Inside the sheath, their proboscis is actually six arms: two saws, two manipulators, a spitter, and a sucker. They saw open your flesh and use the manipulators to sense blood vessels, which they pierce to suck blood.
Madness string 100549
Trauma like that puts you in a headspace that makes clear, lucid thought a cruel joke. He can only see himself there because he is deeply, deeply traumatized from all the hours, days, years spent sleeplessly imagining all the moments he could have shared with his kids.