Unfortunately, the hospital bed photo looks real and the vacation photo is fake. Note the 2 light sources reflecting off the turtle's shell. They make no sense outside, but they match the light sources in the hospital photo.

I saw the vacation pic posted earlier in a now-deleted post that tried to pass it off as real. When asked for a source, OP admitted that they didn't care if it was fake or not, and not long after it was taken down. As funny and damning it would be if they just reused an old photo as proof of life, I highly doubt the vacation pic is legit.

That said, the hospital one is fishy as fuck imo

I can't find the following image from a few reverse image searches:

What are you talking about, he's totally alive. He can even wave his hands for you. Wave your hand, Mitch! There, see, he waved!