Silent Hill 2: Otherworld Brookhaven Hospital Walkthrough

After James explores Brookhaven Hospital, he suddenly enters a new, eerie version of the location called the Otherworld Hospital. Here's how to journey through the Otherworld Hospital in Silent Hill 2 and solve the Chained Box Puzzle.

Entering Otherworld Hospital

After entering Otherworld Hospital, you’ll enter a room with some drapes and a wheelchair. Search around for some ammo and health items, then walk forward to notice a Save Square on your left. 

Continue down this long hallway until you get to the elevator. The basement key is broken and you’re already on the first floor, so head on up to the second floor.

Up on the second floor, take a left, and watch out for a Nurse and Mannequin hiding in the shadows of the Nurses’ Lounge. Keep making your way forward until you're back out in the hallway, where you'll also want to watch out for Nurses. In this large room, uncover the puzzle in the middle with a cloth covering it.

This is the Chained Box puzzle, which has two locks and a slot for a key. 

How To Get The Lapis Eye Key

At the stairwell, notice that you can't get down to the Basement from here and instead head up to the third floor. Up in the X-Ray room, find a note on the table, then keep moving into Exam Room 4. Here, you'll find the Surgical Chair puzzle, which requires the Instrument of Force and Key of Bliss.

Completing it will earn you the Lapis Eye key, the first thing you'll need to open up the Chained Box.

Where To Find The Flat Lock Code

Next up you'll need to find the code for the flat lock on the Chained Box. On 2F, break the wall to get into the laundry room. A gap in this room leads into L2, where you'll find a cart. You'll also find a piece of furniture blocking a path, so push it out of the way.

Push the cart through the gap that you just created, and up under the gap with the white drapes just to the right. From here, you can climb right into L3, and go to the Observation Room.

Inside the Observation Room, find the Director's Room Key. Inside the Director's Room is a ladder leading up to another area of 3F, where you'll find a Treatment Stretcher and a note on a nearby table. Read the note and head through the double doors, watching out for the many enemies ahead.

Make your way forward to the end of the hall, going forward until you reach the gap in the wall next to the elevator. Inside this room, you'll find a Generator, which James will mark on his map and power on. Crawl under the crack into the Restrooms, unlocking the door to circle back around to the Treatment Stretcher. 

Press the button next to the Treatment Stretcher and power it on. You'll reveal the code: 9659. This code is for the flat lock on the Chained Box code.

Where To Find The Turn Lock Code

The Chained Box has one other lock, so up next you'll want to find the code for the turning lock. This puzzle is hidden in M3 and M2. 

Make your way there by heading back down the 3F ladder down to 2F. Go through the big gap in the wall to get to M3.

This room has a crack in the wall leading to a tiny enclosed room, which is M3. Through this room, you can see several items pertinent to the puzzle: a clock, some pills in a sink, and a blinking light. You'll also find a note with your solution to the puzzle, but it requires a bit of thought.

The “one” year they've been watching me is just that, 1. Then there's the “so many” pills they've fed him, which are the number of pills in the sink - six. The last number is the number of blinks before the light stabilizes each time, which is 2.

To get the third number, head into the room with the clock and interact with it. Turn the hand until it rings, which will be at 2 o’ clock.

You should end up with the code 1622 - 1 year they've been watching me, 6 pills, 2 o’ clock, and 2 blinks of the light.

This is the last code you'll need for the Chained Box puzzle.

How To Solve The Chained Box Puzzle

Now that you've got all the necessary codes, make your way back to the Chained Box and enter them. You'll also want to use your key: 

• Key: Lapis Lazuli Key (Surgical Chair Puzzle) 

• Flat Pinpad Code: 9659 (Treatment Stretcher Puzzle)
  

• Turning Lock Code: 1622 (Pills, Clock & Lights Puzzle)
  

The box will contain…. absolutely nothing, much to James’ surprise. But a cloth will fall from the wall, revealing another small puzzle. It's a painting of a woman with two rings missing from her fingers. James will also pull a -1 Elevator Button - which goes to the Basement - from her mouth. 

James will mark this puzzle on his map as the Lady of the Door.

How To Solve The Lady of the Door Puzzle

There's a Save Square near the Lady of the Door puzzle, so feel free to use it before you keep going. Then, hop into the elevator and head to the Basement using your new key. In the basement, you can start finding what you'll need to solve the Lady of the Door puzzle.

Descending To The Basement 

Once you're done with the Lady of the Door puzzle, it's time to go down to the basement.

Despite Maria's hesitance, she'll join you on your journey down to the Basement. Pick up the note on the way, and save at the Save Square if you'd like. Once you reach the bottom, it's time for an intense encounter with a rather…. memorable and familiar creature. Yep, it's the Red Pyramid Thing yet again. 

James will tell Maria to run. You should follow suit, keeping ahead of Pyramid Head. Don't turn around to shoot him - just keep running until you reach the elevator, triggering a cutscene.  

Take a moment to take in what just happened, then prepare to leave this area. 

Leaving Brookhaven Hospital 

Without Maria, you're on your own from here on out. Walk outside of the elevator and make your way to the Reception area to find a new note and a Key to Brookhaven Hospital. You'll also see Laura running outside the window, letting you know it's time to use that new key and make your way out the front lobby doors.