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That old, time-honored unconscious wish to blow it, bigtime.
Like Bill Clinton and the blowjob. These overachieving people seem to love to sabotage themselves just when they've got it all in their grubby, grasping little hands. The good Doctor just is following the sabotage script that's all, and Cary's giving him that little shove - to follow Cary, really - into the abyss.
Terrible, narcissistic advice from Cary. But, what else is new?
It's the page hits, stupid.