Video Game / Sanitarium

"If Jacob's Ladder was reality squared, this is reality cubed"

— J.C. Herz (The New York Times) on the game

Sanitarium is a 1998 Psychological Horror Point-and-Click Adventure Game developed by DreamForge Intertainment and published by ASC Games. It is set in a mental hospital, except when it isn't.

More clearly, it begins with the main character being involved in an a car accident that knocks him unconscious. Upon waking up, he finds that he has lost his memories and has been instituted in a dilapidated sanitarium, while his head and face are wrapped in bandages. While he cannot remember who is, nor where he came from, or how he came to be interned in the sanitarium, fellow inmates refer to him simply as "Max". He also soon discovers that the place is run by an enigmatic figure known simply as "Dr. Morgan". Occasionally, Max finds himself being transported to strange, alternate worlds, sometimes changing his form, sometimes not. A constant feeling of bewilderment and fear follow him as the worlds he visits become stranger and stranger.

Max need to figure out many things: Why has he lost his memory? Why is he in an insane asylum? Is the asylum the "real" world, or is it just another dream?

Not to be confused with the Slender Fan Sequel Sanatorium.

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This game provides examples of:

• Abusive Parents: Exploring Genet reveals Jeddah Driscoll to be this. An incident turned him into an alcoholic, his arguments with his wife often devolved into physical altercations. His wife then passed away, and he turned the violence to his daughter Carol. His child abuse charges were subsequently dropped by the new town mayor. Carol eventually died, but nobody cared. Mother eventually stepped in to take care of things, but decided to take it up a notch.
  • Implied with Morgan's father as well, with a flashback revealing his hardball and perfectionist attitude to his son, who was only showing his friend Max around the hospital's gallery.
• Accomplice by Inaction / Apathetic Citizens: The reason why Mother killed the adults of Genet. One of them, Jeddah, abused his daughter so much that she died while all the adults of the town turned a blind eye to his actions.
• Adventures In Coma Land: Nearly the entire game, as a result of the car crash Max experienced in the beginning.
• A Glitch in the Matrix: The "real world" starts becoming more and more unreal with each chapter.
• All Just a Dream: Barring certain sequences (which are actually Max's memories coming back to him in bits ), the game is just Max's dreams while he was in coma.
• All the Worlds Are a Stage: The game has the penultimate subchapter called "The Gauntlet", right before the final Puzzle Boss subchapter with Dr. Morgan. In it, you find yourself in a mishmash of elements of all of the earlier non-"real world" chapters. Not only that, but to solve various puzzles you have to switch between Max and all of his alter-egos as well.
• Alternate Universe: It turns out that the Morgan from Max's past is not the same Morgan that he encounters throughout the game. The former exists in the real world. The latter exists in Max's dream world.
  • Two of the chapters have an alternate universe version of Max's wife as well, who is a widowed circus performer.
  • Then there's a non-playable AU version of Max himself, who is the final boss.
• Ambition Is Evil: Played straight with Morgan, whose desire to perfect science by any means caused him to lose sight on the MER Cy project and staging a murder when a leading scientist is making headway on the cure.
• Amnesiac Hero: Max, but he gradually regains his memories as the player progresses in the game. There's also Grimwall, but unlike Max, he never found out who he really is.
• Arc Villain: The game intersects Max's adventure through the asylum with other (seemingly) standalone ones, most of which featuring a separate villain that ultimately has symbolic ties to the overarching plot. In chronological order:
  • Mother, unseen ruler of Genet, and the only adult there. She is revealed to be a fungal-like entity behind most of the town's sufferings. Her most heinous acts include: killing off all the adults, mutates a body part of each child, then subjugates them under her will, with severe punishments for those who discovered the truth like Maria. By doing so, Mother believes she could transcend those precious beings to be far superior and perfect lifeforms. Her fixation on children and grotesque appearance could be seen as the virus personified.
  • Iggy, the monster who's been terrorizing the circus island (which itself has begun to fall down with dwindling vistors). As payback for the inhabitants that have wronged him because of his appearance, he escaped underground. With his long tentacles, people on the surface start to disappear into his stomach. He gets very little screen time of his own and never spoke a word, building up the tension of his eventual boss fight considerably.
  • Gromna, the resident Mad Scientist in Grimwall's episode. He was considered a hero of Grimwall's Cyclops race, before performing a traitorous move serving the bug aliens. His project has reached such an advanced status (helped by his unflattering reputation) that he is able to breed artificial combat Cyclops, and successfully captured and mutated those from the outside that have uncovered the truth. It is only with Grimwall's last-minute and secret intervention that his plans crumble. Tying to Significant Anagram below, Gromna is a faithful interpretation of Morgan's most irredeemable qualities.
  • Finally, there is Quetzalcoatl, who has reduced a small village (which vehemently worshipped him) to complete disarray, burning down houses and trapping human warriors who fought back in a Fate Worse than Death in an attempt to strengthen himself. His sudden appearance and subsequently anti-climatic defeat represent the final obstacle and breakthrough to developing the cure.
• Arc Words: "Seek the truth"
• Automatic New Game: The first game will start the introduction cutscene, and start in the tower. A subsequent will start at the main menu.
• Babies Ever After: During the final cut scene, it is revealed that Max's wife was pregnant during the events of the game. The end credits/epilogue shows a picture of them with their new baby.
• Back from the Dead: A dead woman comes back to life long enough to give Max some cryptic warnings.
• Bandaged Face: Max's defining appearance for most of the game, which leaves only his eyes, mouth, and bits of burnt skin visible.
• Bedlam House: Alongside the asylum's gothic look (the tower cells and gargoyle decorations are most notable examples), the asylum is packed with lunatic inmates, unhelpful staff and a willingness to lock their patients in a morgue should they sniff around too much.
• Big Bad: Morgan, who is also the Big Bad Friend to Max. Interestingly, he is not the final boss. He gets defeated in the cut-scene after the boss is destroyed.
• Big "NO!":
  • At the end of Chapter 5, when Morgan straps Max to an operating table to experiment on him, Max lets out two short ones, then a longer "Nooooo!" as he seemingly turns into Grimwall.
  • Reused at the start of Chapter 7 when Max wakes up in a morgue drawer.
• Black Bug Room: More like Black Bug Universe, but still...

