Because the more you look at it the less sense the overt meaning of the mod (and Word of God
) makes. A major, if not the defining aspect of Korsakoff's syndrome is anterograde amnesia - the patient cannot form new memories. Yet Christopher is able to remember details like the number lock combination (in the patched version this is made more ambiguous because the player does not know the sequence of numbers, but we still have no reason to doubt that Christopher remembered them) and the identity of Dr Grayson. This is particularly glaring in the voice log where Dr Grayson says she 'cannot explain' how Christopher remembered her name, given his diagnosis. If this is delusion-Grayson - a hallucination of Christopher - he still remembers her name and voice, though this should be impossible for him!
In fact, the voice logs make no sense given the conceit - that what the player sees and hears is what a Korsakoff's patient sees and hears. If the sections where Dr Grayson reports on Christopher's progress as though to a third party or in a written medical report are real, how is the blind Christopher hearing them? The real Dr Grayson is presumably not reading out her reports in earshot of her patient. If they delusional, not only does this go against his diagnosis (he should be unable to retain details like the name of the clinic or even the name of the condition he suffers from), it contradicts his central 'delusion' - that the world has ended. Why would a paranoid delusional confabulate/hallucinate voices which tell them that their delusions are false and that they are in fact insane? Another point is that at no point is Christopher identified as an alcoholic or suffering from malnutrition, the cause of Korsakoff's.
Although the framework of Christopher's delusions seems to shift, it remains broadly consistent (the world has ended, everyone is 'dead' in some philosophical sense, the 'Collectors' are scheming to gather everything up and stick it back together rather than letting everything fly apart and go its own way). In contrast confabulation in Korsakoff's sufferers is rarely the same twice (they cannot remember what they said last time!) and is usually 'prompted' by some word in the question, which the patient draws on to construct their narrative. A possible solution is that Christopher was actually seriously delusional before the onset of Korsakoff's, which would allow him to draw upon his previous delusions to form a grand theme he keeps returning to (something sometimes seen in real Korsakoff's patients); which would explain why Christopher's pre-Event memories are just as brooding and apocalyptic as his present perceptions whilst most Korsakoff's patients can remember their pre-disease life perfectly well. However, this still fails to address the Grayson issue. If Grayson's audiolog expressing doubt over his diagnosis when he remembers her name is 'real', then when she immediately goes on to say that she has begun dreaming of the memory-maker factory and that her room is getting colder, that is also presumably real.
The game actually makes a certain amount of satisfying sense if you assume that what the player is seeing is 'real' and that Dr Christine Grayson is 'delusional'. Towards the end Christopher constructs a fairly cohesive explanation for Grayson's voice - the Collectors attached her presumably dead soul to him in the hopes that a psychiatrist could convince him he was insane. Instead, he assimilated her, used her against the Collectors (manifesting her as the glowing crowbar) and ultimately subverted her so she wished to escape with him.
