The silence after 'I'm fine'

In the dream I'm sitting at a bedside, same chair I always use, and the patient says 'I'm fine' with a smile that doesn't reach their eyes. The words hang in the air like fog from a breath on a cold day, slow and heavy. I reach for my notepad but there's nothing to write—just that silence we both know is a lie, and the ache of waiting for what comes after.