• Booze Flamethrower: Sarah is taught how to do this by Inferno, which is then used to fight Iggy.

• Breather Episode: In chapter 3, the horror takes a backseat to...comedy? The game switches POV to Sarah, and she visits a circus island full of fun and games, with most of the chapter involving hanging around the island and interacting with its inhabitants. That said, the chapter has its own relevance - Sarah and Max goes to the circus as a yearly tradition, and the inability to find a circus prize in time for Sarah caused Max considerable grief. Through viewing the dream circus in hellish visions via Sarah's shoes, Max is subconsciously trying to move on from her sister's death.

• Chekhov's Gun: You come across radios multiple times, and can turn them on to listen to music or various bits of news about a DNAV virus that is deforming and killing children around the world which becomes a crucial plot point later on.
• Circus of Fear: Playing with. The circus is very unnerving, but only two of the staff members are dangerous and, of those two, only one is actually evil.
• The Cloud Cuckoolander Was Right: Don, Lenny, and Martin in the first chapter. See Foreshadowing below.
• Combat Tentacles: Iggy sports a long pair of those, both to capture island denizens from miles above him and to attack trespassers.
• Cool Big Sis: Having never been able to raise a family of her own, the fire breather Inferno warms up to Sarah quickly, and is more than willing to pass down the techniques to her.
• Corrupt Corporate Executive: Morgan is much happier TREATING the deadly DNAV virus that's killing children world-wide, rather than helping Max develop the cure, because "treating the disease is more profitable than curing it". When Max discovers a breakthrough (thus taking away most of his work), Morgan is glad to sabotage his car, and later poison Max in his coma.
• Circus of Fear: Subverted. The circus itself is harmless, but it's also left stranded by a flood, leaving everyone at the mercy of a Sea Monster of an escaped circus freak. Most of them are jaded and rude, though that's hardly surprising under the circumstances.
• Corrupt Church: The preacher in Genet is...spiritually and morally wanting, to say the least.
• Creepy Cathedral: The courtyard chapel in Chapter 3 plays this straight, contrasting the church in Genet. It's filled with mannequins that Preacher Bob thinks are his congregation, along with his helper pacing back and forth with his hands and knees tied together.
• Creepy Child: Most of the children in Genet, due to their mutations and the general eerie vibe that the town has. Subverted in terms of personality, as most of them still act like normal kids.
• Creepy Circus Music: Fitting with the derelict appearance of the circus island, Chapter 4's main tune is greatly distorted with a tingling of sadness and dread.

