On Shutter Island:

>I feel like he was faking it to get the lobotomy. He made the comment about "...living as a monster or die as a good man?" then he willingly went with the staff. Had he actually relapsed like he had done before, he never would have just gotten up and allowed himself to be led off by the staff. The more I think about this, the more I think I came to the correct conclusion because of the remarks made earlier in the film where the German doctor is telling him how he will never back down from any physical confrontation.

What I thought was interesting, is the way that the camera panned to the light house as the very last scene. To me, this indicates that the light house is indeed where they would perform the lobotomy, and to me, kind of validates his quest in the rest of the movie, since they were in fact performing surgeries in the light house. If the whole ordeal was an elaborate role play with a predictable ending, then clearing the light house of the operation equipment would have been relatively easy to do.<