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It is intended as an indication that his mind is not really well, even though he accomplished his goal of protecting and rescuing the female character from the scumbag creeps of life. It means that he was, is, and always will be a sociopath with violent tendencies, paranoia, and an exaggerated sense of self-importance. It states that he is just as dangerous to her as the creeps he believes he saved her from, if not more so. Classic archetype of the "anti-hero".
As for the exact thing he sees in the rear-view mirror, I don't remember. :-P
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