Lexy Lorenzo

As I’m reading everyone’s theory none of them answer when did he start liking reality from dream or ptsd. Because for the most part everyone thinks that nothin at the hospital was real until he woke up. But whats confused me the most is The gas station lady was painting a bird and you see that bird later on on the desk of the lady who's taking their insurance information, then when that representative goes to speak with her supervisor it’s the same lady who was painting the bird at the gas station. Did he just play those images back into his made up story ?