Conflicts of interest

There was silence, for a moment, as the doctor watched his patient consider the question. This didn’t surprise him.

His opposite was on the sofa, laying back, staring up, the man’s brow furrowing and unfurrowing. His breathing wasn’t audible, but it almost could have been. For someone the doctor didn’t know, it would have been more uncomfortable, more tense, but they were familiar now. It had taken a while to get there. There was no discomfort, even in the quiet. Any distance in age or experiences, differences in their lives were nominal; the distance in the room was more accurate.

He had his notes, a pen and paper, but wasn’t writing. He hadn’t needed to- it was mostly for show, to give himself a moment to consider what had been said. His notes would come later, in the real silence. The doctor’s mind was the notepad he’d need right now.

“I don’t know,” his patient finally replied, as if the question had just been said, and considered. “I’m conflicted. Is that normal?”

“Do you think it is?”

A smirk, almost a smile from the patient. He didn’t look like a patient; at least, not what one might have expected a man visiting a psychologist to look like. “I hate when you answer a question with another question.”

“Irritating, isn’t it?”

“Yeah.” There was another silence, shorter, and the ‘patient’ turned his neck slightly, meeting the doctor’s gaze. “I just thought it would be different.”

The doctor nodded slowly in response, his own brow furrowing, his voice kind, but encouraging. “Different how?” he asked.

His patient looked back up again, his hands clasping on his chest. “We grow up thinking we’ll figure it all out, that nothing’s beyond our reach, right? And that’s a good thing to have,” he said. “You don’t ever want to crush dreams, or tell your kids they can’t have or do something. They need that, to believe in that idea. That there’s good in the world. Because there is.”

He nodded, slowly. He didn’t break the silence, sensing his patient- his friend- had paused intentionally, and was collecting his thoughts to continue.

“But it’s not always that way,” the other man continued. His voice was slower, tinged with sadness, experience. “We don’t always get it all. We get there, and find out it wasn’t what we thought. We get hurt, watch people get hurt, and-”

He stopped again, his expression tightening, frustration coming across his face and leaving in a moment, even as the tension stayed and he continued.  “-And it kills me. It absolutely eats me alive. I hate watching people get hurt, and being able to do absolutely nothing about it.”

“That’s a part of life,” the doctor reminded him kindly. “Things happen, and people and situations change, often well out of our control. You don’t need to solve everyone’s problems.”

“I know that,” the patient responded, with some resignation, and a slight sigh. “I just… I worry about how I’m reacting to it.”

“How’s that?” the doctor asked.

There was a breath- audible, and drawn out, the patient’s mind working behind eyes that stared straight up again. “Because I’m not doing anything,” he said.  “I feel like I’m getting numb to it.”

The doctor’s brow furrowed. He’d put his notepad down, hands clasping on his lap, taking a breath and letting it collect inside him before exhaling, using the time to order his thoughts. “We talked about that,” he said, gently, again, “How you can’t solve everyone’s problems.”

“You think I don’t know that?” the patient responded, angrily. His muscles were tensing, fists clenched. The tension in his mind has transferred to his body. “It’s just… frick, I feel like I’m failing them all, sometimes. Here’s me, in the middle of all of it, doing fine, watching it all burn around me. I should be helping,” he insisted.  His voice was quieter, his breathing uneven, his anger having morphed to sorrow and helplessness. “I should be helping them.”

“Maybe you are,” the doctor said, firmly, but still kind.

“But what if I’m not?” the patient asked, his voice barely a whisper. “What if it’s me, getting harder, getting to the point where I can’t feel anything, where I don’t WANT to feel anything? When I see people go through it all, and I just don’t care?”

The doctor took a breath. He’d had this conversation a few times, with a few people, and it never got easier. He let the silence wash over them for several moments, wanting the immediate tension to drain, for his words to command his friend’s full attention when he spoke again. His own belief was firm, as it had to be.

“You’re here,” the doctor said, slowly, kindly. “You do care, sometimes too much. And that’s a good sign.”

There was a sigh. The patient took a breath, resting his hands on his chest again, letting them rise with his breathing, composing himself. “Yeah. I just wish I knew, somedays.”

There was silence, for a time. The doctor, he took his breath deliberately, and exhaled. “We all do,” he said. “We all do.”


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