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Eleanor rips out her own tongue to save not only herself but Lettie... to show Lettie that she's always been "here" and is more than the technocyte. The first thing Lettie says in 1999 is how they need to cut off Eleanor in order to "cauterize a wound" because of the extent of Eleanor's infection, and yet Lettie hesitates the second she's faced with the real prospect of killing Eleanor, cementing her own death.

Lettie can't let Eleanor go no matter how much she tells herself she needs to. She's compartmentalized the death and disease of her loved ones for years both as a field medic and taking care of her dying relatives growing up. She expects this to be no different. Lettie suppresses her affection for Eleanor over months and months, pushing her away, only for it to bubble up twice as strong at the end.

"Making sure you're still... you," comes WAY too late for it to make a difference. Eleanor is already completely consumed by the technocyte. By her own loneliness. A longing for acceptance that only comes from the infested after Lettie abandons their relationship.

It kills her. It kills them both.

In the next loop, after Drifter uses transference, Eleanor's last attempt to remind Lettie how much Eleanor cares for her is what saves them both the second time around. How they were "thick as thieves for a while" (Eleanor's words), and how even months of indifference didn't erode that sentiment.

They always end up in each other's arms whether they're dying together at the bottom of an infested substation or curled up on the sofa in the backrooms eating pizza. They are literally inseparable and eternally fated to live and die together no matter the loop. im fine