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Level with Me: Male Ward (Outlast)

Content Warning: Outlast is graphic, as are some of the images I’m using in this article. 

Thanks to Hamada for helping with edits.

Red Barrels’ Outlast has a few magnificent highs and monotonous lows. It’s formulaic and struggles to iterate on its ideas. It’s a game with an interesting setting, Murkoff Corporation’s Mount Massive Asylum corrective facility, and a mostly underwhelming cast. Overall, Outlast’s a game I wouldn’t recommend, but I nevertheless harbor affection for it. I rarely play horror games (though that’s slowly changing) and it’s easily the one I’ve spent the most time with.

Outlast Xbox One Dr. Richard Trager promo art

Outlast’s characters and level design aren’t among its strengths. This guy, Richard Trager, and his home are the major exceptions, however. (Image: Red Barrels)

Outlast’s opening chapter is a serviceable introduction to the macabre setting. You’ll swiftly learn all the main gameplay mechanics: running, jumping, climbing, hiding, finding collectibles, and using your camera. You’ll meet a handful of patients—Variants, as Murkoff personnel callously calls them—who are physically deformed and often dangerous. You’ll meet protagonist Miles Upshur’s personal stalker, Chris Walker, whose conviction to kill him is so unwavering it becomes cartoonish. And you’ll probably get killed by one or two of these brutes, cementing that, yes, you’re completely defenseless.

The first chapter is also mostly a straightforward trek through Murkoff’s Administration Block, which makes sense; you don’t wanna overcomplicate things right off the bat. And its final set piece does start ramping things up: you navigate a dark basement to turn on two gas pumps and then pull a lever while evading one Variant. Although there isn’t much variety in how you tackle it, you at least choose which pump to start first and the map’s an increase in complexity without being unfair or daunting—heck, observant players will even spot the floor plan before entering: 

Outlast Chapter 1 Administration Block basement map

Some of Outlast’s best moments are when it teases freedom and swiftly snatches it away. Here, we’re turning the power back on so we can escape, and when we’re seemingly in the clear, inmate Father Martin knocks Miles out and drags him deeper into this dump. (Image: Red Barrels)

And… well, the rest of Outlast basically alternates between two modes. There are a number of sequences like that basement one, where you hunt down keys, literal or proverbial, while evading thugs. And there are fast, hectic sequences where you’re chased down hallways. Both routines feel rather trial and error, especially the latter. If you don’t know exactly where to go, or if one of the game’s mechanics refuses to cooperate—sometimes you gotta jump at exactly the right angle for Miles to grab a ledge—you’re winding up back at your last checkpoint (which are generously spaced, thankfully). Things keep escalating in difficulty, but not by much. Fatigue inevitably sets in.

After escaping the sewer, Miles enters the Male Ward and begins Outlast’s fourth chapter, its midway point. There’s a welcome breather where you wander through a hospital housing a wealth of miserable, dying inmates. Once you enter a specific room, however, an incapacitated Variant starts screaming and a pack rushes in—yup, time for another linear chase, one of the better ones. It’s still typical Outlast, though: you run through a hallway, enter another room, crawl through an air vent, they find another route, you vault over a bottomless pit, and wind up trapped in another room whose only other exit is a dumbwaiter. But, wait—a friendly voice calls out over the loudspeaker! He realizes “you’re not one of them” and urges you to jump in the dumbwaiter. Relief ensues; you’ve escaped the immediate threat!

Outlast Chapter 4 meeting Doctor Richard Trager

Did you notice the message that says “FINGERS FIRST, THEN BALLS, THEN TONGUE?” That’s foreshadowing a certain surgeon’s operating routine… (Image: Red Barrels)

…Only to find yourself at the mercy of a much greater one. Richard Trager is many things: charismatic, psychotic, and the best character in all of Outlast—and yes, that includes its Whistleblower expansion. What ensues is Outlast’s most striking sequence, one inspired by the 1990 horror flick Jacob’s Ladder. Upon meeting Miles, Trager assures his “buddy” he “made the right choice” before brutalizing him, stopping just short of knocking our avatar out. Miles’ vision remains blurry as Trager straps him in a wheelchair and offers a tour. He stops before an exit to “ask” if we’d like to leave, taunting Miles and myself. Then we see more of Trager’s “patients,” teasing what’s in store for us if we can’t escape. He removed one Variant’s tongue simply because he wasn’t “putting it to good use!” Then Trager confides in us that he was “just tired of licking [his] own stamps.” Outlast is rife with gratuitous vulgarities and violence, but in Trager’s den they carry weight.

