Board Thread:General Discussion/@comment-86.46.22.35-20130403153709/@comment-50.53.154.87-20131021171616

It's a plausible thing -- side effects via trauma from phantom limb pain, PTSD, a 9-year coma (which is likely induced during the desctruction of Mother Base, leaving the catastrophe fresh in his mind), not to mention all the medication he'll be given while he's hospitalized... the list goes on. Couple this in with the fact that he never really moved on from killing the Boss and only finds some semblance of solace through war, we then witness the induction of Punished Snake, whose mind is a clusterfuck cocktail by the time he meets "Ishmael".

We already see demonic apparitions of Volgin and Snake from his past, a flying whale eating a helicopter and a flaming Pegasus. Ishmael being a hallucination wouldn't be the most ridiculous thing. There are times when MGS's storyline could be accused of being convoluted, but this isn't one of them. Lumping this into that category comes across as petty one-upsmanship.