Dimmesdale is DISTANT. Dimmesdale is a quieter man and doesn't ask for help even though he is dying. "...agitated his too sensitive and nervous temperament" (106).
Dimmesdale is DISSOCIATIVE. Dimmesdale, even when in great pain, after clutching his heart still ignores an obvious issue's severity and focuses on Hester Prynne's misery. "...better for the sufferer to be free to show his pain" (107).
Dimmesdale is DYING. It is unknown what his problem is, whether it is a disease or condition, but Dimmesdale's health has been rapidly declining and he is in pain. "...to put his hand over his heart, with a first a flush and then a paleness, indicative of pain" (97)