After Kilgore Trout's finger is treated, he gets lost in the basement where the emergency room is located. He is "destitute," with no health insurance or cash. As he wanders past the morgue and the x-ray room, he "automatically mooned about his own mortality." He passes the room of Elgin Washington, a young, "fabulously well-to-do" pimp who operated out of the old Holiday Inn. Khashdrahr Miasma has amputated his foot, perhaps unnecessarily, earlier in the day, and now Elgin has just sniffed cocaine. Elgin wants to make Trout feel diminished, as he does with everyone. He tells him, "I think I may be dying." Then he asks him to listen to him as he imitates the Nightingale. This is a reminder of the talent all black people in Midland City share: imitating birds.
The Midland City Festival of the Arts has been postponed, but Trout has not been informed because he had wandered away by the time Fred T. Barry came to the hospital to tell him. Now he is walking back down Fairchild Boulevard, and the narrator is waiting to intercept him smoking a cigarette. When he gets out of his Plymouth Duster, he tells us, "I feared nothing. That was foolish of me." This is surprising, since he is in a world of his own creation. However, he is about to be attacked by a Doberman pinscher named Kazak. Kazak was taken care of by the husband of Lottie Davis, Dwayne Hoover's maid, and abused and then turned loose. He looks at the old Keedsler mansion, where Beatrice Keedsler had been raised, and where her uncle had committed the murder of five relatives, three servants, two policemen, and all the animals in their private zoo because of a brain tumor. Then the mansion was inhabited by Fred T. Barry's family, and now it belongs to the city. Fred T. Barry wants to make it into a museum, as long as it exhibits the first Robo-Magic and explains "how machines evolved just as animals did, but with much greater speed." When the narrator is attacked by Kazak, his testicles also retracted into his abdominal cavity, and he is told he'll need surgery to bring them down.
Trout still approaches, and now he sees the narrator, his Creator, leap completely over an automobile and land on his hands and knees in the middle of the street. Kazak is knocked silly when he is stopped by the fence. Trout turns around and starts to run away, but the narrator chases him in his car. Kilgore stops running when the narrator calls him by name, in front of the General Electric Company. The monogram and motto read, "Progress is our most important product." This motto hearkens back to the theme of advertising, now tying it to the idea that has just been introduced of machines evolving like living things. General Motors products are making "progress," just as the Robo-Magic evolved.
Now the narrator attempts to turn on the dome light in his car, to let Trout have a look at him. However, he is unable to control the machine that is his automobile just as he is unable to control the machine-characters in his created universe:
I thought it would be a good idea to let him have a good look at me, and so attempted to flick on the dome light. I turned on the windshield wipers instead. I turned them off again. My view of the lights of the County Hospital was garbled by beads of water. I pulled at another switch, and it came away in my hand. It was a cigarette lighter. So I had no choice but to continue to speak from darkness.
The narrator tells Trout, "I'm your Creator. You're in the middle of a book right now - close to the end of it, actually." He tells Trout that he is going to win a Nobel Prize, and have a reputable publisher. All Trout wants to ask him is, "Do you have a gun?" And then, "Are you crazy?" To prove that he is not crazy, the narrator transports him all over the world: to the Taj Mahal, Venice, Dar es Salaam, the surface of the Sun, to the Bermuda of his childhood, and to the Indianapolis of the narrator's childhood. This demonstration of power enforces the idea that the narrator himself is a character, since it links him to Trout by making Trout share his formative experience of seeing a man with locomotor ataxia, acting like a machine.
The narrator now noisily gets out of his car and tells Trout that he is holding something in his hand, even though there is nothing there. Such is his power over Trout that he will see whatever the narrator wants him to. The narrator says,
"I hold in my hand a symbol of wholeness and harmony and nourishment. It is Oriental in its simplicity, but we are Americans, Kilgore, and not Chinamen. We Americans require symbols which are richly colored and three-dimensional and juicy. Most of all, we hunger for symbols which have not been poisoned by graet sins our nation has committed, such as slavery and genocide and criminal neglect, or by tinhorn commercial greed and cunning."
Trout looks up and sees that the author is holding an apple in his hand. This is significant because an apple is one of the most important symbols in literature (stemming from the story of Adam and Eve in Genesis in the Bible), and it has been a kind of symbol throughout this story: the narrator has drawn two pictures of it. But it is rendered meaningless by the words the narrator has just said to Trout.
The narrator tells Trout that as he approaches his fiftieth birthday, he is going to set all his characters free. Then he says "Bon voyage" and "somersaulted lazily and pleasantly through the void, which is my hiding place when I dematerialize." A small hand mirror floats by the narrator as he travels between universes. It is another symbol, a leak between universes, very obviously heralding the narrator's departure from the universe of the characters. Trout's voice is the narrator's father's voice as he yells, "Make me young, make me young, make me young!"
As Trout wanders past the morgue and x-ray room, the narrator uses the opportunity to again remind us of his opinion that humans are machines: "Trout felt nothing now that millions of other people wouldn't have felt - automatically." Even as Trout experiences the most aware, seemingly human feelings of questioning one's mortality, he is acting in accordance with his machinery. This comparison suggests that despite Karabekian's speech about his painting and how it represents awareness, which distinguishes living things from inanimate objects, the narrator has not been convinced.
As the narrator ponders his surroundings before being attacked by Kazak, he has become completely a character in his own created universe, as he tells us, "I should have known that a character as ferocious as Kazak was not easily cut out of a novel." But he is unaware as he looks at the old Keedsler Mansion. We have already seen that as long as he physically exists in the universe of his own creation, he is vulnerable: he was accidentally injured during Dwayne's rampage, and now, supposedly, has a broken toe.
The fact that Fred T. Barry wants to make the old Keedsler mansion into a museum that shows "how machines evolved just as animals did, but with much greater speed" is interesting, since this idea reverses the them of humans as machines and instead gives machines the living quality of evolution. The theme of humans as machines is demonstrated explicitly in Kazak's attack of the narrator. The narrator's response to the attack is described purely in scientific terms rather than emotional ones: "Everything my body had done so far fell within normal operating procedures for a human machine."
The scene in which the narrator tries to turn on his dome light in the car so that Trout can see him more clearly is significant. It is an allegory for the Creator of the narrator's universe, as well as that of the reader. The car, in addition to Trout himself, is a metaphor for the Creator's characters; this metaphor has been built up throughout the story by the theme of humans as machines. It seems to have its own free will as the narrator tries to control it, in order to reveal himself as Creator to Trout.
What the narrator says to Trout about symbols suggests that any symbolism the reader has found in the story is merely the creation of the reader, searching for meaning. This is assuming the reader is American, since this search for symbols is described as a uniquely American quality. An example we have seen of this is the symbol "Goodbye, Blue Monday," which, despite all the meanings heaped upon it throughout the story, has been demonstrated to be empty after all, when Dwayne Hoover shouts it out randomly in the ambulance. The "tinhorn commercial greed and cunning" refers to the theme of advertising, which has permeated the story.