In the fall of 2018, the pianist Nicolas Hodges noticed his body shaking. He brought it up at a routine doctor’s appointment in Tübingen, Germany, where he lives. The doctor said it was probably stress, but recommended that he make an appointment with a neurologist.

Hodges didn’t make that appointment right away. But then, in January 2019, the shaking caused him to play a wrong note during a performance.

“It became instantly clear that I had to find out what was going on,” he said.

Dr. Klaus Schreiber, a neurologist and a classical music lover, observed Hodges performing a few minor physical tasks — walking across a room, undressing and dressing — before he sent him for a series of tests that confirmed Hodges had Parkinson’s disease.

Dr. Schreiber estimated that Hodges had been performing with Parkinson’s for three years.

Hodges, 53, is a leading interpreter of contemporary classical music. As a soloist and chamber musician, he has premiered and recorded works by many important composers of this century, and the last. Recently, his symptoms have forced him to reduce and prioritize his performing commitments.

The worst symptoms, which rarely occur, can leave him feeling, he said, as if he “just couldn’t play the piano.” But the diagnosis has also strengthened his dedication to his artistry and the contemporary repertoire.

Physical limits have forced Hodges to make “aesthetic decisions,” he said, to select what music to commission and to perform with greater rigor. The diagnosis has “made me try to focus even more on what multiple contradictory things are most important to me.”

Hodges has formidable technique and an ability to make the form of even highly complex pieces clearly audible. His tone color on the piano can shift from vinegary to supple in seconds. He is strikingly adaptable to the widely divergent visions of various contemporary composers. In John Adams’s “China Gates” (1977), Hodges has combined rhythmic propulsion with tiptoe delicacy. In Brian Ferneyhough’s opera “Shadowtime” (2004), he tackled a prismatically virtuosic solo while asking enigmatic questions out loud, like “What is the cube root of a counterfactual?” In Simon Steen-Andersen’s Piano Concerto (2014), he faced off against a video projection of himself at a smashed grand piano.

In 2020, Hodges recorded “A Bag of Bagatelles,” which wove together works by Beethoven and Harrison Birtwistle, a close collaborator. The juxtaposition illuminates the complexity, unpredictability and orchestral scale that animate the music of two composers centuries apart. Looking back, Hodges realized that he had recorded the album with untreated Parkinson’s disease.

HODGES WAS BORN in London in 1970. His father was a studio manager at the BBC who later worked in computing, and his mother was a professional opera singer. Hodges began playing the piano at age 6 and composing at 9. Among his early pieces was the first scene of an opera based on the Perseus myth.

Hodges attended elementary school at Christ Church Cathedral School in Oxford, where he took lessons on the viola, the oboe, the harpsichord and the organ, in addition to the piano. He sang in the Christ Church Cathedral Choir, performing works like Benjamin Britten’s “War Requiem” at the Royal Festival Hall under Simon Rattle.

“We were woken up earlier than the rest of the school to practice,” Hodges said. The students who didn’t play music “got half an hour more sleep than I did the whole of my childhood.”

For secondary school, Hodges went to Winchester College, in Hampshire, where Benjamin Morison, a pianist and composer who is now a professor of philosophy at Princeton University, introduced Hodges to contemporary music by playing an LP of music by Birtwistle and Gyorgy Kurtag. Hodges and Morison performed an arrangement of Stravinsky’s “The Rite of Spring” for two pianos and Pierre Boulez’s restless “Structures II” for their teachers and fellow students at Winchester, to bemused reactions.

“I remember him being very precise — and encouraging me to be precise — and extremely musical,” Morison said of Hodges in a phone interview. “He was able to make the music speak as music.”

In 1986, Hodges took a seminar with the composer Morton Feldman at the Dartington Summer School, where Feldman impressed upon him the seriousness of the experimental avant-garde. Hodges also played in a band that covered songs by the Sex Pistols and the Sisters of Mercy.

It was a heady and influential time. “I was improvising; I was listening to weird, dark, funky music, and playing Debussy,” Hodges said.

