Saw this yesterday and must say I found parts of it pretty sickening....

....SPOILERS....

....Specifically the continual scenes of aborted fetuses being tossed in the river and rolling downstream. I thought Showtime's decision to pull this episode from the MoH line-up was understandable and not a ploy or PR stunt at all.

The ending is definitely ambiguous. I did not feel confused at all until Christopher (Billy Drago) shot the prostitute in the torso and then the brain, at which point prostitute's identity suddenly changes to Komomo's. My first reaction (and the one I think makes the most sense) is that Christopher was somehow hypnotized into believing he had shot lost love Komomo. But the more I think about it, the more confused I get. Regardless, it seems for sure at some point he is brainwashed into believing something that is not real.

I don't know about anyone else, but I couldn't help but think of Basket Case once the sister was revealed. Similar both in story set-up and the make-up effects.