Again, Jude apologizes to Andy, his doctor—a friend he’s known for nearly a decade and, not to mention, whose job it is to help him. So it’s becoming clearer that Jude is very uncomfortable asking others for help, and that he maybe even thinks he doesn’t deserve others’ help or kindness. The gaping wound is another shocking detail to emerge in this scene, and the novel reveals it with graphic detail that holds nothing back. It’s a curious rhetorical decision, and one that reinforces the novel’s focus on exploring pain and suffering.