While in the hospital, the patient has a tracheotomy, a tube in his neck to which the breathing tube is connected. In reality, he would not have this surgically placed airway under these circumstances. Also, as the tube is below the level of the vocal cords, either he would not be depending on the ventilator to breath (thus making Renee's action of cutting of his breathing impossible), or he would not be able to speak (which he is able to do easily), as this would require air to pass through his vocal cords. It is impossible to speak if you have a tube in your neck and you require a ventilator to breathe.