Ok, here's what I noticed.
Basically I've heard people debate as to whether the appearance of Libby was a dream or whether it was *really* Libby or the island..
I think it's a bit of both in that it is Michael's own subconscious rising to the surface. He still feels guilty about what he did and so his guilt is affecting his 'reality'.
When I rewatched the scene where he see's 'Libby' in the hospital, I noticed a few odd things, which i've tried to piece together - firstly Mike looks at the monitor next to him - this is the very first thing he does upon opening his eyes, and it drew my intention as it seemed 'forced' - and indeed, it turns out that this was a clue as to what was really going on. The scene is basically part dream and part real - the first part is all a subconscious dream, then when he see's Libby he wakes up and things around him are different. For example:
This is the Monitor before he starts screaming. Notice how 'old' it is:
This is the monitor he see's AFTER he starts screaming - it's clearly different and is 'modern'. Even the readings are different - one would expect them to be higher from all the panic, but they're actually lower - showing that the readings in the previous shot (above) were all a figment of Mike's imagination:
even the patient (who looks like Alvar Hanso and Kelvin, I must say) is different. When Mike first looks at him he doesn't have the gas mask on, but has tubes going into his mouth:
However, after he see'e Libby and starts screaming (i.e. after he wakes up), he looks at the man again, and see's that he does have a gas mask on, aswell as the monitor now being closer to his bed:
The camera angle also changes as Mike is screaming - another indication that he was dreaming..creating false realities based on his subconscious guilt.
Basically, I feel that this proves that 'Libby' isn't necessarily a manifestation of the smoke monster or the island,
but a figment of Michael's subconscious guilt - although one
could argue that the island/Smokie is the very thing which triggers this. But still, I feel that the above was intentional from the creators to give us some footing to understanding the nature of these 'off-island' visions. What does this say about Hugo's vision of Charlie at the mental home? Again, the main parallel here is 'guilt' and 'death'.
Something else which interested me is the fact that he heard mama cass on the radio before he tried to kill himself - Mama Cass is the same chick who sung the song (which names alludes me) in Desmond's opening hatch scene from S2. It's almost as if the creators are trying to allude to the idea of the past replacing current reality - the same goes for the observations above - Mike's dream changes his reality to a skewed version which is triggered by his guilt. I'm not sure how to articulate this properly yet, but there's something fishy going on..they're trying to give us more clues beneath the crumbs..
