The physician narrator is trying to elicit information from a female patient. The reader isn't sure what is wrong. The physician seems to suspect that she is having sexual/marital difficulties: she denies it. Wondering whether "I could slowly pan, with ophthalmoscope" the physician envisions uncovering the evidence of separate bedrooms in the patient's eyes. But all he has to go by is the body language of the woman, who sighs and twists her wedding ring "anti-clockwise"--as if her life were heading in the wrong direction.