At dinner that night, Rivers admits to Bryce that he likes Sassoon very much. He finds him impressive and completely in his right state of mind. Sassoon finds it hard to make conversation with the other patients, who have actual "shell- shock."
At dinner, a "thin, yellow-skinned" man named Burns starts to vomit. He is removed and taken to his room by the nurses, or VADs. Rivers goes to visit Burns, who is extremely thin and has not been able to eat since he arrived. In the war, Burns was thrown into the air by a shell and landed face first in the gas-filled stomach of a German corpse. When he awoke, he realized that his nose and mouth were filled with rotting flesh; he has not been able to eat since. Rivers reflects that Burns's suffering has been without dignity.
In these opening chapters, we are introduced to both Rivers's and Sassoon's internal conflicts, which serve as the core problems of the novel. Rivers is hesitant about admitting Sassoon as a patient into his war hospital. Because he surmises from the clarity of the protest that Sassoon is not really shell- shocked, it seems wrong to allow Sassoon to hide away in a mental hospital rather than continue to fight. As a psychiatrist employed by the government, Rivers is charged with the task of making his patients well enough to return to military duty in France. Yet Rivers is a scientist and an anthropologist before he is a military man. He has a hard time reconciling his duty to send the men back to the front in light of his knowledge of the horrors that they will find there. Torn between his personal feelings and his duty to his position, Rivers questions every decision he is called to make.
Sassoon's internal conflict stems from his passionate pacifist sentiments and his simultaneous desire to protect the men with whom he fought. His open declaration against the war represents a very brave move. Sassoon hopes to be court-martialed, thereby gaining publicity and drawing attention to his campaign to end the war. In Chapter 2, however, he acknowledges the futility of his mission. He feels powerless to stop the metaphorical "large ship" of war that pushes toward him. The question then becomes what the best decision is that Sassoon can make at the time. Sassoon, convinced by Graves that he will not be court-martialed, sees no other option than to allow himself to be admitted into the mental hospital. While in the hospital, however, he is burdened by the knowledge that he does not belong there, and is plagued by the guilt that he is safe while others are dying.