone is in the same boat; the management of healthcare is divided on the opinion of saving money verses saving lives. According to the article “Failure in community care: psychiatry’s dilemma,” By Jeremy Coid, “As a former psychiatric social worker, Mrs Bottomley understands many of the shortcomings of community psychiatric treatment and hinted that she was considering new legislation to ensure that patients could receive treatment in the community. But when an opportunity arose at a meeting of the parliamentary health committee to consider community supervision orders the civil liberties lobby prevailed over the Royal College of Psychiatrists and the final recommendation was against new legislation.” The unacknowledged problem reveals a lack of informing, and a selfish voice behind the healthcare system.

The NSF for Mental Health breaks down the individual models of treatment and care systems to improve the equality of patients. Anybody who contacts their healthcare provider with a common mental illness should with no questions asked, be properly assessed, and “be offered effective treatments, including referral to specialist services for further assessment, treatment and care if they require it” (Woollcott). They also receive round-the-clock service, and have access to NHS Direct, which is first-level advice and reference to specialist help lines and local services.

What the healthcare system needs to ensure for homeless people in the future is proper care and professional assessment of their illnesses, increase the availability of resources and access to healthcare centers, and improve specialist teams for homeless people so that mental health nurses and other health professionals can give round-the-clock local service to the homeless people. The needs for these people are great, and the service in the past has been beyond poor. The first step is realizing the problem and creating ways to solving it.

from the essay Learning To Accept a Better Life- Tommy Carr

Lopez emphases in the book that it is essential for doctors to treat each individual person, and not just the disease, in order to truly help people with schizophrenia. Lopez was determined to help Nathaniel from the beginning, however it took Lopez weeks to truly connect with him, but once the connection was there, it couldn’t be broken. Throughout their journey Lopez discovered that Nathaniel was suffering from schizophrenia, a disease that doctors still don’t know much about. Schizophrenia is a very complicated brain disorder that affects one percent of Americans. An astounding 25 percent of the homeless population suffers from mental illnesses, ranging from depression, bipolar disorder, to schizophrenia and personality disorders. People with untreated mental illnesses stand for 150,000 to 200,000 people of the estimated 744,000 homeless populations around America (Fact sheet). People who suffer from schizophrenia often hear voices, may think other people are reading their minds or controlling their thoughts, as well as perceiving people are planning to hurt them. These symptoms can be extremely scary and often lead to fearfulness, withdrawal, or extreme agitation. People with schizophrenia often don’t make sense when talk, much like Nathaniel, “A car whooshes by and his mind reels. ‘Blue car, green car, white car,’ he says. ‘There goes a police car, and god is on the other side of that wall,” (Lopez 6). There is little known about what causes schizophrenia, but it is thought to be genetic, and researchers are still trying to learn more about the disorder. Since not much is known about the disease, there are only treatments to try to relieve symptoms, but not to cure the disease. Most people with schizophrenia have to cope with long lasting symptoms throughout their lives. Other symptoms of schizophrenia are hallucinations, delusions, and trouble with movement, resulting in clumsiness and coordination problems, (Fact Sheet). But at times they may seem relatively fine, “A half hour earlier I was with a madman. Now I’m with my own personal professor of music appreciation,” (Lopez 112).

Advances in science and medicine have lead to a greater reliance medications to solve problems. In the novel The Soloist by Steve Lopez, Steve meets a homeless man with schizophrenia. Throughout the story Steve tries to find the best way to deal with Nathaniel’s schizophrenia. In the beginning he is solely set on getting him on medications and in therapy. Like many he believe that the magic of drugs to “cure”, disregarding the needs of the individual case. It is sometimes hard when someone is struggling to remember that there is not always a cure but there is always help. In clinics across the world music and art are being used as therapies for those with mental illnesses. In The Soloist Nathaniel has found his own therapy through music, yet all through out his life medications have threatened his love. As illustrated through The Soloist music and friendship can do more to help someone than medication.
When Steve interviews Nathaniel’s last roommate, Eugene Moye, the reader gets a look into the effects of music on quieting his mind. Looking through Moye’s eye he saw how “He went nighty miles an hour all the time, filling the walls the he filled time and space, ranting, raging and rapping about the great injustice done to the black man. “It wasn’t silly anger. It was a sort of informed anger and he was very adamant and very intelligent.” The only time Nathaniel calmed down was when he played music. (Lopez 247) This shows how” even in his most manic state, Nathaniel has music to manage his illness and quite his rants.

