When Henry returns to the subway station later in the game, Cynthia has become victim 16 of the 21 Sacraments.
She now comes after Henry as the other victims do. She slithers on the ground when being attacked and impales Henry with her bare hands to grab his heart. Victim 16 uses her long hair to tangle up Henry, slowing his movements and making him easier to grapple and damage. To complicate matters, when she is floored she will slither along the ground wildly, making Henry's stomp attack almost useless.
In the Subway World, she appears at the turnstiles, the Lynch Street Line platform, the men's bathroom, and the King Street Line Platform. If she isn't pinned down in the Subway World, she will appear in the Building World in Garland's, the alleyway with restaurants, and the room with the numerous locked doors. She will also haunt Room 203 in Apartment World.
- As a ghost, Cynthia closely resembles an onryō, a malevolent spirit in Japanese folklore, particularly the manner in which onryōs are portrayed in kabuki theater and contemporary Japanese horror films such as Ringu and Ju-on. In addition to this reference, Cynthia will usually come crawling through a portal, much like the ghosts from the films cited before.
- If the player places a Holy Candle in front of Cynthia while battling her ghost form, she will stand in place and scream as her hair begins to float in every other direction. This differs from other ghosts, which simply fall down.