For several years, he considered pursuing composition, to the dismay of his more traditionally minded mother. At age 23, he decided to refocus on the piano. “I just was having more fun as a pianist,” he said. “Composing is too much hard work.”

As part of that decision, Hodges began studying with the pianist Sulamita Aronovsky, who had defected to Britain from the Soviet Union. A car crash shortly after the move had ended her career as a performer. “She used to say to me, whenever I would come to her lesson and complain, ‘Mr. Hodges, you have to accept everyone has these problems,’” he recalled. “‘It’s the people who get past these problems who have careers.’”

Hodges has since performed as a soloist with orchestras including the New York Philharmonic, the Boston Symphony Orchestra and the London Philharmonic Orchestra — usually in contemporary repertoire and often with pieces written for him. He is a professor of piano at the State University of Music and Performing Arts in Stuttgart, Germany, and almost constantly premieres new work solo and in chamber music formations.

“All these composers that we had idolized when we were teenagers, he has subsequently commissioned pieces from,” said Morison, who remains close with Hodges. “It’s an extraordinary thrill to witness that.”

WHEN HODGES RECEIVED his diagnosis, the news came with conflicting emotions. The first, Hodges recalled, was a certain cockiness. “I’m going to be a medical miracle,” he thought to himself. “I’m going to carry on whatever happens.”

When that phase passed, Hodges felt relief. He had a clear diagnosis, and the dopamine treatments prescribed by Dr. Schreiber helped. “The medication makes it possible for me to sometimes feel and play like I don’t have it,” Hodges said. “When you’re suffering from something like that and you’re untreated, you feel like you’re getting old before your time, you feel like your children have worn you out — and my poor children were blamed for that.”

Hodges has had to make painful decisions while prioritizing performing commitments. Since 2012, he has played in Trio Accanto, an ensemble consisting of Hodges, the German percussionist Christian Dierstein and the Swiss saxophonist Marcus Weiss. The group has toured Europe’s major new-music festivals and recorded six albums of contemporary music together.

When Dierstein and Weiss learned of Hodges’s diagnosis, they were shaken. “We’re scared, and we are as concerned and sad as we were when we first found out,” Dierstein said in a video interview. “But it was always clear to us that we want to continue playing with Nic and that we’ll take the illness into account.”

After a period of reflection during the coronavirus pandemic, Hodges decided to withdraw from Trio Accanto. He found the logistics involved in traveling to concerts and dealing with the complex instrumental setups required by many pieces too taxing. The 2024-25 season will be Hodges’s last with the group.

Playing with Trio Accanto “was ideal chamber music for me,” Hodges said. But, he added, “Parkinson’s makes it necessary for my life to be simple.”

Hodges has also learned to structure the doses of his medication — including a dopamine inhaler, a receptor agonist patch and extended-release pills — in a way that supports his concert roster. This often requires stark sacrifices: He essentially schedules the worst of his symptoms.

In February, Hodges performed Rebecca Saunders’s “to an utterance” for piano and orchestra, a work composed for him, at the Elbphilharmonie in Hamburg. A final rehearsal the afternoon of the performance meant he had to take dopamine once at 4 p.m., and again at 8 p.m.

“There might be moments when I feel like I’ve taken a bit too much,” Hodges said earlier that day, “but in the situation of playing, that’s way better than having taken too little.”

In an email, Saunders said that Hodges still plays with intensity. “His recent performance of the piano concerto ‘to an utterance’ was brilliant, and I found it deeply expressive,” she wrote. She is planning to write him an ambitious new piece she described as “a big, long solo based on the concerto.”

Seven other composers are currently at work on new piano concertos for Hodges. This spring, he recorded Betsy Jolas’s complete solo piano works and premiered a new piece by Christian Wolff, “Scraping Up Sand in the Bottom of the Sea.” Hodges also plans to record an album with works by Debussy and contemporary composers, similar to his double portrait of Beethoven and Birtwistle.

On rare occasions, Hodges has felt he was treated differently because of his illness. One composer recently “looked straight at my hands as if they would be twisted or bleeding,” he said. But many more of his collaborators have been supportive, helping him adapt without condescension or pity.

