The Soloist

For most individuals who have it, schizophrenia is a lifelong condition. Statistics show about one in a hundred people could develop it.

According to the National Institute of Mental Health, more than 2 million Americans suffer from schizophrenia in any given year. Of those people, only one in five recovers completely. Remission, if it occurs at all, follows a lengthy period of treatment.

What are the symptoms of this condition and at what age, typically, do they occur? Onset (which is not always quickly recognized or treated) often begins in the late teens or early twenties. The illness greatly impairs a person's ability to function:

Symptoms include hallucinations, delusions, disordered thinking, and social withdrawal. Most people with schizophrenia continue to suffer chronically or episodically throughout their lives. Even between bouts of active illness, lost opportunities for careers and relationships, stigma, residual symptoms, and medication side effects often plague those with the illness. One of every 10 people with schizophrenia eventually commits suicide. (Fact Sheet from the National Institute of Mental Health)

Nathaniel Ayers was given a schizophrenia diagnosis.  How has that impacted his life?

He still recalls the treatment he was given, early on.  It included heavy doses of Thorazine, bodily restraints and shock therapy.  Like other patients similarly treated, when such an approach to the disease was an accepted protocol, he remains highly mistrustful of health-care providers - even those who, today, use a different path. 

Mr. Ayers remembers.  Those memories are frightening.  Because of his prior treatment, he rejects treatment today.  Many patients, with a similar history, have a similar attitude. 

Individuals with untreated schizophrenia sometimes gravitate toward street-living, far from the confines of institutional life with all of its rules and protocols.  On the streets of Los Angeles, Nathaniel finds safety in music - despite the unsafe surroundings.  He finds calmness of spirit when he plays whatever instrument he takes into his hands. 

He had to abandon the idea of playing double bass on the streets.  Such a large instrument doesn’t travel well in a shopping cart.  Instead, Mr. Ayers switched to the violin, then the cello.  Self-taught, on several instruments, he can even play the trumpet.  He still has his musical gift, but his goals now are simpler than during his Juilliard days:

My vision is to stay in good with God and not worry about far-off stuff, just get across the street safely and be thankful. Honor thy mother and father, don't be disrespectful to people, be good, and maybe the music will take care of itself.  (See Lopez, The Soloist, page 61 of the hardcover edition.)

Even for Nathaniel, that’s easier said than done when one lives on the street.  The good news about Los Angeles is the weather - it’s usually warm.  The bad news about Los Angeles is the weather - it helps bugs to thrive. 

When one sleeps on the street, bugs still go where they go.  Sometimes, as Mr. Ayers told Mr. Lopez, those bugs find their way into his trousers.  And that, among other things (like rotting trash, stinking urine, screaming people, scorching asphalt and sprawling squalor), could be distracting to the man who runs “Little Walt Disney Hall.”