Breuer’s initial appointment with Nietzsche begins with a full physical examination. He then asks about his medical history with the hope of finding connections between Nietzsche’s health and the circumstances within his life that may have contributed to his illness. As with all his patients, Breuer notes that Nietzsche is willing to talk at length about the issues related to his health, which include nausea, vertigo, headaches, loss of appetite, fatigue, occasional fevers, and fading vision. One specific condition, “mood shifts,” allows an opening for Breuer to probe Nietzsche’s psychology. Breuer asks Nietzsche if he ever experiences melancholia, which he intends as a way of delving into the patient’s despair, and Nietzsche answers that he does experience melancholy, but only because he is brave enough to allow himself to experience it. This is the first time Breuer sees Nietzsche’s assertiveness and boldness. When Breuer finally asks Nietzsche about despair, suggesting that his ill health creates conditions in which despair is a natural result, Nietzsche answers that his sickness is distinct from who he feels he really is. Body and mind are not one and the same for Nietzsche, and he does not conflate his illness with his identity. Breuer briefly reconsiders Lou’s contention that Nietzsche is suicidal, deciding to reserve judgment on that question.