The only plot twist is...
That in the end Andrew got cured but still chose lobotomy because he couldn't live with what he have done and experienced.
That's the whole point of the movie, besides of getting into the head of a mentally ill person.
Honestly although I find this movie interesting I don't like the ending that much because it basically says that everything that happened the entire movie isn't even what really happened. Which kind of sucks. I don't know if the novel is like that since I haven't read it. But the movie doesn't do a good job of telling a coherent story in my opinion.
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