Grief, drug overdose, death, suicide, Trepanation and murder are big plot devices in this film.
Various characters, including Jacob and Charlie, are seen discussing going through a strange ritualistic act known as Trepanation, a process which involves a person drilling a hole through their own head. Shots are seen throughout the film of people doing it, and this features shots of blood and brain-matter being briefly shown. Jacob apparently did so because he was depressed and wanted to escape from life (later it's revealed that he in fact shot himself which Nika mistakenly believed was Trepanation). Charlie's said reason for doing it to himself was because he was "young, depressed and completely stupid". He refuses to do it to anybody else for fear of damaging them in some way.
Jacob lies in a hospital bed, discussing what happened to him during his drug overdose.
Nika points a revolver at Charlie with the intent to kill him. Charlie tells her the truth of what happened when Jacob died, stating that Jacob shot himself in the head after Charlie flat-out refused to do the Trepanation thing to him, after which Nika discovered Jacob's dead body (blood is seen splattered on a stage mirror while the scene takes place). Nika then discovers a VHS tape in which she does Trepanation on herself (a drill is seen hitting her skull, followed by blood running down her face). She then remembers everything and realizes that she had blocked it all from her mind to avoid the horror of it all.
The ghost of a dead drug addict drifts around.
A girl pokes a dead blackbird with a stick in the road.
It is mentioned that Nika and Jacob's parents are dead from a car crash.
Nika has a nightmare in which she imagines Charlie attacking her brother with a drill. He grins in a creepy way and blood splashes everywhere.
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