fresh meat, page 76

boy, this page looks WEIRD without the shading.

so i'll talk a little about what kim's saying here. the next page is the last of this scene, so there isn't much more to develop.
you may have noticed in the scene where kim was moved wards and switched check-in groups, that tabitha is the only one in kim's check-in group there for actually attempting suicide. in the scene in question, on page 49, tabitha latches onto kerris's introduction to soften why she's there, adding a "too" to her statement despite the fact that she is not there for ideation itself. this doesn't fool kim; she latches onto the similarity here and says "i'm also here for suicide."
let's rewind a bit. kim has introduced herself during a few other scenes in the story. on page 22, she avoids stating why she's there at all. she rejects judy's extension of camaraderie and understanding here, and the scene moves on.
on page 34, she introduces herself again, and we see that she states she's in the ward for "depression"... the introduction of tabitha and her reason for being here is the first time kim states openly that she's there for suicide to other patients, and in a way that indicates she noted the similarity between her and someone else. this is not insignificant, as it isn't necessarily the first time kim has been introduced to another character who also attempted suicide in the ward.

so, we have to decipher what's different about tabitha in kim's eyes. let's go back.
kim is generally a pretty hostile person. a lot of the readers are getting tired of it, but the hostility here is very important. kim is hostile to staff members as well as other patients. from this, we can extrapolate that she is not hostile exclusively because of anger about the power dynamic, nor because the other patients can't leave (in fact, she gets upset when other patients get to leave).
we have also observed her act hostile towards staff members before she was aware that she would be institutionalized at all, so we can assume this isn't hostility solely blossoming from anger about being there.
she has been shown to look down on the other patients, with a belief that they deserve to be there, unlike her. it would be easy to assume she probably tears people down in her head. this scene elaborates that she does this to push them away. more specifically, she pushes people away and lashes out because the kindness itself is repulsive. nothing is more angering than a reason to hesitate when you're looking down the barrel in the cyclone of wanting to die.
coming to terms with this pattern in yourself is pretty agonizing. you realize what an asshole you are and always have been. you knew it, but once you realize your pain isn't necessarily special, that other people feel something essentially equivalent, and they act with kindness, it's a new kind of asshole that you are. it's suddenly choices you made, and, as tabitha said, the choices make you the person you are.
it reinforces ideas that you already had about yourself, you think about how you deserve to die, and the cognitive dissonance hits immediately, because you know the reason you're like this is because you want to die.
in this particular conversation, kim is doing what she's been doing -- she's fighting for her suicidality. this scene is meant to be poignant and notably different from others, because tabitha is such a pacifist, so clearly kim's not fighting tabitha here; she's fighting herself.

while kim is the protagonist, and most of the scenes primarily serve to develop her character, and the audience's understanding of her character, the dialogue is written in such a way that it's meant to be able to help tabitha move past what she needs to move past as well. the most obvious ways are pointing out the flaws in her "except for me" logic. another is the simple suggestion that she's seeing more choice here than she's actually being given. the third is asking her "what makes you so different?"
this line is very vague, but there are several things kim means at the same time:
1) what makes you different from the animals who don't deserve to die
2) what makes you different from the other patients here, we're all not exactly choosing what we have to do
3) what makes you different from the other patients here, why do i CARE about YOU
4) what makes you different from me, why do you act kind in this horrible world
tabitha is the kind of person who clearly stays up at night thinking about things, so it isn't necessarily for naught just because she isn't visibly responding to what kim is saying.
i'm not explaining any of this super well haha, but it's written to be so if i were a reader, i could reasonably assume tabitha leaves without being shown as much as i could assume she stays. i wanted to provide compelling evidence for either assumption without them contradicting each other.

the other thing that i wanted to mention is that what kim is saying here is obviously relevant to the climax of drop-out. this isn't really something that gets super into it, but the next page kind of wraps a bow on why kim was on the wall of the canyon, if anything does in this story at all.