"I pause to record that I feel in extraordinary form. Delirium perhaps."
At times, Malone appears largely cognizant. He remembers where he is and that he's probably dying eventually. By identifying the delirium, he demonstrates a resistance to dementia and even death itself.
"Words and images run riot in my head, pursuing, flying, clashing, merging, endlessly. But beyond this tumult there is a great calm, and a great indifference, never really to be troubled by anything again."
Malone can sense his impending death. He understands that something is not quite right about his situation, but these moments are few and far between. For the most part, he's listening to the chaos and allowing us to read some of it through the character of Macmann.
"I have spoken softly, gone my ways softly, all my days, as behoves one who has nothing to say, nowhere to go, and so nothing to gain by being seen or heard."
Malone has resigned himself to an unimportant existence. He never thought highly of himself before he was arrested, and now he has confirmed the suspicion that nobody missed him. With this quiet resignation to insignificance, he lives out his days calmly, so as to not attract any undo attention.
"Lemuel is in charge, he raises his hatched on which the blood will never dry, but not to hit anyone, he will not hit anyone, he will not hit anyone any more, he will not touch anyone any more, either with it or with it or with it or with it or"
In this astonishingly incoherent ending, Lemuel is described by Malone as a non-threat. His gory visage is just a reflection of power, not violence. He would never hurt his patients. He's just demonstrating his authority in this situation.
