It feels like it was intended to be a religious allegory considering the other symbolism in the game.
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It felt like a breeze compared to Point Lookout's bullet sponge hillbilly mutants and impossibly tough ghouls. Its subject matter could be applied to so many things that deal with personal identity, though. The focus is entirely on "how can you be sure you are who you think you are?" and how people struggle to find themselves amidst others trying to tell them who they should be.