Some may say that the extraordinarily artistic may be a bit eccentric or might be crazy but some may also say that it takes a unique mind to be able to create the beautiful things in which the arts has to offer, “Plato said that creativity is a “divine madness…a gift from the
gods.” and “Senicca recorded Aristotle as having said, “No great genius was without a mixture of insanity.” (Neihart)
Maybe all of us are on the verge of madness and some succumb to it much easier than others. It seems that Lopez had enough creativity that upon meeting Nathaniel instantly knew that he was a wonderfully gifted individual. He did not allow the fact of knowing Nathanial had a mental illness, to sway his decision to persue a relationship with him.In The Soloist Lopez says, “Nathaniel, I say to him on afternoon near the tunnel at Second and Hill, “I think I might come spend the night with you one of these evenings.” “This gets his attention. He looks at me like I’m the crazy one. “Why would you do that?” “Why not? I’d just
like to see where you stay and what it’s like out there.” (Lopez 60)
The Soloist is a thought provoking look at the life of the homeless, the mentally ill and the mind of a gifted artist; Lopez enmeshed himself in Nathanial’s life, a world of mental illness and pain, homelessness and shame. Yet he continued to be there for this man who started out as a story for his column and became a life long friend. Henry Carrigan with Publishers Weekly, in the interview Lopez and was asked, “What lessons has Nathaniel taught you?” Lopez responds with, “He took an impatient man and taught him patience. He helped me appreciate, and feel inspired by music I knew nothing about. His passion for his mission rekindled my passion for my own. My life is much busier now, richer, more challenging,
more rewarding. And I picked up a guitar I had long ago abandoned.”
It is a remarkable thing the human mind, one that holds a vast amount of artistic creativity and madness. That music can be used to calm the demon inside is an extraordinary thing. One could only imagine the struggles that are undertaken when dealing with someone who is suffering with a mental illness, but hopefully those who will read Nathaniel’s
story will have a renewed faith in life itself. That there is hope and with that hope there is life.

In The Soloist, Lopez did not clearly state that the key to having a relationship with Nathaniel was patience. He did not say that the reason Nathaniel reached so far was because of the patience he had with him day after day, month after month from the first day they met. Yes, Lopez does know patience is important, but he also believes that lying to Nathaniel is acceptable. “Patience is no doubt a wonderful virtue, but mendacity has its advantages as well” (Soloist 141). Lopez does not even have the respect to say lying, instead he has to use a synonym. If Lopez was writing this in hope that others would follow his footprints he should have exaggerated the importance of not pushing an individual, and taking the amount of time the individual needs.
Family Links is a social service agency that also runs a homeless shelter. Through their years of experience they found that “patience and a very carefully measured amount of tolerance are our greatest assets” (Behavioral Healthcare). Treating or helping schizophrenics or other mentally ill individuals requires patience because rarely will they acknowledge they have a problem. If someone does not think they need the help then it will require more time and constant care with them. Being empathetic towards the ill will allow for a greater trust which is very necessary and hard to earn.
Ms. Marie Day has a close family member who is diagnosed with schizophrenia. Through her time with this family member she has found that “misinformed people assume that medications are all that schizophrenics need. ‘There has to also be support, understanding and patience,’ Ms. Day says. ‘And there has to be a willingness to answer the phone 20 times a day, if need be’ (Globe Life). It is important to stay connected with these people because they need the security of having someone there to support them and to be there for them. You cannot take a day off from these people and “you cannot feel shame for these people. It is essential to accept them on their own terms” (Globe Life). Of course every case has some differences, but they all have one thing in common and that is patience will always be necessary.

Nathanial had dealt with this disease for most of his life if not all of it. Schizophrenia is a chronic, severe, and disabling brain disease. Approximately 1 % of the population develops schizophrenia during their lifetime (Schizophrenia). Like in the book Nathanial had showed the signs of this illness time and time again. From paranoia, hearing voices, feeling someone is going to harm them he showed all these signs. The thing is Steve really had no idea what he was doing was helping him. Nathanial eventually had gotten better but with some down falls along the way. The main way to treat schizophrenia is to medicate it with antipsychotic drugs (Schizophrenia). But Nathanial would have nothing to do with that kind of treatment due to his past. So keeping in mind that Steve hadn’t used any drugs to aid him it is remarkable that he made the difference that he did, also with the help of different case workers and musical influences. Steve figured out after a while that the best way to help him was to do so through music. Music was the one thing that helped Nathanial through his life and made him push for recovery.

“Schizophrenia is a chronic, severe, and disabling brain disorder that affects about 1.1 percent of the U.S. population, age 18 and older in a given year. People with schizophrenia sometimes hear voices others don’t hear, believe that others are broadcasting their thoughts to the world, or become convinced that others are plotting to harm them. These experiences can make them fearful and withdrawn and cause difficulties when they try to have relationships with others. (NIMH)”
Nathaniel has trouble interacting with others and his environment, who is to say whether Mr. Lopez is doing the right thing trying to help him? Nathaniel fits this description one hundred percent and Depending on how bad the mental condition is, I believe that it is a good idea for someone to take and help guide a person in need to a better value in life. Especially since Mr. Lopez has his heart in the right place. Mr. Lopez never really pushes Nathaniel physically into doing anything he doesn’t want to do. He sets events up that Nathaniel would like to do, such as music oriented events, and makes it feel so Nathaniel belonged to part of the community. Slowly but surely after almost two years of guidance, Lopez helped Nathaniel find his way and Nathaniel thanked him for it. It helped him get out of his sense of solitude that had engulfed his mental world. Mr. Lopez showed him a world of opportunities and that Nathaniel can be a part of a great experience. If Mr. Lopez would have pushed Nathaniel out of his comfort zones to fast everything would have been a disaster for Nathaniel.

