Yeah, it's Otis. He's in this passage to poke a sly finger in the ribs of Gately's internal battle with the Higher Power he's selected seeming to leave him in a position/state of near-impossible-to-escape-from-Substance: incredible pain, confined to the bed with nothing better to do, a Dr. offering a veritable menu of drug choices. Gately wants to know why he's been put in this place of supreme vulnerability when he's clawed himself away from Substances; what sadistic Omnipotence would do this to him? Now think of Lord; he tried to play g-o-d to eschaton, and because of a lapse in his divinity, he wound up with a monitor on his head. It's a way of answering Gately indirectly; the Higher Power may not be as powerful as Gately assumes, maybe he's (Gately) in the place he is because the Higher Power 'looked the other way' at the wrong moment. When Gately think-shouts out to the Higher Power, he's unaware that the Higher Power is right next to him...not really, but that's what I think DFW is doing here.
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