Hodges says that his goal, now, is to adjust his career “to ensure that I have the best chance to slow the progress of the disease and thus keep playing with any qualities I might have had before Parkinson’s more or less intact.”

He knows that might not last forever. “If I should stop playing, then I hope that my friends tell me I should stop playing,” Hodges said. “But, at the moment, it’s working.”

A ransomware attack this week on a California-based health care system forced some of its locations to close and left others to rely on paper records.

The system, Prospect Medical Holdings, which operates 16 hospitals and more than 165 clinics and outpatient centers in Connecticut, Pennsylvania, Rhode Island and Southern California, announced the cyberattack on Thursday.

A Prospect Medical spokesman could not estimate on Saturday when services would return to normal. It was not immediately clear how many of the system’s sites were affected.

On its website, Eastern Connecticut Health Network, an affiliate of Prospect Medical, listed locations that would be closed until further notice, including a medical imaging center, an urgent care facility and an outpatient blood-draw center, among others.

CharterCARE Health Partners, a Rhode Island affiliate, said on Facebook Thursday that it had to reschedule some of its appointments and to revert to paper records. The Philadelphia Inquirer reported that computers were also down at Crozer Health facilities in Delaware County.

“Prospect Medical Holdings, Inc. recently experienced a data security incident that has disrupted our operations,” the company said in a statement on Saturday. “Upon learning of this, we took our systems offline to protect them and launched an investigation with the help of third-party cybersecurity specialists.”

The company said it was focused on “addressing the pressing needs of our patients as we work diligently to return to normal operations as quickly as possible.”

It did not provide details on the nature of the security breach.

Waterbury Hospital, in Waterbury, Conn., said on Saturday that it was continuing to have disruptions. It also said that some of its outpatient and diagnostic imaging services had not been available on Friday or Saturday. On Thursday, it said it was relying on paper records.

Cyberattacks on hospitals have become more common, said John Riggi, national adviser for cybersecurity and risk at the American Hospital Association.

In 2022, One Brooklyn Health, a hospital group that serves low-income neighborhoods in New York, was hit by a cyberattack that also forced staff members to use paper records. Employees said at the time that it was a learning curve, given that most hospitals have been using electronic records since the 1990s and that some diagnostic test results were coming back slower because of the cyberattack.

CommonSpirit Health, which has more than 140 hospitals and more than 700 care sites nationwide, was the target of a cyberattack last year that led to postponed surgeries, doctor visits and other delays in care, NBC reported. And in 2020, Russian hackers launched a ransomware attack on United Health Services, which has at least 400 facilities, making it the largest attack of its kind at the time.

Cyberattacks are becoming more frequent, in part because the coronavirus pandemic brought many more health care services online, Mr. Riggi said.

“We’re relying more on cloud-based services, remote third parties,” Mr. Riggi said. “So all of these things are done with good intention — ultimately to improve patient care and to save lives. But the unintended consequence of this is that it has expanded dramatically our digital attack surface.”

Hospitals and clinics typically use third parties to write code and develop the technology for these systems, so it’s imperative these third parties deliver secure technology, he said.

The Food and Drug Administration on Friday approved the first pill for postpartum depression, a milestone considered likely to increase recognition and treatment of a debilitating condition that afflicts about a half-million women in the United States every year.

Clinical trial data show the pill works quickly, beginning to ease depression in as little as three days, significantly faster than general antidepressants, which can take two weeks or longer to have an effect. That — along with the fact that it is taken for just two weeks, not for months — may encourage more patients to accept treatment, maternal mental health experts said.

The most significant aspect of the approval may not be the features of the drug, but that it is explicitly designated for postpartum depression. Several doctors and other experts said that while there were other antidepressants that are effective in treating the condition, the availability of one specifically shown to address it could help reduce the stigma of postpartum depression by underscoring that it has biological underpinnings and is not something women should blame themselves for.

The hope is that it will encourage more women to seek help and prompt more obstetricians and family doctors to screen for symptoms and suggest counseling or treatment.

“This is a patient population that just so often falls through the cracks,” said Dr. Ruta Nonacs, a psychiatrist with the Center for Women’s Mental Health at Massachusetts General Hospital. “When women are told, ‘You have postpartum depression,’ it’s embarrassing, it is demeaning, it makes them feel like a bad mom.”