There is a time in the book when Lopez starts to lose his fight, and is beginning to give up hope for Nathaniel, and he begins to contemplate the idea of forcing him into treatment. The reason he thinks this would be a good idea is that Nathaniel doesn’t want any help, but Lopez thinks it would be good for him. This is not the way to go about helping the homeless. They should only get the help they want. There are a couple of reasons that the homeless shouldn’t get help if they don’t want it. First off, there is no need to waste more of the U.S. taxpayer’s dollars on people who are not going to be appreciative of it. If they don’t want the help, don’t waste the money. With the nation being more than Ten Trillion dollars in debt, what is the point of giving money to people who don’t want it? There isn’t any.
The second reason we shouldn’t help the homeless who don’t want it, is that it is immoral. If we are taking someone from where they are happy, and want to be. And if we are then forcing them to do something they don’t want to, and in turn making them unhappy, that is wrong. Why do we have the right to in essence be taking someone’s happiness? If the person isn’t causing any trouble, and isn’t going around making scenes, and threatening people, why should we force them into treatment? Along with this, it is also wrong to in turn bribe, or trick them into treatment. If they don’t willingly, without incentive go get help, then I don’t believe that they want any treatment. This means that tricking or bribing them is not right because it isn’t what makes them happy. Many people may argue that, if they have some sort of mental illness, they may not know what’s best for them, or what makes them truly happy. This is a very true argument however, if these homeless people are getting by, and don’t have much to complain about, who says they aren’t happy? It seems to me that they know what’s going to make them happy more than someone else.

Mental hospitals have not always used humane forms of treatment. Until the late 80’s many patients were subjected to torture or “treatment.” Psychiatric ward patients would experience, “…seclusion (isolation), most often without clothing; restraints (being strapped to a bed with leather restraints, often in a spread-eagle position); forced “medications” (powerful psychoactive drugs); forced labor (called “industrial therapy” or some other term), and, sometimes, electroshock. (Unzicker)” It’s amazing that all this was all done with the intention of trying to diminish the mental illness. Patients who experienced these forms of cruel treatment became fearful with receiving help. A good example of a former patient who became extremely paranoid of medical treatment is Nathaniel Ayers. In Nathaniel’s early years of being diagnosed mentally ill he was forcefully taken off to mental hospitals. “Anybody who has been through what Nathaniel has been trough with handcuffs and shock therapy and Thorazine does not want to hear about meds.” (“Rewarding Mr. Ayers’ courage”) Many older people who suffer psychological diseases lost faith in medical treatment twenty years ago due to the atrocious treatment they received at mental hospitals.
Physical treatments, such as lobotomy and electroconvulsive therapy, were also very grueling ways to treat mental illness. A lobotomy is a neurosurgical procedure that cuts the connection between the prefrontal cortex and the rest of the brain. The doctors would drive a small ice pick through the patient’s eye socket and chip away at their frontal lobe. This caused the psychological disorder to disappear but it made the patient completely emotionless. Swiss psychiatrist Gottlieb Burckhardt first preformed the lobotomy in 1890 and the procedure became popular here in America in 1939. Electroconvulsive therapy or shock therapy, the treatment Nathaniel received, creates seizures by sending electrical currents through the brain. This treatment seems to cause changes in brain chemistry that can improve symptoms of mental illness. In the early years of shock therapy high voltages of electricity were used without an anesthesia, which caused extreme memory loss and sometimes even death. Nathaniel was so terrorized by this treatment that it made him loose all trust in doctors. “Dr. Prchal’s first attempt to “seduce” him into treatment… Nathaniel tells her to go away. Anyone whose name begins with “doctor” is no one he cares to see. (Lopez 96)” Many patients received these treatments without any consent. Most mentally ill who were forced into physical treatment lost trust in modern medicine.

Nathaniel believes that he does not have a mental disorder and is capable of caring for himself. In reality, his mental illness prevents him from being able to think rationally and listen to reason. For example, time and time again Lopez tries to get Nathaniel to move into an apartment at the Lamp. Nathaniel refuses saying, “Every criminal in Los Angeles will be coming through that door right there and they will steal everything I’ve got. That’s how the drug addict operates. He will steal and steal and steal to support his habit, and now I am not going to be in here with all my things so they can just come in here and take whatever they want.” (Lopez, 168) He believes he is safer out on the streets than in an apartment. However, if he moved into an apartment he would be safe from the random bum attacks that are rampant in the L.A. area and have a place to keep all the instruments he now owns. It makes no sense for a person to believe that thousands of dollars worth of musical instruments are safer out on the streets rather in an apartment. That is the problem with Nathaniel. His thinking is distorted and he refuses to listen to reason. He doesn’t understand that living in one of the Lamp apartments would allow him to practice his music with no distractions and also provide him with opportunities to take lessons. Lopez has opened the door of opportunity for Nathaniel, but he is not always willing to walk through the door.

