Hello.

Here are my thoughts about what this is really about.

It's about a man that lost someone dear to him by the name Esther years ago in a car crash. Now he's older and dying of cancer. The game take place when he is dying in a hospital of his disease and the island is his minds way of resolving his loss once and for all and to let go. He haven't managed to do this before.

The narration is not altogether coherent and jumbled pointing to old memories that he doesn't remember as much of as he used to. This is also explained by him being sick, unconscious, dying and heavily drugged.
Most of the images of the car and its parts look old (Might be burned though.) and the things from a hospital new. The pictures of women are also old.
There are ultra sound pictures and him talking about stones in his stomach points to cancer. I don't think all talk about stones is about his kidney stones.

Anyone have any other thoughts? Would be interesting to discuss this.