In the medical wing of St. Maria's Monastery, Murphy Pendleton comes across a room with an X-ray machine and three Screamer cadavers lying on stretchers. While two of the Screamers will lash out at Murphy or engage in a brief fight if he examines them, the third has an open chest cavity. There is something inside, but Murphy is unable to locate its exact location.
The only clue to the puzzle is a memo found on the desk near the X-ray machine.
"Please note that the western courtyard door is currently locked. That paper eating neurotic brat went one step too far and swallowed the key. How in the world does this sort of thing happen so often?
Anyway, he's scheduled for a procedure later this week, and I plan to rectify the matter at that time. Until then, please bear with the inconvenience of walking all the God-damned way around just to visit our medical wing.
Director of Operations"
Since the Monastery key is needed in order to exit the medical wing and return to the main hall, Murphy needs to use the X-ray machine to look inside the Screamer's stomach. Now knowing what's actually in there, the player can examine the Screamer to reach inside and use the control stick to move Murphy's arm in order to find it. The stronger the vibration, the closer Murphy is to the key. Along with the key, Murphy pulls out the last fragment of the poem needed to keep the Bogeyman away.
- This is the second time in the franchise that memos have discussed patients swallowing keys, with the first being the 'Magpies' from Silent Hill: Origins.