“One of the most interesting recent findings is that music with a strong beat stimulates our brainwaves to resonate in time with the beat….Slow classical pieces of music slow our brainwaves from ‘alpha’ to ‘beta’ levels thus inducing the same mental state as a deep meditation.” (Gear) Is this what Nathaniel is doing? He loves to play Classical Music and according to this statement here it’s quite possible that when he does this he is bringing his brain back into a calm center away from the chaos that is schizophrenia. If we think about the text, there is an area when Nathaniel begins to learn how to play a trumpet. Continually throughout this section he experiences fits of rage and seems to be more confrontational towards everyone. He even yells at Steve “I DON’T EVER WANT TO SEE YOUR FACE AGAIN OR IT WILL BE THE END OF YOU!” (Lopez p.260) This is not normal to the Nathaniel we have been reading about. His fits are usually restrained to smokers. Never has he been so violent towards others. To take this point a step further, one should take a look into the past. When Nathaniel spent his years at Juilliard one of his roommates was a man named Eugene Moye. Moye had the unfortunate experience of rooming with Nathaniel after he had his break down. Moye recalls that Nathaniel would rant, and rap about the great injustice done to the black man. He would draw on the walls filling them with murals and caricatures of classmates and teachers or whatever was running through his head at the time. “The only time Nathaniel calmed down was when he played music…. But there was more talking than playing.”(Lopez, p.246-247) Moye soon moved out. Nathaniel needs to play. He is calmed. Music is the drug for him. Music brings his brain back to a state of organization.

Although medication may seem like the best approach in some cases, the patient should always be treated with careful consideration to the medication being prescribed. In one case study examining the attitudes of people in the medical profession towards mentally ill people it was discovered that people hold stereotypes that are damaging to the patients’ recovery process. It found that “believing that people with schizophrenia are difficult to talk to, and people with schizophrenia have themselves to blame were predictive of high social distance.” (Volmer) This means that certain stereotypes are held among people in the medical profession who have been isolated socially. People often do not understand the mentally ill and therefore a stereotype is formed, claiming these disabled people put themselves in the situation. In one study, demonstrating the benefits of interpersonal relationships among schizophrenics, a group treatment method examined. It says the treatment groups “serve more general rehabilitative purposes if leaders apply principles of group leadership which recognize the neurological substrate of schizophrenia and which take into account the specific interpersonal characteristics and needs of individuals who have the illness.” (Wilson) This is best exemplified in the book when Nathaniel begins to go to Lamp and integrate himself back into society. When he begins interacting with other schizophrenics, like Carol and James, he has breakthroughs. He talks to Carol, a fellow patient at Lamp, and discusses the importance of music in his life and is generally overjoyed he has a fan and a friend. In the case of James, the man challenges Nathaniel’s ability to function and his sense of pride is restored claiming he has a place to live and becoming proud of his achievements. The Lamp community is an example of the correct way to treat patients and because it does not force them to be subdued by medications, it is Nathaniel and many other patients’ only chance at success.

I do not think we should just give up on the homeless if they do not want help. I mean look at Nathaniel, he did not want help at first. Yes, it may seem like the homeless do not care at times and some of them don’t but we cannot treat all of them the same way. Each of them is different and they learn differently. This brings me to the fact that we should not just give up on the homeless. They may cost us some money but won’t they just cost us more if we don’t help them. There are some cases where the homeless person may just want to stay homeless just because they have tried the other route and were not satisfied, but there are cases where the individual does not know any better and just is stubborn and will deny help. Does that mean we listen and let them suffer more? No we need to give them a tough love kind of help. Just because someone wants something does not mean we always give it to them. We give them it if we think it is the best in their interest.

Homeless people need to be given options. For example, Nathaniel was never severely forced into things. He was given opportunities and was allowed to choose what he wanted. Sometimes things were pushed a little harder than usual but Steve Lopez backed off once he realized that. Nathaniel’s case was a little simpler, in a way, because he had a passion for music and Lopez was able to bribe him. I think bribing is good in some ways. Yes it may be immmoral at times but not all is bad. Take for example, bribing a child to do chores. There is no harm done. All we need to do for the homeless is enlighten them; give them options and opportunities before we just give up on them. Also we cannot judge if one is happy or not, because a feeling of happiness can vary from person to person. It is possible that the homeless do not realize what else is out there so they feel they are happy. If we are able to show them another way maybe they will change their minds about life. We need to give them a chance to experience both worlds.

Also, I do understand that everyone is the judge of their happiness but don’t you become more and less happy when you experience new things. Meaning we base our happiness off of our experiences in life. To me it is all part of the learning process. We have to find good things in life that we like, but if we do not try them we will never know. The homeless have to be given options to try. Then they can decide and rule out things after that. If they discover they wish to stay homeless then that is fine, if they are not causing problems.