• Daddy's Girl: Sarah and Eileen

• Dark World: While many levels are explicitly surreal, others look almost normal, but there's still something wrong about them (especially the "real world", which gets increasingly unreal with every chapter).
• Dead Man Writing:
  • In Genet, Max can find a diary records the author's thoughts on her abusive father, who have broken her family apart. That diary belongs to Carol, Dennis' secret hide-and-seek weapon. The secret comes from the fact that she had been Buried Alive (thus not allowing any players to win the game), and Max only finds her as a rotten skeleton.
  • In the Morgue, someone carved out a strange message inside their compartment. With their glass eye, it turns out to be a poem describing how to talk to a living tree outside.
• Deadpan Snarker: Max, when the situation calls for it.
• Death of a Child: There's a strong theme running throughout the game of child endangerment. One of the first chapters takes place in an abandoned town where all of the adults have disappeared and left the children alone, who are slowly being turned into deformed abominations. That same chapter features the story of a young girl who was killed by her abusive father while the townspeople turned a blind eye. Another chapter has you play as a young girl in a Circus of Fear, and other chapters feature things like alien babies being thrown into a furnace. As the game progresses and you learn more about the main character, you find out that he and his wife had been searching for a cure for their unborn child, who is suffering from a fatal disease. This is compounded by the fact that the protagonist was severely traumatized by the death of his little sister when he was a boy.
• Death of Personality: The Cyclops-Bug hybrids are shown to be suffering from this, as a consequence of experiments Gromna commited on them. The mutations gradually incapacitate their consciousness, speech patterns, and eventually character. The one who managed to keep most of her marbles (and give Grimwall the Exposition Dump) mentions she can't hold on to it much longer.
• Doppelgänger: Max's shadow and the two Morgans.
• The Dragon:
  • Dream World Morgan is unwittingly this to Real World Morgan, due to him thinking they are the same person.
  • The scarecrow to Mother, who keeps trespassers away from her.
• Dying Dream: Both Morgans try (and fail) to invoke this trope for Max while he's in a coma by keeping him confined and confused (Dream World Morgan) and slipping him poison (Real World Morgan).
• Earn Your Happy Ending: Max recovers from the wild coma-inducing journey, foils Morgan's attempted murder (and his plot to monetize the vaccine), the world is saved by his discovery, and he gets to reunite with his family, now grown larger by one healthy baby.
• Easter Egg: In Chapter 2, entering the empty hut with a fish painted on it and clicking a particular feather on the angel statue will transform Max into a bird, allowing him to fly. Flying to the bottom right corner of the area will reveal a picture of the game's producer.
• Elvis Lives: One asylum patient thinks he's Elvis, anyway.
• Evil Gloating: Morgan in all of his forms is quite fond of these.
• Evil Laugh: Dream World Morgan and The Scarecrow.
• The Faceless: A big part of Max's arc. His face is covered in bandages. When he is seen in flashbacks, his face is always hidden. The one exception is a flashback from his childhood. Fully averted in the ending, which shows a family photo of Max standing happily with his wife and newborn child.
  • This is one of the rare Video Game examples where the protagonist (who isn't a blank slate) pulls it off for most of the game.
• Face–Heel Turn: Gromna is repeatedly mentioned to be Famed In-Story, and a major heroic figure in ending the war between the Bugs and the Cyclops. What eventually causes him to switch allegiances to the former's race is unknown.
• False Widow: Played with. Inferno isn't exactly lying about her widowhood, but since she's a part of Max's dream, that means that her dead husband never actually existed in the first place, and her real-world self is Max's wife, and he's quite obviously very alive.
• Final Boss: Max's Shadow. You don't confront it outright, and must outsmart the being before time runs out.
• Find the Cure!: Max works with Morgan at MERCY corporation in order to find the cure for the DNAV that is deforming and killing the children of the world, after numerous failures he finally discovers a working cure. MERCY also develops a cure - HOPE, but it turns out it kills children instead of curing them.
• Foreshadowing: The first chapter contains a room of babbling loons who each talk about different worlds...worlds that you will travel to throughout the rest of the game. Then there's the stained glass windows in each segment of the sanitarium, Zippy the Clown's predictions... really, a second playthrough of the game can be seen as a grand conga line of Fridge Brilliance.
• Freudian Excuse
  • Hinted that this is at least part of Morgan's motivation. His overbearing father's attitude likely bleeds into him, causing him to become more aggressive, amoral and efficient in the name of science, eventually losing scope of why MERCY existed in the first place.
  • Mother saw the treacherous sins on children the most prominent adults of Genet committed and decided to take matters into her own hands.
  • Inverted with Max, who used his own past tragedy as motivation to become a doctor and help people.
• Game-Breaking Bug: Although it has since been fixed, originally one could get permanently stuck in Chapter 2 due to a typo in the game's code relating to the animation of a particular crow taking off from and returning to its nest.
• Given Name Reveal: Max's name is fully revealed as Max Laughton, during a recollection of his first day joining the HOPE cure's development project.
• Go Among Mad People: Most of the game. Except not really-turns out it's a Black Bug Room caused by Max being in a poison-induced fever dream.
• Good is Not Nice: The Aztec god Olmec certainly isn't a pleasant being. He reacts rudely to being summoned, addresses villagers by lowly denominators (and does not enjoy being called names back by a justifiably angry mason, whose daughter is trapped in a temple devoted to him), and initially disregards any threats that might have happened in the village. Yet, he gradually comes to see their plight, does the best he can to salvage the situation (such as rescuing the aforementioned mason's daughter) and ultimately defeats Quetzalcoatl.

