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Sunday, March 20, 2011

A Beautiful Mind ( The Movie )


A Beautiful Mind is a 2001 American film based on the life of John Forbes Nash, Jr., a Nobel Laureate in Economics. The film was directed by Ron Howard and written by Akiva Goldsman. It was inspired by a bestselling, Pulitzer Prize-nominated 1998 book of the same name by Sylvia Nasar. The film stars Russell Crowe, along with Jennifer Connelly, Ed Harris, Christopher Plummer and Paul Bettany.



PLOT

In 1947, John Nash (Russell Crowe) arrives at Princeton University as a new graduate student. He is a recipient of the prestigious Carnegie Prize for mathematics; although he was promised a single room, his roommate Charles Herman (Paul Bettany), a literature student, greets him as he moves in and soon becomes his best friend. Nash also meets a group of other promising math and science graduate students, Martin Hansen (Josh Lucas), Richard Sol (Adam Goldberg), Ainsley (Jason Gray-Stanford), and Bender (Anthony Rapp), with whom he strikes up an awkward friendship. Nash admits to Charles that he is better with numbers than he is with people.

The mathematics department chairman of Princeton informs Nash, who has missed many of his classes, that he cannot begin work until he finishes a thesis paper, prompting him to seek a truly original idea for the paper. A woman at the bar is what ultimately inspires his fruitful work in the concept of governing dynamics, a theory in mathematical economics. After the conclusion of Nash's studies as a student at Princeton, he accepts a prestigious appointment at the Massachusetts Institute of Technology (MIT), along with his friends Sol and Bender.

In 1953, while teaching a class on calculus at MIT, he places a particularly interesting problem on the chalkboard that he dares his students to solve. He is not particularly interested in teaching and his delusions even cause him to miss the class. When a Salvadoran student, Alicia Larde (Jennifer Connelly), comes to his office to discuss why he did not show up, she also asks him to dinner and the two fall in love and eventually marry.

On a return visit to Princeton, Nash runs into his former roommate Charles and meets Charles' young niece Marcee (Vivien Cardone), whom he adores. Nash is invited to a secret Department of Defense facility in the Pentagon to crack a complex encryption of an enemy telecommunication. Nash is able to decipher the code mentally, to the astonishment of other codebreakers. Here, he encounters the mysterious William Parcher (Ed Harris), who belongs to the United States Department of Defense. Parcher observes Nash's performance from above, while partially concealed behind a screen. Parcher gives Nash a new assignment to look for patterns in magazines and newspapers, ostensibly to thwart a Soviet plot. He must write a report of his findings and place them in a specified mailbox. After being chased by Soviet agents and an exchange of gunfire, Nash becomes increasingly paranoid and begins to behave erratically.

After observing this erratic behavior, Alicia informs a psychiatric hospital. Later, while delivering a guest lecture at Harvard University, Nash realizes that he is being watched by a hostile group of people, and although he attempts to flee, he is forcibly sedated and sent to a psychiatric facility. Nash's internment seemingly confirms his belief that the Soviets are trying to extract information from him. He views the officials of the psychiatric facility as Soviet kidnappers. At one point, he gorily tries to dig out of his arm an implant he received at an unused warehouse on the MIT campus, which was supposedly used as a listening facility by the DoD.

Alicia, desperate and obligated to help her husband, visits the mailbox and retrieves the never-opened "top secret" documents that Nash had delivered there. When confronted with this evidence, Nash is finally convinced that he has been hallucinating. The Department of Defense agent William Parcher and Nash's secret assignment to decode Soviet messages was in fact all a delusion. Even more surprisingly, Nash's "prodigal roommate" Charles and his niece Marcee are also products of his mind.

After a series of insulin shock therapy sessions, Nash is released on the condition that he agrees to take antipsychotic medication; however, the drugs create negative side-effects that affect his sexual and emotional relationship with his wife and, most dramatically, his intellectual capacity. Frustrated, Nash secretly stops taking his medication and hoards his pills, triggering a relapse of his psychosis.

In 1956, while bathing his infant son, Nash becomes distracted and wanders off. Alicia is hanging laundry in the backyard and observes that the back gate is open. She discovers that Nash has turned an abandoned shed in a nearby grove of trees into an office for his work for Parcher. Upon realizing what has happened, Alicia runs into the house to confront Nash and barely saves their child from drowning in the bathtub. When she confronts him, Nash claims that his friend Charles was watching their son. Alicia runs to the phone to call the psychiatric hospital for emergency assistance. Nash suddenly sees Parcher who urges him to kill his wife, but Nash angrily refuses to do such a thing. After Parcher points a gun at her, Nash lunges for him, accidentally knocking Alicia and the baby to the ground. Alicia flees the house in fear with their child, but Nash steps in front of her car to prevent her from leaving. After a moment, he tells Alicia, "She never gets old"--referring to Marcee, who, although years have passed since their first encounter, has remained exactly the same age and is still a little girl. Realizing the implications of this fact, he finally accepts that although all three people seem completely real, they are in fact part of his hallucinations.

Caught between the intellectual paralysis of the antipsychotic drugs and his delusions, Nash and Alicia decide to try to live with his abnormal condition. Nash consciously says goodbye to the three delusional characters forever in his attempts to ignore his hallucinations and not feed "his demons". He thanks Charles for being his best friend over the years, and says a tearful goodbye to Marcee, stroking her hair and calling her "baby girl", telling them both he would not speak to them anymore. They still continue to haunt him, with Charles mocking him for cutting off their friendship, but Nash learns to ignore them.