She added, “There’s also a lot of stigma about taking antidepressant medication, so that might make this treatment more appealing because it’s really a treatment specific for postpartum depression.”

An estimated 10 to 15 percent of women who give birth in the United States experience depression during pregnancy or in the year afterward. The condition can be accompanied by intense anxiety, shame, guilt, impaired sleep, panic attacks and suicidal thoughts or attempts. And it can make it difficult for mothers to provide their babies with the care, bonding and nurturing that is crucial for healthy development.

“Having access to an oral medication will be a beneficial option for many of these women coping with extreme, and sometimes life-threatening, feelings,” Dr. Tiffany R. Farchione, the director of the F.D.A. division responsible for the approval, said in a statement.

The pill, zuranolone, which will be marketed under the brand name Zurzuvae, was developed by Sage Therapeutics, a Massachusetts company that produces it in partnership with Biogen. It is expected to be available after the Drug Enforcement Administration completes a 90-day review required for drugs affecting the central nervous system, Sage said. The companies have not announced a price for the pill.

The companies had also applied for approval to use the drug for major depressive disorder (also called M.D.D.), a much larger potential market. Sage and Biogen said in a statement late Friday night that the F.D.A. had told the companies that “the application did not provide substantial evidence of effectiveness to support the approval of zuranolone for the treatment of M.D.D. and that an additional study or studies will be needed,” and it added that Sage and Biogen “are reviewing the feedback and evaluating next steps.” Several psychiatric experts have said the data for the drug’s use in treating that disorder is less convincing.

The only other drug approved for postpartum depression is brexanolone, also developed by Sage and marketed as Zulresso. But brexanolone, approved in 2019, requires a 60-hour intravenous infusion in a hospital, carries risks of loss of consciousness and costs $34,000. Sage says only about 1,000 patients have received it so far.

Taking a pill for two weeks is much easier, not requiring a mother to leave her baby for several days. However, the F.D.A. did require the label to include warnings about possible suicidal thoughts and behavior, sleepiness and confusion. The label will also include a so-called “black box warning” that patients should not drive or operate heavy machinery for at least 12 hours after taking the pill. The pill should be taken in the evening “with a fatty meal,” the agency’s announcement said.

Doctors said Zurzuvae would not be appropriate for everyone experiencing postpartum depression. For those with mild to moderate depression, talk therapy can work well. Dr. Kimberly Yonkers, chairwoman of the psychiatry department at University of Massachusetts Chan Medical School, said she would probably not recommend Zurzuvae for patients with longstanding recurrent depression or for “somebody who has a severe episode with a suicidal attempt or hospitalization because you don’t give them a treatment for two weeks and then stop it.”

Appropriate patients, she said, might include “people who have not had a complete response to another antidepressant.”

Dr. Alison Reminick, director of the women’s reproductive mental health program at the University of California, San Diego, said about 10 percent of her patients would be likely candidates. Those would include women experiencing depression for the first time. Such patients are at higher risk of developing bipolar disorder, she said. Although drugs such as Lexapro, Zoloft and other selective serotonin reuptake inhibitors (S.S.R.I.s) work, they can cause mania in those patients, she said.

She would also offer Zurzuvae to women whose depression was accompanied by anxiety or insomnia because studies suggest it may ease those symptoms.

“I’m a huge fan of S.S.R.I.s,” Dr. Reminick said, but noted that many patients resisted trying medication. “I think this will be much easier to get them to just try this for two weeks.”

Data submitted to the F.D.A. came from two company-funded clinical trials involving about 350 patients. A majority of those receiving Zurzuvae (72 percent in one trial, 57 percent in another) clinically responded to the treatment after the two-week course, meaning that their scores on a standard depression scale improved by 50 percent or more.

Depression also improved in women receiving the placebo, a common phenomenon in studies of depression treatments, possibly because interacting with medical teams in a trial is itself helpful. But in the group receiving Zurzuvae, the improvement was consistently greater, by several points, beginning three days after starting the medication. Fifteen days after taking the first pill, Zurzuvae patients were significantly more likely to have a low enough depression score to be considered in remission.