@kruiz.siewing
It did seem as though Lopez truly wanted Nathaniel to experience a better life, and yet, Lopez seemed to forget that Nathaniel was fully aware of the life on the other side of the fence. When a person sees someone sleeping on the street and chasing rats away with a broken drumstick, it’s easy to believe that they never experienced sleeping in a 4 bedroom, 2 bath house with a 3 car garage. It’s easy to believe that they have never been exposed to art and culture, have never driven in a car, don’t know what the food in a 4 star restaurant tastes like. We instantly ascribe upon them the history and knowledge of a child.

The truth was, Nathaniel grew up in a fairly normal household. He went to schools just like the rest of us, until Juilliard, which was well beyond the abilities of most of us. He went to movies, hung out with friends, and did all of the things that we believe make up a normal life.

At one point in the story, Lopez was driving Nathaniel through the manicured lawns of the Los Angeles suburbs on the way to Lopez’ home. Lopez wrote that he wondered what Nathaniel thought of this world. That passage struck me as incredibly arrogant and condescending toward Nathaniel’s background and history. Just because you see someone sleeping on the street does not make them an animal. Chances are, they have lived a much fuller life already than we can imagine.

I think that the only real thing of any value that Lopez gave to Nathaniel was friendship. I think that’s why he became livid when he believed that respect and friendship had been false [when he thought Lopez was trying to commit him into an institution].

When I lived in Seattle, there was a homeless man that was once a brain surgeon. I can only imagine what little credit he now receives for having experienced the usual trappings of a “normal” life. Anyone that sees him sleeping curled up in a doorway could never picture him heading out for a round of golf after a tough day in the operating room.

So, while I agree with you that the homeless should be given options to “try the good things in life”, it’s also important to remember that many of them have already done so and, for one reason or another, have rejected those things in favor of something else. Maybe temporarily, maybe permanently, but certainly, of their own free will.

In Steve Lopez’s “The Soloist,” Nathaniel Ayers is a schizophrenic homeless man, and LOpez becomes his friend by trying to help him deal with his mental illness. Ayers is one of those people who does not trust medications or hospitals at all because of terrifying experiences he had when first diagnosed with his disease. Throughout the course of the book, Lopez makes every effort to get Ayers off the streets and into a safe living environment, with limited success. Afer working with him for over a year, little progress was made, and Ayers was still living on the streets. If Ayers had been persuaded to give mediation another try, he would probably have been further along in his recovery process. Millions of Americans take antipsychotic drugs, and many of them report that the medications give significant relief from their symptoms, enough to function in America’s society (Quigley). As the ulitmate goal in “The Soloist” was to rehabilitate Ayers to the point where he could hold down a job and live in his own place, medication seems to be the best form of treatment possible.
Another consideration in the treatment of schizophrenia is the fact that a common symptom of the disease is hostility or even aggression towards caregivers (Post). These people can potentially harm those taking care of them, their own family, and even strangers on the street, as in “The Soloist.” It is important to control these dangerous characteristics, to keep everyone involved safe. Antipsychotis medications “greatly reduce patient’s hostility and aggressive behavior, which can pose a risk to caregivers or patient’s families,” (Post). It is vitally important to protect the people working with the mentall ill, both for their own safety and so they can continue working in this remarkable field.

