The quote reflects the intense emotional struggle of facing someone in a competency hearing, suggesting that the experience is both difficult and painful. It uses the metaphor of hell to emphasize the distress and discomfort associated with the situation, highlighting the compounded anguish of the event.

In Jodi Picoult's "Perfect Match," this vivid imagery illustrates the protagonist's turmoil. The phrase "raw liver-insult added to injury" suggests that not only is the hearing a torturous experience, but the circumstances surrounding it exacerbate the pain, showcasing the deep psychological impact on the character.