We’re pushed into Trager’s operating room, he waxes philosophic about faith and capitalism, and finally cuts two of Miles’ fingers off. The visuals blur a sickly red, much like when we’re near death, and Miles’ agonized screams further sell his pain. Then, a lucky break—Trager leaves momentarily. A quick time event occurs and, regardless if you bother with it or not, Miles shakes himself free. He vomits. He grabs his camera, assuredly taking notice of the two bloody stumps now on his hands. We’re in control again.

Outlast Chapter 4 Male Ward Dr. Richard Trager scripted sequence exit

Outlast games have scripted sequences where control’s taken away from you. You can still move your head during most of this one, reinforcing how powerless we really are. The Male Ward’s music and collectibles accentuate the tension, too. (Image: Red Barrels)

A mutilated Variant beacons us and explains that Trager and him were formally Murkoff executives before the boney blighter went insane. Then he starts shouting, telling us that the sawbones is coming—cue his entrance. If you didn’t hide by this point, a chase ensues. If you did, Trager “sympathizes” with his unsightly science experiment by stabbing him with his oversized shears. If you record that with your camera, Miles writes a note wherein he curses the quack out. Finally, Trager walks into his operating room, discovers we’ve left, and screams—he detests “quitters!” By the way, you never need to revisit this wing within the ward. 

Whether you’ve been discrete or not, you’ll arrive at the elevator (every other potential route is locked or blocked), which—of course—requires a key. A nearby bed is conveniently positioned right under an air vent, which Miles can reach by jumping. A short crawl forward drops you down a hallway and next to a door. Pushing the barricade out of the way is your first priority—this door leads back to the elevator room. It’s your escape route if you need to temporarily shake Trager (who can’t enter the vent) and once you secure the key.

Outlast Chapter 4 Male Ward Dr. Richard Trager main hallway

The main hallway. Going backwards brings you to the elevator, the two rooms on your left help you get to the door at the end, and you’ll eventually loop back around here via that door on the right. (Image: Red Barrels)

This hallway is dark, though the two doors on your left aren’t locked. A third lit door at the end of the hallway is blocked by more junk you’ll need to push (Outlast games subtly guide players through their lighting, blood trails, and other tricks). However, doing so leaves yourself vulnerable. As soon as you start walking forward, Trager emerges, though you can sprint into the nearest room without him noticing. It’s big and decently lit; the quack will spot Miles if you dawdle. Thankfully, a litany of beds litter the room, many of which contain Trager’s victims. But you can hide under them, and a door in the back-right corner leads into the next room (a door that’s closer and on the left leads into an empty restroom). Trager patrols the hallway indefinitely, so the safest option is to use these back rooms to approach that door. 

The connecting room is similar, though the beds in the back are tightly arranged in a manner that makes running and crawling difficult. Proceed with caution, especially since this room is also lit generously (and has another empty restroom). It subtly builds tension, too. One of Trager’s victims is still clinging onto life and rattles his chains, making it harder to hear the “doctor” (hostile Variants have audio cues to alert you if they’re nearby; Trager’s are him mumbling and playing with his shears). Another valetudinarian in the center rests under a spotlight, which might tempt you to visit him. Don’t; he’ll yell, immediately summoning Trager. To your left after exiting this room is that door. Pushing the barricade takes a few moments, though—Trager will spot you. 

