Also a matter of perception, both in terms of exactly what was being said/shown (was it "What the hell have I done?" or was it "What the hell just happened?")
Specifically with regard to the Racnoss, David Tennant himself said it was a "What have I done" moment of realization.
As to the others, that is one of those personality traits that seems to shift slightly from incarnation to incarnation (and writer to writer). But then, when the Doctor was swinging more towards the realm of "screw it and kill them all", the companions typically stopped him - or at least begged him to think before he took action. They didn't encourage him - which River certainly does. And Amy and Rose to varying degrees do/did as well.
I still say that the Doctor's downward spiral started with Adric's death - but that's another discussion altogether :P
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Specifically with regard to the Racnoss, David Tennant himself said it was a "What have I done" moment of realization.
As to the others, that is one of those personality traits that seems to shift slightly from incarnation to incarnation (and writer to writer). But then, when the Doctor was swinging more towards the realm of "screw it and kill them all", the companions typically stopped him - or at least begged him to think before he took action. They didn't encourage him - which River certainly does. And Amy and Rose to varying degrees do/did as well.
I still say that the Doctor's downward spiral started with Adric's death - but that's another discussion altogether :P