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The reason you don't hear Charlotte scream in the denial ending is because Kristina wants to pretend it didn't happen, and deludes herself into remembering a nice, sanitized version of what actually happened. Hearing the screaming, is facing the truth
Although it may **appear** you've saved Charlotte in one of the endings, it's actually a figment of Kristina's imagination. That's why the ending is called "Denial"... it's a denial of the real truth. Thought this was patently obvious... with the ending being called "Denial". "Saving Charlotte" part of the "good ending" is a figment of Kristina's imagination, it's a delusion her mind cooked up because she was too fragile to cope. I would suggest you google what "denial" means in psych and it would make sense. It means lying to yourself to make yourself feel better.
I got sarah and the video explaining things re why and the clinic scene
I got surgical kit and photo and explanation from the surgeon
This should be common sense:
-Spoilers being hidden should be used in instances that a topic does not involve a subject that is a spoiler in itself of heavily tied to spoilers.
-If you place a spoiler warning in a topic description, there is no need to use it in the messages. Fair warning has already been more than sufficiently been given. Anyone daring to open a topic about the endings and that has spoiler warning in the title does not mind with spoilers.
This isn't rocket science. All that you're doing is making the experience harder to read.
In typical fashion for FMV interactive narratives, the only way to get the full scope is to try out all permutations, watch every scene, explore every path. There is never a complete ending, since in order to open some doors you have to close other options.
Why did her friend scream her name? Because she was desperate. And her friend was the only person possibly within a reasonable earshot. Deep down, it is possible that, on a rational level, she knew that it would be better for her friend to save herself and possibly survive in order to alert the authorities. But she was desperate at that moment, in deep pain. Her only hope, even if irrational, was to shout the name of the only person nearby. Who can fault her?
As for the protagonist, she had little to no chance to overpower all of the captors. And this is assuming that we saw all of them. There could potentially be more people helping with that illicit operation. She was still groggy by whatever drug they game her. And the criminals were probably well armed. The best course of action was obviously to run away from the place.
Exposing herself and attempting a surprise attack would more than likely lead to both women being murdered.
At least one was able to survive and denounce what has taken place. Even though she was left emotionally scarred by survivors guilt.
Kristina has been mentally traumatised from this event and has been seeing a psychiatrist who is helping her work through what happened, to accept the truth and be at peace with her actions. Until it is revealed that she has been on a psychiatrist lounge the whole time, the whole plot up until this point has been Kristina making up a story in her mind as to what happened. This is because she has been in denial. Depending on the choices you make, which affects her character attributes such as guilt, denial and acceptance, it is either a ghost story or one where she thinks she has found out the abductors are the surgeon, the headmaster, the vet and Jack.
But, when she wakes up on the psychiatrist lounge and he puts her back under, it is revealed that she was simply randomly abducted at the bar by the group of strangers. We don't know why they did it, what exactly they did to Charlotte, and if they were ever caught. It is these unknowns that lead Kristina to speculate and make up stories such as they were capturing and killing girls for live organ transplants. The worst bit for Kristina is that she is guilty that she abandoned Charlotte in her escape and didn't go up to the stairs to save Charlotte. So the more detailed Kristina's story is up to this point, including saving Charlotte, the worse the outcome is, because she is deluding herself that all these things happened which didn't. Kristina had no choice but to leave Charlotte and must come to the acceptance of this.
So Charlotte is actually dead. Because the real plot goes back to the night of Emily's wedding, Emily isn't actually dead.
So the point of the game really is exploring what it is like to have trauma.
As Emily says - having a trauma can make you deny reality and see your deeper feelings turn into monsters.
Chilling game.
If you are into this sort of story, about recollections, denial, hallucinations, I suggest the 2 Alice games (one is a remake owned by EA), Batman Arkham Knight (its story is surprisingly good), the fmv game Erica and the indie game Sagebrush.