What is real for Adam? It's impossible to say. Often in literature we see characters whose versions of reality differ from those of the people around them. In I Am the Cheese, Adam experiences different versions of reality within his own mind. Before the accident he consciously witnessed reality changing around him when he discovered that his family was part of the Witness Re-Establishment Program. After the accident he doesn't even realize that he's experiencing different versions of reality.
There is one reality, shared by all humans. That means Adam is removed from reality.
Reality bites. (Or, put more eloquently, reality is never as romantic as the world of our imaginations.)