Not a favourite episode for me, there didn't seem to be an ending. Did the Doctor resolve his conflict or was he rewritten.

The Ensign who was killed; I'd never seen her before either!

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@danio1972 He resolved his conflict. Reading the poem he realizes that his life has changed from meeting and killing the ensign and he must keep going. The fact that he decides to treat Janeway and let her go to sleep proves he got out of the loop once he realizes that the core of the issue was "can i live with what i have done?". And yes, the ensign was just a episode character, she never appeared before. I would be strange to kill like this someone the espectators liked or knew.