The ending comment doesn't dispute anything in the clinician's notes. Jack knows that he's talking to a "shrink," but he doesn't remember that he's talked to this person many times before, always telling the same story.
On "Going Up," about a third of the time after I die it restarts me directly in the path of the descending gear on the right. If I hadn't wound up in ghost mode on the first level, I'd have been upset. :)