Mr. Lopez starts off by doing the right thing. He befriends Nathaniel, visits him and is just there for him. But when Mr. Lopez starts feeling the need to lie to Nathaniel to help him that is where the question of right and wrong comes into play. Is it right for Mr. Lopez to lie to Nathaniel hoping that it will be better for him in the long run? No it is not. People that suffer from Paranoid Schizophrenia already have a problem with trusting people. Trust takes a very long time to build; Nathaniel finally put trust into Mr. Lopez so it is not worth it for him to lie to Nathaniel and possibly ruin a very good relationship. Mr. Lopez may have the best of intention when it comes to Nathaniel but lying to him is not the right way to go about fulfilling the hopes and dreams that Mr. Lopez has for him. Even the best of intentions can cause pain and heartache and losing a wonderful friendship is not worth it. Nathaniel needs to come around to the idea of living in an apartment in his own time, when he’s good and ready. After about a year and a half of trying Nathaniel still decides he is not ready and Mr. Lopez needs to respect his decision and take comfort in the fact in knowing that he tried his best. If Nathaniel ever changed his mind and decided that he did want help then he knows that he can always count on Mr. Lopez to be there for him but only if Mr. Lopez does not destroy their relationship by lying to Nathaniel.
Music is what keeps Nathaniel sane; it is the only thing in his life that makes sense to him. Disney Hall, the tunnel where Nathaniel plays his music is his sanctuary. It is where he feels comfortable. “Clearly music makes him happy, and how many musicians in the world have as much time to play as he does, entirely free of expectation? For him, it isn’t work. Sure, he gets down on himself occasionally, frustrated by his limitations. But he doesn’t have to worry about training for an audition, like he did when he was younger, and he doesn’t need to earn a living at it. For Nathaniel, music is freedom.” (The Soloist, 2008) pg. 137.
A young man named Joe Harper that lives with Paranoid Schizophrenia started to like being secluded from everything because he was then not a danger to himself anymore. He had no say in anything, then he found something that worked even better. “I have been sectioned many times and the experience does not seem to bother me anymore. I know the drill. For four or five years I was in hospital about 90 per cent of the time. The wards were, and probably always will be, my second home. It did not matter whether I was in a secure unit or an open ward; I got to like it because I was safe from myself. I forgot that all my rights had been taken away.” (Back in Control, 2007). When Joe Harper was sectioned, he was trapped he could not do things he wanted to do, he could not even go to the bathroom by himself unless the nurses told him that it was okay to do so. He was constantly being watched over and always being told what to do. This is much like Mr. Lopez and Nathaniel’s relationship. Mr. Lopez is always telling Nathaniel what he should do and is consistently pushing Nathaniel to go live in an apartment that would be much like being sectioned just like Joe Harper. People would always be watching over Nathaniel if he lived in one of those apartments unlike the streets where he does not have to answer to anybody but himself. Joe Harper states, “But if a nurse gets too involved then they come into the illness. Sometimes when a nurse has asked me too many questions, I have thought: ‘Oh no–they are involved with the people who are out to get me.’ It is about getting the balance right.” (Back in Control, 2007). Another comparison between Joe Harper’s story and the relationship of Mr. Lopez and Nathaniel, Mr. Lopez is now getting too involved in the situation by lying to Nathaniel and trying to get him to do something that he does not want to do. I agree that it is good to help somebody but you have to know when to stop just like Joe Harper says it is about finding the right balance. Then a life changing experience happened for Mr. Harper. “The turning point was six years ago when a good doctor, who was part of a community assertive Outreach team, took me on. I have a great relationship with the team’s community psychiatric nurses. Now if I have a problem one of them is with me within a couple of hours. Before, I would just have ended up being sectioned. The team keeps me well. I have been well now for two years. I live independently and I work a day or two a month giving talks to health professionals about my experiences. I am off illegal drugs and am taking my medication. It is brilliant- for the first time in years I have clarity. (Back in Control, 2007). What works to help Joe Harper’s Paranoid Schizophrenia is the same thing that will help Nathaniel’s Paranoid Schizophrenia and that is just simply having someone there that he knows he can rely on. To know that no matter what the situation he can just give Mr. Lopez a call and know he will be there for him in a matter of a few minutes.

Lopez had a mission when he was writing this book because the message he was delivering was very specific. Homelessness among the mentally ill is a very controversial subject. Many say that it is embarrassing to our great nation because we cannot pick these people up onto their feet when they obviously cannot help themselves. Nathaniel’s story delivers this message very passionately because it is vividly described in the book that he has a serious problem and he cannot help himself. It’s pretty apparent that Lopez wrote this story for the purpose of exposing the homelessness problem among the mentally ill. Lopez saw this problem first hand. Skid Row is said to be the home of nearly “10,000 homeless persons on any given night” (Chideya 1). With this terrible sight only five blocks from his house, you can’t help but realize that this problem needs to be fixed.
Lopez went to great ends to help Nathaniel with his mental illness. One of the doctors that showed much inspiration for Lopez was doctor Mark Ragins. Ragins stressed that Nathaniel had to help himself out by walking through the door that everyone was holding open for him. Lopez and all of the specialists could only guide Nathaniel to the door that symbolized his recovery. Lopez didn’t always describe the recovery of Nathaniel in great detail. Lopez tended to focus more on Nathaniel’s mood swings and special opportunities rather than discussing how Nathaniel could be helped. It would have been nice to see more statistical values that related to mental illness and homelessness. At the end of the book it had been two years of painstaking recovery for Nathaniel. It would have been helpful if Lopez had backed this portion of the book that demonstrated average recovery time of the mentally ill homeless. As described in the book, Los Angeles’ Skid Row was one of the worst homeless problems in America. Lopez should have explored why this problem was so high in Los Angeles and how it got to be so bad.

In The Soloist, journalist Steve Lopez discovers a schizophrenic homeless man, Nathaniel Ayers, who is playing Beethoven’s Eighth on a two stringed violin. Although Lopez knows little about music, he is determined to challenge Nathaniel’s comfort zone to get him off the streets, and in the process, creates an uplifting friendship for both of them.
Nathaniel’s paranoid schizophrenia had been developing for years, possibly stemming from racial barriers in the professional music world, which began at Julliard, a very selective music school. Nathaniel’s first roommate, half-African American Eugene Moye, believed he was crazy because of the drawings he inscribed all over the walls of the apartment, creating “a mad tapestry of race-tinged, twenty-year-old angst.” The real comfort in Nathaniel’s life was his music, basically a self-applied music therapy to subdue his inner turmoil.
Lopez had not listened to classical music until he met Nathaniel, and without ever playing a musical instrument in a group, he could not have understood the full physical and mental value of the compositions. That is one of the sources of problems in their relationship. When Lopez coaxes Nathaniel out of his tunnel into a homeless shelter called the Lamp program by storing his instruments there, it’s almost as if Lopez is parenting him, which met with a fair amount of resistance. The music serves as Nathaniel’s stress relief by putting him into a mental concentration that blocks out all distractions and absorbs him into the mood of the music rather than the stressors of life. By holding his instruments at Lamp, Lopez is holding back his musical drugs and forcing him to get treatment.
The story reflects moods that developed in the music Nathaniel played, helping him cope with his mental illness. The power of music, and the deep commitment that Lopez instilled into his relationship with Nathaniel, allowed both of them to take away a powerful life-changing experience.

