In the Meat Locker, if you don't choose either of them...
What happens when you run out of time? Is it just a 'game over screen', also what happens if you don't choose a dialogue option quick enough?
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As for if you pick no one, I read Kenny just says you are worthless, pushes you aside, and kills Larry. Then it acts more like if you try to save him with you against Kenny and not Lilly.