The effect continued after the patients stopped taking the medicine, throughout the 45 days that they were monitored in the trials. But several maternal mental health experts said longer-term data was needed to determine if patients relapse.

The main side effects of Zurzuvae were sleepiness and dizziness. The trial participants did not show evidence of increased suicidal thoughts or withdrawal symptoms after stopping the drug.

Amy Bingham, 33, of Gibsonville, N.C., received Zurzuvae in a clinical trial in 2018, about six months after giving birth to her son Benjamin.

Ms. Bingham, who works from home for a call center, had experienced depression as a teenager, but her postpartum depression symptoms were different, including panic attacks, tears and shortness of breath.

“I was very anxious that I would do something wrong, that Ben would get hurt because of a mistake I would make,” she said, “that I wasn’t able to respond to his needs effectively and that because I wasn’t able to, he would be an unhappy baby.”

Sometimes, she said, “I would think I was a terrible mother because I couldn’t soothe my own child.”

Her depression scores recorded in the trial improved by the third day on the medicine and reached remission levels by Day 15, according to data shared with The New York Times.

Under standard procedure in such trials, Ms. Bingham did not know if the pill she took for two weeks was Zurzuvae or placebo. She said: “I didn’t feel a lot of improvement at first. It did take about a month for me to start feeling some of the benefits.”

But gradually, she said, “I did start to feel calmer.”

“I wasn’t having as many days where I was feeling as tearful,” she continued. Eventually, “I felt that I could enjoy my time with my son.”

Zurzuvae contains a synthetic version of a neurosteroid or brain hormone called allopregnanolone, which is produced by progesterone and helps regulate a mood-related neurotransmitter, said Dr. Samantha Meltzer-Brody, director of the Center for Women’s Mood Disorders at the University of North Carolina at Chapel Hill and a lead investigator for the trials of Zurzuvae for postpartum depression.

During pregnancy, “levels of estrogen and progesterone rise many-fold and then they fall precipitously at the time of childbirth,” she said. She added that, for genetic or other reasons, women who develop postpartum depression seem especially sensitive to that surge and drop-off, which also lowers allopregnanolone levels.

Typically, “increases in allopregnanolone help deal with acute stress,” said Amy VandenBerg, a psychiatric pharmacist at the University of Michigan. Zurzuvae might address postpartum depression by essentially replenishing depleted allopregnanolone and targeting the same neurotransmitters to stabilize mood, she said.

Although many cases of maternal depression begin in pregnancy, the pill is not being recommended until after childbirth because it operates on a hormonal pathway and wasn’t tested in pregnant women, Dr. Meltzer-Brody said. The label will warn that the drug could cause harm to a fetus and will advise women to use contraception while taking the pill and for a week afterward.

The pill was not tested in women who were breastfeeding their babies. Several doctors said they would inform patients who were considering taking it that there was little data about the drug’s effect on lactating. Some women might be able to pump milk for the two weeks they plan to take Zurzuvae and resume nursing afterward. Some S.S.R.I.s and other antidepressants have been found to be safe for breastfeeding.

About 15 to 20 percent of women in the trials continued taking other antidepressants they had been on for a while. Experts said it was possible that for some patients Zurzuvae would be an adjunct medication or would be used as a bridge to longer-term antidepressants.

“It’s not the only treatment that’s helpful for postpartum depression, but the innovation and the excitement about this is that it’s specific, designed to target postpartum depression based on potential biological causes,” said Wendy Davis, executive director of Postpartum Support International, a nonprofit that raises awareness and provides resources for those experiencing maternal mental health issues. “It gives the understanding that there is a biological reason for what you’re feeling right now,” she said, adding “It is not your fault.”

The fact that there’s a medication prescribed for a mother’s depression might prompt family members to “give recognition to it and increase how much help they give mom,” Dr. Reminick said.

“If it gets more people into treatment, that’s wonderful,” Dr. Nonacs said. “If it doesn’t work, they’re connected with providers and we can try other things. So it opens a door for treatment that has been hard to open in the past.”