@sarah.daniels3
One of the big points in “The Soloist” is that it is not the diagnosis that is important, it is the help and the stability that is needed for the homeless with mental disabilities. Lopez covered this a lot in his book. Most of the people who worked with the homeless with mental illnesses kept saying that Lopez really needs to look past the diagnosis and work on getting Nathaniel help and other things that he needed. It was never disclosed that Nathaniel has schizophrenia, but it was assumed and used to explain some habits of Nathaniel’s by Lopez, who is not a doctor and has no more knowledge than the common person about mental illnesses. The examples given by Lopez that support the theory that Nathaniel is schizophrenic could be from a number of other things and really does not prove that Nathaniel has it, plus people have a tendency to see what they want to see. In this case Lopez wants to see a diagnosable problem that can be fixed by medications.

@michael.thayer
Michael,
I found your blog very intriguing, and fascinating. It is interesting that a “strong beat stimulates our brainwaves to resonate in time with the beat,” especially the small part on classical music. If you could exaggerate on that your piece would a very strong claim and arguing point. While reading your entry a few questions arose: Is music the only ‘medication’ that schizophrenics such as Nathaniel need? What do other schizophrenics need if they do not play an instrument? Is music a temporary cure for schizophrenics like Nathaniel? Is it reasonable for Nathaniel to be out on the streets with an expensive instrument?
Music cannot be the only medication that schizophrenics need. They do not necessarily need drugs, but on the road to recovery they will need empowerment, hope, knowledge and satisfaction, according to the National Alliance for the Mentally Ill. Empowerment helps an individual reach a goal and promotes self-esteem. For Nathaniel and other schizophrenics who find their calling in music, playing their instrument could empower them. The next step, Hope, is found through being surrounded by family members and friends. A musical instrument cannot give you hope. The Knowledge on all the available treatments is necessary if the individual wants to make a complete recovery. Finally, Satisfaction in their life, family, living arrangements, and social networks. Music could satisfy some aspects of an individual’s life, but not the entire aspect of life.
Music is a temporary cure for schizophrenics such as Nathaniel. This is because it is not 100% guaranteed that music will always be there. There instrument might break or get stolen, they might attain arthritis from playing so much, the individual may lose interest in playing. The possibilities are endless so it is important to not put all the confidence that music is the one and only cure for those in need. It might work for a while, or for a long time, but one cannot promise that it will always be there. What will always be is trust, guidance, therapy and friendship and support.
In Nathaniel’s case where he is constantly on the streets it is not safe for him to have multiple instruments that cost thousands of dollars. Many of the sane homeless are financially unable to live on their own, many of them would not think twice about stealing from a schizophrenic. They would do anything to have the opportunity to pawn the instruments, no matter the consequences or what they might have to do to Nathaniel. It is okay for Nathaniel to play these instruments on the street, but to have all of them at once is a different story.
It is very important for schizophrenics (homeless or not) to have something such as music they can participate in. Along with the music they must be able to get along with others and know what is right from what is wrong. To know this the individuals must go through other process for their disease (not necessarily drugs) at their own pace in time.

