The skull in the painting has been opened up by ribbon, to suggest the work of the doctors at the mental hospital, attempting to make a proper diagnosis. Kurelek depicted the rat spirit as inert, unwilling to leave his prison even though it has been opened up for him. This was Kurelek's way of showing his doctors what their job was. He writes, in his autobiography, "Now clean me out, I challenge you scientists, and put me back together again – a happy, balanced, mature, fulfilled personality. Lift that rat out and unwind him and let him run free!"