The therapeutic aspects of the story did not grip me so much, but I did like the "slice of life" look at the story provided. The seamless integration of details about life on the lunar outpost kept me quite engaged.
As to the issue of how Dr. Holmes and MacDougall interacted, I can see how the apparent role reversal between doctor and patient could be problematic. I got the sense, however, that MacDougall was not a typical laborer but was instead another psychologist sent, surreptitiously, to work with Holmes. I was a little too lazy in combing through the printed version of the story to find the clues that I thought I picked up on during the narration, but here are a few:
MacDougall: “You don’t have to be perfect, you know? You’d no doubt tell me to share what’s hurting.”
I thought it strange how he would use this wording and express some familiarity with the process of psychological counseling. It could just be that he is parroting Holmes from their previous session.
“If you want to talk about it…? Some other place and time, when it’s not so crowded?”
The rebuff was on my lips, but I pulled it back. ”Maybe. Yeah. We’ll see.”
He looked disappointed. ”You just can’t stop being the professional, can you? Not even for a minute.”
And here he offers a diagnosis that resembles what Vijay offers in the very next scene. Again, it could just be a coincidence and part of MacDougall's entrainment having been subject to such interpretation before. Still, it seems strange.
To my surprise, he grinned. ”Let’s not strain you too much. How about we start with you telling me a little about yourself? We can work up to the other thing.”
And then there's this. MacDougall presented himself as interested in Holmes as a person, not as a patient. So even if he really did want to hear what was troubling her why continue to adopt a process of inquiry that mimics counseling? "Tell me a little about yourself" and "we can work up to the other thing" don't seem like the sorts of things that guys say to women they are interested in getting to know.
Of course each of these quotes could be explained away as a guy interested in talking to a girl and realizing that adopting this faux-professional persona is a foil to get over the awkwardness of the underlying doctor/patient relationship. I really can't counter that with any evidence from the story. But it seems that Holmes' personal troubles were known well enough that someone might have attempted to get her counseling and would have realized a need to do it quietly if Holmes was to engage at all. Introducing a love interest to engage a doctor who is having difficulty taking care of herself (e.g., not using the day room) because of her failing/failed marriage seems a little tidy to be purely coincidental.
Even if I'm totally wrong, I still find it intriguing to think of MacDougall's presence as a kind of sneaky psychosocial development.
