Silent Hill 4: The Room
Other appearances

Hospital World
Apartment World (2nd time)
Attack methods

Patients are monsters in Silent Hill 4: The Room. They can usually be found in the Hospital World and Apartment World 2nd time.


They are large humanoid creatures, standing tall in height and towering over Henry Townshend. They resemble a feminine monster with grotesquely distorted facial features. They have mottled gray skin with chunks missing from their bodies and wear bloody gray hospital gowns as well. They move very fluidly and lack the twitching movements common to many other monsters. They always wield pipes in their hands, which they use to attack victims. Normally they make low-pitched breathing and growling noises, and when struck, they make grunts that sound very much like belching and burping.


They are large, menacing opponents that attack relentlessly but slowly. They deal large amounts of damage and take an impressive amount of punishment as well. However, they are easily interrupted or avoided and can be defeated without much effort (but plenty of time) by a constant flurry of blows. They often appear in groups of two or more, making it much more difficult to defeat them. The rusty axe is the recommended method of dealing with them. Another method is to use Richard's Revolver found in his apartment in the Otherworld, as it is capable of knocking down these enemies in one or two shots.


The Patients may be manifestations of Walter Sullivan's possible aversion to hospitals and the like, finding them terrifying as the Patients themselves are imposing.

At first, the name "patient" implies someone who is unhealthy being cured by a doctor. However, it seems more likely that Walter views "himself" as a doctor, and the Patients are literally Walter's patients.

F Mannequin

Walter's misogyny in the spiral staircase.

The bloodstains on their hospital gowns makes it seem as if they are bleeding from where their wombs should be, suggesting that they are a manifestation of Walter's possible hatred for his biological mother who abandoned him at birth, as he seems to have taken both their lungs and wombs out. They may also symbolize Walter's search for a mother.

They may symbolize Walter's possible hatred and contempt of women in general (misogyny), as in the hospital world, Walter is seen disemboweling one. Similar imagery can also be seen in the Spiral Staircase, such as female mannequins in cages, stabbed in the womb area with needles or spikes. Another female mannequin can be seen stabbed in the head with scissors and hung by nipples.[1] This type of imagery may also allude to to the 21 Sacraments and the Death Machine, as it's the last needed sacrifice, with Eileen Galvin representing the "Mother Reborn", and meeting an exceptionally gruesome death. This would mean that rather than him necessarily disliking women, it represents his strong desire to be with his mother again.

The Patient's facial and hair appearance resembles that of Claudia Wolf. This is especially observable during the Hospital World's intro cutscene, where Walter is seen "operating" on one. Much can be speculated about this. It may be theorized that it's simply an easter egg. However, it can be theorized that Walter knew Claudia. Maybe Walter admired Claudia and chose her as his model. It's also possible that Walter dislikes Claudia because she couldn't fulfill her mission of bringing God in the world.


  • There are 20 Patients in total.


v · e · d
Major Characters
Henry Townshend - Eileen Galvin - Walter Sullivan - Cynthia Velasquez - Jasper Gein - Andrew DeSalvo - Richard Braintree - Joseph Schreiber
Other Characters
Frank Sunderland - Billy Locane - Bobby Randolph - Eric Walsh - George Rosten - Jimmy Stone - Mike - Miriam Locane - Peter Walls - Rachel - Rick Albert - Robbie the Rabbit - Sein Martin - Sharon Blake - Steve Garland - Toby Archbolt - William Gregory - James Sunderland - Mary Shepherd-Sunderland
Aluminum Bat - Chainsaw - Handgun - Submachine Gun - Knife - Pipe - Bug Spray - Chain - Eileen's Bag - Golf Club - Nightstick - Pickaxe of Despair - Revolver - Rusty Axe - Riding Crop - Spade - Stun Gun - Torch - Wine Bottle
Bottom - Conjurer - Eileen Head - Ghost (Victim 16 - Victim 17 - Victim 18 - Victim 19) - Greedy Worm - Gum Head - Hummer - Patient - Sniffer Dog - The One Truth - Toadstool - Tremer - Twin Victim - Wall Man - Wheelchair
Albert's Sporting Goods - Ashfield - Bar Southfield - Garland's - Hotel South Ashfield - Room 302 - Room 302 of the Past - Silent Hill Woods - South Ashfield Heights - South Ashfield Station - Spiral Staircase - St. Jerome's Hospital - Toluca Lake - Water Prison - Wish House Orphanage
21 Sacraments - Death Machine - Haunting - Holy Candle - Manifestation - Map - Monster - Real World - Ritual of the Holy Assumption - Saint Medallion - Sword of Obedience - The Order - Walter's Otherworlds - Great Knife - Sexuality - Halo of the Sun - Red Square
Items - Keys - Puzzles - Soundtrack - Limited Edition Soundtrack - Secrets and Unlockables - Memos

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