He kills Dwight Yoakam. Then he calls 911 and says they need to bring an ambulance or a hearse (referring to what Dwight said, I think). Then he ends back up at the mental hospital and gets pissed at J.T. Walsh for telling his dirty stories.

Doyle (Dwight Yoakam) says, "Fair enough. Just dial 9-1-1 and ask them to send an ambulance - or a hearse, I guess." Then Karl (Billy Bob Thornton) gets up and gives two whacks to Doyle right on the head. He walks into the kitchen and dials 9-1-1- and tells them that he just killed Doyle. He also tells them that the second whack nearly split Doyle's head in two. He mentions the ambulance/hearse commit and tells them that he will be waiting for them to arrive. He then sits down with a jar of mustard and spreads some on a piece of bread/biscuit? and takes a bite. Fade to black.

Fade in to Karl sitting next to Charles (J.T. Walsh) and staring out the window. Charles is telling Karl about the last girl he kidnapped and tortured. He liked her the best because he let her live a few days longer than the rest. He usualy loses interest quickly, but he kept this one alive. He also stuck a rag in her mouth and taped it up with duct tape. She couldn't complain that loudly after that. Charles then tells Karl that he doesn't like people who talk too much. He likes to do all the talking. That's why he likes Karl because he doesn't talk too much.

Charles asks Karl what it was like to be out in the real world. Karl says it was nice and that he met a boy and became friends with him. Charles says, "I bet you did." He implies that Karl had some sort of sexual relationship with the boy by saying he doesn't bend that way, but whatever Karl liked was okay with him. He just wanted to hear some details. He asked Karl if he killed the boy. Karl then tells Charles that he doesn't want to listen to him anymore. He then says he doesn't want to hear him speak anymore at all. Charles looks surprised and then gets up and walks away taking his chair with him.