• Happier Home Movie: Watching these comes into play in the "Mansion" sub-chapter.

• Heartbeat Soundtrack: The ambience to the final level, "Morgan's Last Game" consists of your heatbeat mixed with the tones of an EKG monitor. This fits, considering the poisoned IV dripping down during this sequence. It also flatlines when Max pulls out the IV.
• Hide Your Children: Horrifically adverted. Children are mutated, enslaved, experimented on, dissected. Perhaps the game gets away with it because it's all happening in the hero's head. That being said, there is a plague in the game that infected the young, and the audience never gets to see this happening in the real world.
• Hybrid Monster: Iggy, though it depends whether the human head and torso on top of his squid head is actually part of him or a body of a victim that somehow got stuck up there.

• Institutional Apparel: Max wakes up in the asylum wearing teal patient scrubs with his head swathed in bandages.
• Involuntary Shapeshifting: Max does this throughout most of the game. In the penultimate Gauntlet, he does this on his own volition. Each one also isn't random, and ties to crucial elements of his past: Sarah was his sister, Grimwall was his childhood comic book hero, and Olmec was a god he researched as part of his trip to the desert. With one exception, each of his forms has a different voice actor.
• Ironic Nursery Tune: "Don't go into the pumpkin patch. 'Cause if you do, you won't come back. Mommy says to stay way...if you want to play another day."

• Kid Hero: Sarah saves an entire circus island from a tentacle monster with only her bravery and ingenuity fire breathing tricks!
• Large Ham: Grimwall
  "Now that evil machine will be silent for a while!"
  "No More Genocide Today!"
  "Grap!"

• Left the Background Music On: Most of the music in Chapter 3 comes from a record player that Dr. Morgan hooked up to the P.A system, with four songs to pick that each affect a different patient in the courtyard. The record player also makes a scratching sound when a record is removed.
• Lotus-Eater Machine: After the Maze, Morgan attempts to trick Max into believing he's in the real world and just had a nasty bump on the head, and dreamt everything. Max breaks out of it when he realizes SARAH IS SUPPOSED TO BE DEAD, even though she's alive and living with him and his wife. Still a kid. And levitating.
• Mad Scientist: Morgan, the dream world version. Given the real Morgan's personality, it isn't a stretch to see why Max thought of him this way.

• Mama Bear: Mother thinks she is this - a protective mother doing her best for the children. In reality, her warped morality caused irreparable harm to the town, and Maria doesn't think her ascension will do the children much good.

