A/N: This is completely Sweeney Todd revivalverse. My elaboration on the interaction of Toby and the Doctor (which is an understated role only present in John Doyle's production). The characters are not mine, they are Sondheim's, Christopher Bond's, Hugh Wheeler's, John Doyle's and their respective actors'. Based on what can be seen of the two characters in the revival, discussions I've had, and personal experience.
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The need to help is the hardest need to deny. It is the only need that comes from desire for others and not for self. Trying to ignore it is practically impossible - it latches onto whatever scrap of decency is still left in human beings and can only be combated by selfishness. A good, or even decent person, cannot fend it off rationally without feeling that they are being completely insensitive towards the needs of others. So they follow their need to wherever it takes them - the streets, prisons, hospitals.
Hers took her to an asylum.
She entered the asylum with a serious, but optimistic tone. She had come to change lives. She had come to cure ills. She had come to be a breath of fresh air to those who were miserable, wretched, and hopeless. The need to help burned within her, so hot that, for a while, it could carry her through cold nights of no sleep. It could warm the hands she used to reach out to the destitute. It could light the way through the dark corridors as she returned to her room in the early hours of the morning, after nursing a patient through an episode.
But it could not change anyone.
Though years of working, the light became dimmer and dimmer as she realized that sympathy, kindness, and love were not what any of these people needed. Her mind had trouble forming that thought without guilt. She had always believed that those traits could solve any problem. Eventually, she began to understand that what compassion did was let people slip into the past, where they were coming from. It pushed them backwards instead of pulling them forward.
She didn't want to accept that.
In this other world, everything she'd thought was wrong. Everything she had given her life to. But as she watched her patients slip away, she disconnected, and brought them back. She left herself behind, she left her need to feel like she was being encouraging to these poor souls, and focused on getting them through. On being, calm, cool, blank, and pulling them through. The definition of selflessness, and she never got that self-satisfied, good deeds feeling.
The thing about the need to help is it is all consuming. It will not let go, and leaves no room for self-preservation. It will take everything you have under the guise of being a service to others.
She worked this way for years, occasionally remembering the days when she was careless enough to care. Whenever she did, though, she put those thoughts out of her mind. They were not helpful. They would only push her back, like they had her patients. Every now and then, a patient came in that some repressed part of her would try to connect with, try to be a friend to. She would catch and stop it, so she could be strong, steady, and emotionless to help them, too. Except one. One child came in, and something about him caught her and would not let go. Something in his eyes seemed to offer her redemption.
His name was Tobias Ragg.