Of a fictitious little sister who never existed
And this is why part of my life is so twisted
But I can never be as sick as that bitch is
And by the way that picture is one of my relatives

from Eminem – The Apple Lyrics on Rap Genius

Meaning

His mother was so psychotic that she made up a fake sister of his who died falling out of a window when Em' was a baby.
Also notice the last line, in my opinion it eliminates the “Sarah theory” since “relative” is an unlikely term to designate a sister.

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