The Soloist is a 2009 American film based on the true story of Nathaniel Ayers, a Juilliard musical prodigy who has schizophrenia. The film is set in Los Angeles, California where an L.A. Times writer, Steve Lopez, has his life changed forever. The story begins featuring Lopez at his job frustrated with a dose of writer's block. He is unable to find a lead or story captivating enough for his column and to save his job. As a result, he goes looking around the streets of L.A. for inspiration. While looking, he runs into Ayers who is homeless and making very little eye contact, speaking hurriedly, and repeating phrases about unrelated topics—winters in Cleveland, how he feels about the composer, Beethoven, and playing the cello. Almost immediately, Lopez believes he has found his story, and Ayers believes he has found a friend. They become acquainted and nevertheless inseparable as their unique relationship begins to develop.

Flashbacks to Ayers' childhood reveal that he developed schizophrenia at an adolescent age. He first experienced auditory hallucinations while playing the cello at a music rehearsal at Juilliard as a student. He heard male, female, and youthful voices telling him different things such as “I'll protect you from the pain”, “they can hear your thoughts”, and “run away, Nathaniel.” The voices are transient and become more prominent the more he plays the cello. His love and talent for music therefore became both a gift and a curse. Ayers reluctantly runs away from his family, friends, and life as a result of not understanding his condition, not knowing where to turn to for help, and not wanting to harm his family.

Back to present time, Lopez learns of Ayers' past from his estranged family and attempts to bring him back to music. He uses a donated cello to persuade Ayers to perform at various locations. Ayers is both terrified and hesitant as the voices become seemingly impossible to ignore. The struggle to overcome this fear and to keep his delusions at bay take over the majority of the film. Throughout all this, Lopez begins to realize that it is not about exposing Ayers in his column in the L.A. Times anymore. It is about a new friend desperately needing his help. Therefore, he pushes for Ayers to get psychiatric help, and Ayers is finally able to find level ground with his schizophrenia. Lopez is able to appreciate Ayers' condition.

The Soloist, I believe is an accurate portrayal of schizophrenia. Ayers experiences auditory hallucinations, disorganized speech, a blunted affect and negative symptoms such as social withdrawal and anhedonia. All of these are clearly present for greater than six months. He also exhibits homelessness and has poor hygiene. This movie is also based on the true story of Nathaniel Ayers, so I feel that helped immensely in portraying the condition in real life, outside of the pages of a textbook.

“The Soloist,” based on a true story, chronicles the course of schizophrenia throughout a musician's life. We are first introduced to Nathaniel Anthony Ayers, Jr. (Jamie Foxx) when Los Angeles Times reporter Steve Lopez (Robert Downey, Jr.) hears him playing his violin next to a statue of Beethoven. Despite his violin only having two strings, he plays one of Beethoven's pieces effortlessly. At first glance, it is difficult to believe Nathaniel's talent – he appears disheveled, is dressed bizarrely including a visor, construction vest, and a Hawaiian lei. And he is homeless. When asked by Steve if he likes Stevie Wonder (which is written on his visor and shirt), Nathaniel begins to express tangential thoughts with rapid speech and is difficult to interrupt. Already within the first few scenes, this movie accurately portrays behaviors that may characterize an individual with schizophrenia.

We soon learn that Nathaniel attended The Juilliard School, but dropped out before the end of his second year. The movie weaves back and forth between present day and Nathaniel's young adulthood to portray the onset of his disease, including the prodrome and first psychotic break. His sister Jennifer tells Steve that as an adolescent, Nathaniel played the cello, becoming increasingly focused on music and no longer playing sports. Once he moves into an apartment to attend Juilliard, he becomes withdrawn from others, and begins compulsively spelling his full name aloud to himself. As the stress of his program increases, he is shown having auditory hallucinations of mens', womens', and childrens' voices. These hallucinations become frightening and derogatory, and begin to impair his functioning at school. Eventually the voices become commanding in nature.

After reading an article about Nathaniel in the newspaper, a reader donates her cello to him. Steve tells Nathaniel that for safe-keeping, the cello should be kept at the Lamp Community, which is an organization that helps to end homelessness in individuals with severe mental illness. Within Lamp, we get a glimpse of a medication group in which one woman says she doesn't like taking her lithium because it stops the voices, but sometimes her voices comfort her. Although this statement is inaccurate in that lithium is effective for hallucinations, it provides a window to patients' attitudes about taking medications. It is not uncommon for patients to refuse medications; Nathaniel does not want to take medications.

The rest of the movie takes us on Nathaniel's journey of gaining notoriety and being given the chance to play at the Walt Disney Music Hall. Despite Nathaniel's opposition to getting an apartment at Lamp, perhaps due to his Juilliard experience, he does so to receive cello lessons from a member of the LA Philharmonic. The stress of the recital causes Nathaniel to experience an exacerbation of his symptoms, and walk off stage. Steve has Jennifer agree to be Nathaniel's conservator, which requires Nathaniel to sign paperwork stating he has schizophrenia. Upon reading the papers, Nathaniel becomes upset and violent, fearing commitment to a psychiatric hospital, and threatens to kill Steve if he ever sees him again.

Overall, this movie portrays schizophrenia in a thoughtful and precise manner. Delusions, hallucinations, and behaviors are portrayed truthfully, as is the functional impairment they cause. Additionally, the film illustrates the toll of caring for individuals with schizophrenia, to provide them with appropriate care.