He has long since forgotten who he used to be.
He remembers that he was charismatic, or at the very least he had been told that he was; in truth, he had not contemplated his charm often, save for on occasions where it had been brought to his attention—when a loose and easy smile brought him the indulgence of his parents and teachers, or when that same charming manner attracted women into his bed. He had not been a particularly vain person, and physical beauty was not as important to him as it was to other men. If he was guilty of anything, it was a lack of pride; he was almost ashamed of his charm. To him, it were a hindrance; he had wanted to be taken seriously, and men seldom respect a womanizer.
He doesn't have that problem any longer.
He remembers the sensation of a hand gently stroking his cheek, of soft lips pressed against his own. He remembers when the Island was beautiful and serene, and he remembers a time when death was a stranger to him.
But he cannot remember his former self.
Gone is the personality that inspired intrigue in women and mockery in men; it has been replaced with violent, unpredictable, prideful insanity, the product of cruel, hateful hands. The island had robbed him of much more than his charm—it had stripped him of his identity. All the drugs, all the killing simply pushed him towards the edge. But it was Hoyt the self-appointed warlord who promised him power and wealth, who made him turn back, made him look at sanity and say no, he had felt the last lingering piece of his former self die, crushed inside a husk of a man. It had been the final step of his forced reincarnation, and the first step towards his new life.
Insanity is his constant companion, and it is as much a part of him as his flesh. Never again will he feel lips against his, never again will he go back to the painful familiarity of sanity, and never again will the Island symbolize freedom and peace. Those days are over—that man is dead and it will do no good to mourn him.
At times he finds himself searching through his memories, trying to piece together a portrait of a charming man who is now a stranger to him. Each time he is unsuccessful, and it occurs to him that perhaps he does not want to remember. It is his current self that matters now; it is the one that strikes fear into the hearts of otherwise strong men, and the one that makes him the most feared man on an island full of madmen.
And so with each passing day sanity fades further into the recesses of his memory, blurring together with everything else Rook Island destroyed until Vaas wonders if he ever existed at all.