Outlast Chapter 4 Male Ward room 2 dying, yelling man who got me killed twice

Enemy AI in Outlast is lacking, a weakness Trager sort of circumnavigates through his narrow corridors and spontaneous spawning. Even the Variants’ stiff animations kinda work here: these dying people are tightly strapped to their beds; of course they won’t move naturally. (Image: Red Barrels)

This leads into another hallway. Turn right (left’s a dead end; the ward has a few dark dead ends to trick you) and run towards another bed and vent. After Trager walks away, you can drop back down and explore. There’s a locker room (that may contain a battery, which powers your camera’s night vision) and another miserable Variant. But it’s dangerous, since Trager now patrols this otherwise unimportant area. 

Crawling through this vent safely drops you into another restroom. You’ve reached a checkpoint, can catch your breath, and are free to take your time searching for a nearby document. You’ll soon realize that you’re also a short stroll away from the office that has the elevator key. Grabbing it yields another checkpoint and, of course, Trager suddenly bursts through the door, the one that loops back into the hallway with the two rooms. You have two choices: head back into that last room to hide, or circle it and dash back towards the elevator. Curiously, Trager stops chasing you midway through (though if you backtrack, there’s a chance he’ll still be roaming that final wing)…

Outlast Chapter 4 Male Ward Dr. Richard Trager quip

Trager’s floor gradually opens up. It only takes twenty-ish minutes to clear, but unlike other areas, it never overstays its welcome. By the way, Trager’s voice actor, Alex Ivanovicir, is phenomenal, and the butcher nicely breaks up the game’s dour monotony. (Image: Red Barrels)

We start the elevator and, thus, get one final Trager jump scare. He’s (somehow) jumped down a floor and tries entering. When the elevator starts moving again, Miles successfully pushes Trager out. He attempts one final lunge, but his torso gets crushed while the elevator moves between floors, which instantly kills him. His shears also fall through the slit in front of the door, predictably preventing us from arming ourselves. Still, this was a cathartic victory, one of precious few Outlast gifts us. And if any of its villains earned such a painful death, it’s Trager. 

Anyway, we jump out of the elevator’s escape hatch and ultimately end up in the cafeteria, which a somber Variant has lit ablaze. That’s another memorable set piece, one elevated by one of Mount Massive’s most sympathetic inmates. If you record it with your camera, Miles notes how this man is choosing to violently burn to death “rather than stay in this place.” And then all the momentum Outlast was building comes to a screeching halt as it regresses. Chris returns, and we close our time in the Male Ward with a redux of the sewer sequence: we press two buttons while running through a map that’s more straightforward than Trager’s hospital ward. At least the quack gets one last laugh: that exit he teased way back isn’t actually an exit at all!

Outlast Chapter 4 Male Ward Dr. Richard Trager spoiler this only leads deeper into this dump

The next chapter starts with you walking along the outskirts of a dark courtyard while avoiding Chris. After you shake him, you’ll hit the exit… only for Chris to teleport in front of you for a quick, cheap spook. (Image: Red Barrels)

Nearly every subsequent sequence continues retreading familiar beats with level design less complex than the Male Ward; heck, Outlast and Whistleblower’s final areas are practically straight lines. This isn’t to say they’re all disappointing, to be clear. Outlast’s atmosphere remains decently creepy, something a sequence where you lose your camera—and, therefore, your night vision—exemplifies nicely. But you won’t be challenged by them if you survived the Male Ward.

None of Outlast’s or Whistleblower’s other sequences touch Trager’s. It’s the pinnacle of their atmosphere, mechanics, and level design, mixing Outlast’s on-rails style of scares with some space for player expression. And where Chris, the Walrider, Eddie Gluskin, and a few other creeps were built up as threats across the games, Trager’s an isolated, one-chapter wonder unrelated to Outlast’s core narrative. The fact he’s Mount Massive Asylum’s most well-realized, dangerous inhabitant is a testament to the talent Red Barrels possesses—and I hope they create more Trager-tier villains in the future.

Outlast: Whistleblower Chapter final corpse Dr. Richard Trager

Unsurprisingly, Trager’s a favorite amongst fans and Red Barrels. He narrates Outlast’s Xbox One launch trailer, his corpse cameos in Whistleblower, his operating routine is homaged in Outlast 2, and he represents his game on Outlast Trinity‘s cover. (Image: Red Barrels)

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