Nash grows older and approaches his old friend and intellectual rival, Martin Hansen, now head of the Princeton mathematics department, who grants him permission to work out of the library and audit classes. Even though Nash still suffers from hallucinations and mentions taking newer medications, he is ultimately able to live with and largely ignore his psychotic episodes. He takes his situation in stride and humorously checks to ensure that any new acquaintances are in fact real people, not hallucinations.

Nash eventually earns the privilege of teaching again. In 1994, Nash is honored by his fellow professors for his achievement in mathematics, and goes on to win the Nobel Memorial Prize in Economics for his revolutionary work on game theory. Nash and Alicia are about to leave the auditorium in Stockholm, when Nash sees Charles, Marcee and Parcher standing and watching him with blank expressions on their faces. Alicia asks Nash, "What is it?" Nash replies, "Nothing. Nothing at all." With that, they both leave the auditorium.

NURSING FACTS AND INFORMATION

Antipsychotic Drugs

An antipsychotic (or neuroleptic) is a tranquilizing psychiatric medication primarily used to manage psychosis (including delusions or hallucinations, as well as disordered thought), particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s. Most of the drugs in the second generation, known as atypical antipsychotics, have been developed more recently, although the first atypical antipsychotic, clozapine, was discovered in the 1950s and introduced clinically in the 1970s. Both generations of medication tend to block receptors in the brain's dopamine pathways, but antipsychotic drugs encompass a wide range of receptor targets.

Usage

Common conditions with which antipsychotics might be used include schizophrenia, bipolar disorder and delusional disorder. Antipsychotics might also be used to counter psychosis associated with a wide range of other diagnoses, such as psychotic depression. However, not all symptoms require heavy medication and hallucinations and delusions should only be treated if they distress the patient or produce dangerous behaviors.

In addition, "antipsychotics" are increasingly used to treat non-psychotic disorders. For example, they are sometimes used off-label to manage aspects of Tourette syndrome or autism spectrum disorders. They have multiple off-label uses as an augmentation agent (i.e. in addition to another medication), for example in "treatment-resistant" depression or OCD. Despite the name, the off-label use of "antipsychotics" is said to involve deploying them as antidepressants, anti-anxiety drugs, mood stabilizers, cognitive enhancers, anti-aggressive, anti-impulsive, anti-suicidal and hypnotic (sleep) medications.

Antipsychotics have also been increasingly used off-label in cases of dementia in older people, and for various disorders and difficulties in children and teenagers. A survey of children with pervasive developmental disorder found that 16.5% were taking an antipsychotic drug, most commonly to alleviate mood and behavioral disturbances characterized by irritability, aggression, and agitation. Recently, risperidone was approved by the US FDA for the treatment of irritability in children and adolescents with autism.

Side Effects
Following are details concerning some of the side effects of antipsychotics:

* Antipsychotics, particularly atypicals, appear to cause diabetes mellitus and fatal diabetic ketoacidosis, especially (in US studies) in African Americans.
* Antipsychotics may cause pancreatitis.
* The atypical antipsychotics (especially olanzapine) seem to cause weight gain more commonly than the typical antipsychotics. The well-documented metabolic side effects associated with weight gain include diabetes, which can be life-threatening.
* Antipsychotics increase the likelihood of a fatal heart attack, with the risk of death increasing with dose and the length of time on the drug.
* Clozapine also has a risk of inducing agranulocytosis, a potentially dangerous reduction in the number of white blood cells in the body. Because of this risk, patients prescribed clozapine may need to have regular blood checks to catch the condition early if it does occur, so the patient is in no danger.
* One of the more serious of these side effects is tardive dyskinesia, in which the sufferer may show repetitive, involuntary, purposeless movements often of the lips, face, legs, or torso. It is believed that there is a greater risk of developing tardive dyskinesia with the older, typical antipsychotic drugs, although the newer antipsychotics are now also known to cause this disorder.
* A potentially serious side effect of many antipsychotics is that they tend to lower an individual's seizure threshold. Chlorpromazine and clozapine, in particular, have a relatively high seizurogenic potential. Fluphenazine, haloperidol, pimozide and risperidone exhibit a relatively low risk. Caution should be exercised in individuals that have a history of seizurogenic conditions such as epilepsy, or brain damage.
* Neuroleptic malignant syndrome, in which the drugs appear to cause the temperature regulation centers to fail, resulting in a medical emergency, as the patient's temperature suddenly increases to dangerous levels.
* Dysphoria.
* Drug-induced parkinsonism due to dopamine D2 receptor blockade may mimic idiopathic parkinsonism. The typical antipsychotics are more prone to cause this, compared to the atypical antipsychotics.
* Sexual dysfunction, which may rarely continue after withdrawal, similar to Post-SSRI sexual dysfunction (PSSD).
* Dystonia, a neurological movement disorder in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
* Hyperprolactinaemia. The breasts may enlarge and discharge milk, in both men and women due to abnormally-high levels of prolactin in the blood. Prolactin secretion in the pituitary is normally suppressed by dopamine. Drugs that block the effects of dopamine at the pituitary or deplete dopamine stores in the brain may cause the pituitary to secrete prolactin.
* There is evidence that exposure may cause demyelinating disease in laboratory animals.
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