Пациент не имеет желания общаться с нами.

From Lesson 261:Genitive of negation·Russian

Questions & Answers about Пациент не имеет желания общаться с нами.

Why is it желания and not желание?
This is the genitive of negation. The verb иметь (to have) is transitive. When a transitive verb is negated with не, its direct object often takes the Genitive case instead of the Accusative. This rule is especially common for abstract concepts like желание (desire).
Couldn't we just say у пациента нет желания?
Yes, you absolutely could! Both mean the same thing. However, using the verb иметь (to have) is more formal. It is frequently used with abstract nouns like желание (desire), право (right), or возможность (opportunity). You will often hear this phrasing in medical, legal, or official contexts.
Why is there a -ся on the end of общаться if they are communicating with someone else?
The verb общаться (to communicate) is always reflexive. It implies a reciprocal action, meaning to interact or converse with one another. It is almost always followed by с plus the Instrumental case.
Which pronoun is нами?
It is the Instrumental case form of мы (we). The preposition с always requires the Instrumental case when it means with in the sense of interacting or doing something together.

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