Ishihara hasn't exactly straddled the line of being a caricature in his cruelty in Rainbow since I've felt he's gone over it a few times already. With the last episode and this one, he's becoming even more disturbed as he deals with Sakuragi in solitary since he's just a few days away from finishing his sentence. The need to have him dead continues to grow by the minute and he's panicking since so much could be revealed in his freedom. The good doctor Sasaki's suggestions aren't exactly all that friendly either in how he provides ideas on how to eliminate Sakuragi, though the need to make sure that there are no visible injuries is the main thrust of it all.
Sakuragi has certainly earned his friends over the last several episodes, and especially with the fire, which is why we see people like Mario and the others doing what they can to get him some food. With it being ten days since he's had anything to eat, Sakuragi should most definitely be dead. But with the help of his cell mates, and that of the guard Kumagai who is slipping him some food as well, Sakuragi has held on and is in a position to make it through the rest if things continue on as they are. But such a thing can't happen as those who are helping him are slowly revealed, especially when the doctor sees a guard standing outside his office and begins an investigation himself to figure out who it is that's helping the prisoner that simply must die.
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