[He squeezes James's hand, listening patiently as the man talks through his thought process. Victor can understand about purpose and duty. It's how he sees being a doctor in Storybrooke. He does make the choice between duty to the job and being with James and Lucy easy, but that's only because Victor would do anything for family-- and did go to extreme lengths for them in the past.

But he does understand that sense of wrongness and worrying about abandoning his patients and his duty to the town]

I can't tell you what to do if that time ever comes, James. I've never actually had that choice on whether to stay in one world or another. [He traces the Starfleet symbol on James's hand] If we were both in your world, there would be no question: you should go back to your ship. But here... I don't know. I wish I had an answer.