@sarah.ralls
Sarah,
I find the idea of using music as a so called “cure” to mental illnesses, an absolutely fascinating one. Since the beginning of time people have been making music in one way or another. Whether it was for fun, to escape, or just something that killed time, people all around the world were doing it. I believe that the very basis for music is to be a partial cure from whatever is bothering you. At any given time when you hear music it sparks feelings in you. They may be bad, they may be good, or they may not have a lean towards good or bad, but one thing is for certain, everyone has some type of music that they listen to and it just takes them away. No matter the circumstances the music takes them where they want to be, it allows them to live dreams, and express feelings, and it never lets them down. One can argue that this is why Nathaniel, a main character in The Soloist, plays his instruments. This is the reason that it is possible for music to be a so called “cure” if only for a moment’s time. Music is a powerful thing, that when used to its fullest potential can “cure” even the harshest illnesses.
It is stated on Dictionary.com that music therapy is “the treatment of disease (as mental illness) by means of music” (“Music Therapy”). This is a practice that is in use all over the world. It is thought to enhance one’s condition, and has been reported to have dramatic effects on patients of all kinds. MusicTherapy.org claims that music therapy can work on “Children, adolescents, adults, and the elderly with mental health needs, developmental and learning disabilities, Alzheimer’s disease and other aging related conditions, substance abuse problems, brain injuries, physical disabilities” (“Who Can”). With this in mind almost anyone can benefit from music therapy. With such a wide array of possible patients, music therapy may be one of the largest, most applicable treatments in the world. Many health professionals feel very strongly about the benefits of music therapy and think it should be used more often that it is. They believe the results are incredible, as stated on MusicTherapy.org such results as “Increased attention, Improved behavior, Decreased self-stimulation, Enhanced auditory processing, Improved cognitive functioning, Decreased agitation, Increased socialization, Improved receptive/expressive language, Successful and safe self-expression, Enhanced sensory-motor skills” (“Outcomes”). With results like these who can argue against music therapy. MusicTherapy.org goes so far as to claim the results are replicable. Only someone sure of their results claims this.
In the end, what will be will be, and the power of music will be. It has numerous reports of “healing powers” and many personal experiences to back it up. Everyone has experienced the power of music in one way or another and they all know inside how moving and powerful that experience was. In the future I would not be surprised to see music therapy become a common treatment for patients with mental illness.
Works Cited
“Music Therapy.” Dictionary.com. 2009. 4 Mar. 2009.
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“Outcomes.” MusicTherapy.org. 4 Mar. 2009.
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“Who Can Benefit from Music Therapy.” MusicTherapy.org. 4 Mar. 2009.
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@hannah.stroebe
I, could not agree any more with the view point that we should not give up on the mentally ill, as we in all actuality have mostly done. The mentally ill should be treated and monitored and acted on as if they were children who are not yet ready to make rational, responsible, and independent choices, because they simply are not and unfortunately may not ever be and that should be decided on by a certified professional, on a case by case basis. The relationship should simply be one that closely resembles the relationship between parent and child. In terms of allowing the “parent” to make all the important decisions for the “child” and have the same kind of legal parental authority and discretion to provide the best for any individual who it has been determined incompetent to make those decisions for themselves, as a result of mental illness. This plan of aggressive interaction and personal care would be placing the mentally ill in an environment that they may receive the treatment they need. In terms of medicine, counseling, and other programs to help them discover themselves outside of their debilitating sickness, which if left to their own devices they might not ever be free of this mental disease or make the choices necessary on their own. Therefore making it totally the responsible and societal accountable call to place these individuals under the care they need, with the right kind of certified caregivers/parental figures.
In terms of the environment that would be conducive to the mentally ill, the staff that would be sufficient to supervise and make the good decisions for these individuals, and a governing body to oversee and make policy, could be a bit of a challenge to institute initially, but is not that complicated to envision, especially if the right kind of motivated, intellectual, educated group of people, stepped up to the privilege and responsibility. The most suitable scenario to associate with, may be one that is already in use with varying degrees of effectiveness and popularity, but none the less a feasible option, with a proven and known track record, one that is in use with addicts, troubled kids, ex-convicts: this option being a halfway house or foster homes. The staff that are hired to work at these establishments have varying degrees of qualifications to collectively provide the best service possible, with the most reasonable budget. These homes would provide the mentally ill with the treatment, supervision, and interaction with the community that could eventually provide just the balance needed to get these folks contributing and living their lives in a more meaningful productive fashion, to whatever degree is possible based on their case by case situation.

@hannah.stroebe
I really like how you emphasize that we cannot give up on the homeless, even if they do not want our help. It seems like most people would give up just because a homeless person is not thrilled about receiving help, but the only way we can permanently fix the homeless problem, is by persevering and helping the people who need help. I completely agree with you that we cannot give up on the homeless population just because they don’t want help, but I also think there is a fine line between helping, and forcing people into doing something that they do not want to do. I do not think it is moral to force someone to do something, even if they are in the worst situation possible.
I think your argument would be stronger if you added the other side of the story. You mention that we cannot give up on people, even if they say no to help, but I think that there is a difference between not giving up on the person, and going too far. The only way someone will accept help is if they want it, if they don’t want help there is nothing we can do about it. I think the situation that Lopez discusses in terms of Nathaniel, is different. Lopez does not force anything on Nathaniel, he advises and provides options, but everything that Nathaniel does is Nathaniel’s doing, not Lopez’s. I like how you mention that we should give them options, but I think you could go into more detail of what those options might be and how to make those things happen. I think it’s a hard situation when it comes to mentally ill homeless people, but you do not specifically mention a type of homelessness, and if you did, that would make your argument stronger. Looking at different perspectives is always a good way to strengthen your argument. “There are some cases where the homeless person may just want to stay homeless just because they have tried the other route and were not satisfied, but there are cases where the individual does not know any better and just is stubborn and will deny help. Does that mean we listen and let them suffer more?” (Stroebe). We cannot make someone see the other side; they have to make that leap on their own.
Furthermore, you’re right, happiness is different for everyone, but again, examples would help your argument. Something like, for example, some people find happiness in the simple things in life, such as food and occasional shelter, and some people find happiness in material things and expensive objects. Some people are content with living out of a bag and moving from night to night. And some people rely on a house and static things in their lives. Examples like those could show more specifically what you’re talking about. “Also I do understand that everyone is the judge of their happiness but don’t you become more and less happy when you experience new things,” (Stroebe). This statement if very broad, and left me wondering what you meant, again, examples would help clear up the uncertainties in your argument and would make if easier for the reader to understand what you’re talking about.