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As a result, we have even more questions than answers. (Doctor and his daughter, Scenes of violence in the final, Unsuccessful escape?).
The plot style is intriguing.
Play game as normal, getting all objects.
Use the Crowbar to retrieve the Key in B5 (that thing you reach for and drowned previously).
Then upon the 2nd trip to the Hospital Room, go to the last file cabinet in the corner and open it.
Finish the game then.
You may need to use the syringe to buy yourself some time and see some flashbacks, but I don't think it's required for it to trigger this ending.
The icon is the Chainsaw. Curious what you have to do with it.
"Pain
Will you learn about it?"