Okay so here are spoilers. Note: FL in this means First Love (I know it usualy means female lead but there isn't one in thsi story.)
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So ML, his sister, her best friend, all of his childhood friends, and the first love were in a mall that collasped. They all died. First love tried to save him, but it didn't save him it only kept him from being killed instantly. So while everyone else died, he didn't. That's why he's sick now, he is in this world but also in the 'real' world slowly dieing while looking at his first love.Time moves differently between the worlds and while years are passing in the book world, in the 'real' wold he is still alive though fataly injured and it's only been maybe hours, he actually does get better, but that means he died in the 'real' world. When ever he tries to think about the real world that's when he has the bleeding and stuff because that is what is happening to him in the 'real' world. When he paniced because ML was bleeding while he was out of it is because first love bleed to death in front of him. He ditched the first love after first love's confession, honestly don't remember why, and meeting at the mall was where he was planning to apoligize and try to start over. First love was kind of mean to him when they met again but before the mall and that's why siser wrote him as an asshole in the story. Her explination on writting her brother as abused and then killing himself is kind of yuck. It was to warn him to not to try to get together with first love. So brother is his sister in this world, sisters best friend is same, all of his frinds from childhood are his friends, and ML is his first love. The main characters are OC and not anyone from their real lives. So basically because he's not dead in the 'real' world, he's not fully in this one. Some people do remember, his sister and her friend, one of his childhood friends (the one who avoids them), and now ML has the memories back, some of them anyway. But the memories don't change everything, ML still is the same person with his memories of this world and the newer memories of the 'real' world on top. After ML gets lost in the mountains where he got hit on the head he has forgotten this world and has back some memories of the 'real' world. That panic he's having at the end of this chapter is because he was back to his 'real' world self for a bit. Everyone else is already dead, he is the only one who is alone and dying. By trying to save him FL/ML just prolonged his pain, since they aren't the book characters ML still would have fallen in love with MC and not have gone after the real main character from the book. So what is going to happen now is that ML is going to help him sort out what has been happening (no one else remembers the actual accident even if they remember the past life) and confront people who could have helped him but they just let everyone think he was crazy and it left him even more isolated. With his real body dead and everything sorted he doesn't need to drink to cover the pain, he also is no longer depressed and sick. Then they live happiliy every after. They have a 'honeymoon' in one of those hotels with the under water bedrooms.

I've read the novel and those of you who seem confused I can tell you what you want to know. Just ask.