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James murdered his wife because she was suffering from lung cancer and he was tired of caring for her, dealing with her ♥♥♥♥, and watching her suffer. He carries a mix of guilt and anger about the situation because while he is aware that what he did was wrong a part of him feels justified.
Maria is a manifestation of his ideal version of his late wife created to test his dedication to her. By leaving with Maria he has failed this test and succumbed to his own selfishness and personal desires rather than redeeming himself by finally staying true to his late wife.
Maria coughs to imply that she is also sick and that the cycle will soon repeat itself until James learns his lesson. The line, "Take care about that cough" is meant to indicate that James has not changed, has let go of his guilt and regret, and is now actively threatening to kill Maria too if she finds herself in the same position as his late wife did.
Aight, where? I'd love to hear about that if you have some good links for me dude.
That's not a time loop. That is literally the intended read of the ending, same as it was on the OG PS2 version. He takes Maria home, didn't move on, and Maria gets the same sickness Mary had. Time isn't looping here.
There we gooo~
Someone who knows the difference between the words "Cycle" and "Loop." James repeating the cycle doesn't mean he's traveling back in time and starting over. He's committing the same sin a second time with no remorse, he'll suffer for it a second time too.
It's not Lung Cancer. It may be some form of Cancer but not Lung, as it causes intense scabbing on the skin and hair loss. It's most likely some form of Leprosy or Autoimmune disease.
Guy Cihi says he asked one of the developers about it and they told him it's some rare terminal form of Eczema or Melanoma.
Way I remember it he never says what the disease is, just calls it "The sickness" or somethin. I know his wife has a really bad cough before she dies though so the reading of the Maria ending stands.
She has really bad skin scarring in the Leave ending (and also the In Water ending in the OG), and also thinning hair and she's emaciated.
Tracks with cancer then. You said one of the devs may have called it a really bad form of melanoma right? I wonder than if Maria coughing is a symptom of the same disease or just to imply that she is also sick since coughing is the most obvious outward symptom of early onset illness.
It tracks with cancer if she's being given cancer treatment, I.E chemo and radiation. We don't know what the extent of her treatment is. It's possible she was given none other than prescriptions because her doctor clearly states in the OG recording that "There is still no effective treatment for her condition."