Idiopathic
Everyone felt proud and relieved when the last performance ended. Organizing the six concerts required a tremendous amount of work, there was a lot of fear of failure, and much was at stake. Everything went as well as it possibly could. Music lovers and the media pronounced the concerts a triumph. Just as Charlie predicted, classical pianists went straight to work teaching themselves how to play
Scarlet Rhapsody
. It took extra work because most of them had never learned to swing. Nav made sure to release Meena's recording quickly, before copycats released cover versions.
For the first time in almost two years, Meena wasn't scheduled to do anything. No touring. No work for an upcoming album. No meetings, commitments, negotiations. Everyone was free to take a break.
Meena's agent let her know that offers arrived daily. Several top-tier filmmakers wanted her to star in upcoming features. This was a dumb idea, and she turned these offers down. Making a film is a long commitment that usually requires traveling somewhere inconvenient. Meena had no reason to believe she had the ability to act. Accepting a major role seemed like a good way to embarrass herself. It might be something to consider in a few years, after there were lots of other musicians breathing life into new jazz.
A more interesting option was modeling. The world's top fashion magazines proposed putting Meena on their covers. The idea was that they'd invite top designers to create garments specifically for Meena. The best fashion photographers would shoot her. The photos already taken of Meena proved that she was a good model. She loved fashionable clothes, and it was nice that each of the projects would only take a few days. This was a perfect job for a sex symbol.
But the first thing everyone wanted was a vacation. That was a problem. Her face was so famous that it made it challenging to go anywhere. Diane mentioned that she and her Master owned a private island in a remote part of the South Pacific. There was a very nice vacation home there, with a beautiful white sand beach and a large pool. It was very private because the entire staff consisted of robots. If they could agree on dates, it was possible that Diane and her Master could join them. The notion of being on a remote island with three beautiful women appealed to Nav. But he had difficulty focusing on travel because he felt tired.
For the first few days after the concert, Nav thought he needed to catch up on his rest. But after several long nights of sleep, Nav felt no better. The first clear sign that something was wrong came when Feva said his infrared vision showed Nav's temperature was lower than usual. Feva got their medical kit, which showed that his blood pressure was low. He collected a drop of blood, which revealed nothing unusual. Still, it was decided that they'd contact a doctor tomorrow.
When the next day dawned, Nav could not get out of bed. He felt like a machine with a dead battery.
A team of specialists examined Nav closely. They did brain scans, magnetic imaging, tissue sampling, and other tests that produced confusing results. The next day Nav's doctor announced the diagnosis - but it wasn't very helpful.
"For now, we're saying that Nav suffers from idiopathic depression," the doctor said. "Ideopathic is just a fancy medical term that means we don't know what's causing his condition. It shouldn't be possible for Nav to get depression because he was vaccinated against it when he was a child. But the brain scans are consistent with depression of some kind, tissue tests support that diagnosis, and he shows symptoms of depression."
"What can you do about it?" Meena asked. She was scared. Nav had always been a source of strength and comfort to her; the idea that he was sick was frightening.
"For now, I am going to ask some more specialists to offer their recommendations. There used to be a lot of treatments for depression, and there are good reasons to think one of them will work, but I want to go slowly because I can't find any evidence that anyone ever had this particular condition. Until we discover what caused Nav's illness, it's unclear what would be the best treatment.
"One thing we need to remember is that Nav was part of the first generation to receive the cure for aging. There are very few people who've been alive this long. We think we understand aging and the cure for it, but we don't know everything. Nav and his contemporaries are leading us into unexplored medical territory."
"How do you know he's not just tired?" Charlie said. "He doesn't seem sad. He just has no energy."
"It's a bit of a myth that depression is a form of sadness. It's more accurate to look at it as a form of chronic exhaustion that interferes with a patient's ability to live normally. It's why he can't summon up the energy to get out of bed. And he has some clear symptoms of depression.
"Nav has something called 'ruminating voices.' When depression was common, many depressives reported that they were tormented by a nagging little voice in their head. The voice keeps saying the patient is stupid, or ugly, or unloved, or some other horrible things that ruin their spirit. Nav is hearing a voice like that all the time."
"What does his voice say?" Meena asked.
"Well, it's very odd. It involves you, Meena. Nav's inner nag is telling him that he's not good enough for you. That he's not as smart as you, as creative as you, as loving as you - that kind of thing."
Meena looked shocked for about a nanosecond. Then she burst into tears.
"Dear, you need to remember that these are delusions. I've told Nav these are delusions, and he understands. Nav is a very accomplished man who deserves everything he has, for reasons you know as well as me. It's important to remember that people aren't mentally ill on purpose. His thoughts are not logical. These voices will go away when we figure out what treatment he needs."
Meena was sobbing uncontrollably. "Are you thinking of any particular treatment yet?" Charlie asked.
"Actually, there are several treatments that might work. I have a whole list. What I want to do now is figure out which one is MOST likely to work best," the doctor said. He didn't mention that his own best guess was that Nav would respond to an antiquated form of treatment called ECT, or Electroconvulsive Therapy.
It was a very effective treatment for depression for many years, but it stopped being used much when doctors invented antidepressants. For reasons that were never fully understood, depressed patients who suffered from seizures usually showed remarkable improvement afterward. This led to the discovery that sending an electric shock through the brain triggered a seizure. At first, the treatment was painful and unpleasant, but doctors eventually discovered they could anesthetize the patient enough that they weren't conscious during the shock and seizure. Muscle relaxers prevented painful side effects from thrashing around uncontrollably. ECT caused short term memory loss, but had no long term side effects, and it worked so well that some patients insisted on being treated with ECT. The doctor thought it might literally jolt Nav out of his depressed state.
But ECT hadn't been done for years. Nav's doctor wondered if there was a museum somewhere that could lend them the equipment. And he wasn't going to subject Nav to something so unconventional unless other specialists supported the decision.
