Markland Hospital is a location in Afraid of Monsters. It is the first setting as well as the last setting, depending on the ending, in both Afraid of Monsters, the Director's Cut, and Dark Assistance.


Markland Hospital is the first area revealed in Afraid of Monsters. The game starts through a cutscene in which the setting is revealed to be generally peaceful and nonthreatening, even bright from sun shining in through the windows. The city can be seen through various windows and patio screen doors, but the hospital halls are generally empty, with patients and doctors likely inside hospital rooms.

The camera pans to reveal David Leatherhoff, who heads into the nearby bathroom. Inside the bathroom, he talks to himself in anger about his addiction, after placing a set of pills he has brought with him on the sinks. One of the bathroom doors open, prompting David to walking inside. Upon entering the stall, he begins to hallucinate.

After David awakens from passing out on the floor of a bathroom, the window is shattered with an eye drawn from the hallucinations on the wall behind it. There are also, mysteriously, more pills. In the original, David comments that he must have had a "crazy dream," but in the Director's Cut he claims that he "must have passed out," indicating his recognition of the passed time.

Upon leaving the bathroom, David realizes that the hospital is now empty and locked down, as it is nighttime in the city. In the original, he discovers the knife outside the bathroom and shortly the gun, as the monsters are immediately present and attacking him from all sides. David navigates through various rooms, but the exit doors, as well as many other hospital doors, are locked.

Breaking through one broken door, David is able to escape to the roof, where a map can be found pointing to the different buttons.

In the Director's Cut version, however, David navigates the hospital for a little while, finding it to be empty but somewhat well lit. However, various doors are locked and a pile of boxes block his way down the exit stairs, preventing him from leaving and causing him to look for another exit. He discovers a kitchen knife with blood in one of the bathrooms. Some of the beds also have people under the sheets, either dead or sleeping, but unaware of David. He discovers a gun at some point, laying on a serving table next to a set of boxes.

David encounters a room with a lumpy bed and an adjacent room with a flashlight. As soon as he takes the flashlight the window smashes, and the lumps in the bed are gone. David gains access to the construction areas on the outside of the hospital, and breaks the window of an office to access another floor where is eventually stopped by a tangle of lights and wires blocking his path. Touching the sparking mess quickly kills David, so David cannot crouch underneath the wires. Nearby the tangle of wires and a painting, a note from one of the janitors in the hospital indicates the power needs to be shut off in order to fix the situation. David navigates to the cafeteria, where he discovers a maintenance area and a switch to turn off the power.

Once David shuts off the generator to the hospital, twitchers spill out from the darkness. Dressed as doctors and patients, they begin to fill the way back. The wires are now shut off, with blood scribbled on the floor saying "Thank you!" David continues to progress deep into the hospital in trying to escape, encountering handcrabs in the vents, wheelchair twitchers in an area for insane patients, and eventually spitters in another cafeteria. In the original, however, handcrabs are encountered first, with a spitter then a twitcher in the same hallway. The design is much smaller and cramped, with blends of twitchers and spitters in the halls. Eventually, in both games, David finds the way out of the hospital through the sewers, where he escapes to the city.

Markland Hospital is visited once again near the end of the game. In the Heaven sequence, specifically the maps titled 4mother, the hospital has become an abstract maze. There are upside down rooms and hallways that are angled at certain degrees or ones that even spin uncontrollably. Here, more wheelchair twitchers are encountered.


Hospital Vents
Depending on whether or not the original or the Director's Cut is being played, the monsters in the hospital can vary in terms of number and first appearances. Common enemies in both games are the twitchers, and in the Director's Cut they are the first enemies encountered. In the original game, however, a good deal of handcrabs appear, and they are the first enemies encountered. In the Director's Cut, handcrabs are much less common and usually only appear in small janitor rooms, maintenance areas and vents. Other enemies include the spitters, which appear much earlier and are much more abundant in the first game, and the wheelchair twitcher, which are only present in the Director's Cut.


  • The hospital also makes appearances in one of the four endings for the Director's Cut and the only ending for Afraid of Monsters.
  • According to the developer Andreas (ruMpel) Rönnberg, the hospital is based off a bad experience he had in a hospital when he was a child.
  • The hospital also briefly appears as a location in the final map of the game, Heaven.