• The Mind Is a Plaything of the Body: Multiple shape-shifting events
  • At its most extreme with Olmec, who is almost the exact opposite of the kind, compassionate Max.
• Mind Screw: A good example is the pumpkin children. In fact, there's a lot of unexplained symbolism.
• Monster Clown: Averted, shockingly. Some of the clowns are unfriendly, but none of them are dangerous. The scariest one is a living measuring pole, and it's helpful to the player.
• Mummies at the Dinner Table: Made extra disturbing by the fact that it's a kid.
• Mundane Horror: The more realistic levels feature tons of this. A seemingly normal American town which has no adults and is full of disfigured children, a mental asylum with friendly guards and patients, with one of them cheerfully telling you that she "ate her husband with carrots and rice", etc.
• Nice Guy: Max and Timmy O'Toole. Mr. Baldini is also very accommodating towards Sarah, who has no money to spend in his circus.
• No Party Like the Donner Party: In Chapter 3, Morgan is conducting an experiment in the asylum's courtyard, by playing music and observing the patients' reactions. The first track that plays is called "Donner Party Waltz", and a cannibal patient named Vera is the only one who likes it.
• The Nth Doctor: Max's shapeshifting (except for Grimwall, who sounds different but is still played by Max's actor).

• Only Sane Man: Maria Santiago among the children in Chapter 2. The reason she's considered the most rebellious child by Mother, with being continuously punished, is because it's more or less clear she knows what's really going on with them. She's also the only one willing enough to give Max useful information, and the only one who doesn't get mad at Max for warning them about Mother's intentions, to the point Mother possesses her mind into submission.
• Ominous Pipe Organ: Played both ways. The church in Chapter 2 has a relatively calm organ piece while inside, though the chapel in Chapter 3 plays it straight for horror.
• The Paragon Always Rebels: Seems to be a running theme with Morgan/Gromna/Quetzalcoatl.
• Plant Aliens: Mother originated from a vine seed that fell from the sky. The mayor of Genet insists of letting it grow, even when it is clear something is wrong with those vines.
• The Plague: The DNAV which deforms, cripples and eventually kills its victims, which are exclusively newborns. Genet provides how Max interprets this virus as through Mother.
• Porky Pig Pronunciation: One of the inmates, Don, has a pronounced stutter, so he is prone to this:
  Don: The doctor here has resource-resource-re-s-s... He's very good!
• Posthumous Character: Sarah has died years before the game take place, and gets 10 minutes of total screen time to herself. Despite this, she remains a central component of Max's altruistic character; reinforced by the playable version of her seen ingame, a mental reconstruction of her appearance in her final moments by Max, doing the thing she likes most - visiting circuses.
• Preacher Man: Preacher Bob takes himself seriously but is a comical instance of this trope. In addition, Chapter 2 makes mention of an influential small-town preacher.
• Red Herring: Three literal red herrings. One is a red fish painted on the roof of a building. The main character even comments that he was sure he would find something inside.
• The Reveal: A whole lot
  • Chapter 2: "Mother" is an alien, and is behind most of Genet's horrible happenings.
  • Chapter 3: Max was called by his parents because his sister was dying.
  • Chapter 4: Morgan is behind everything.
  • Chapter 8: Everything other than the opening and the flashbacks was a Dying Dream resulting from Morgan trying to kill Max; also, there are two Morgans; the one who sabotaged Max's car and the one who exists in the dream world and tries to prevent Max from making any progress.
  • Chapter 9: Max's wife is pregnant.

• Rotating Protagonist: Every few chapters have the spotlight swayed away from Max to instead focus on other characters' unrelated adventures crushing evil. However, all playable characters are just manifestations of Max's mind, and those sideplots ended up relevant to the main story in one way or another, shedding light on the backstory, or adding symbolism to the overall theme.
• Scary Scarecrows: A scarecrow can be found chilling out on a crucifixion in the pumpkin field of Genet. While he is slightly hampered by how far he can reach you, his foreboding appearance, evil crackling and gruesome death more than makes up for it.

• Significant Anagram: Gromna = Morgan, who both are amoral scientists and for some reason, very good publicity..
• Songs in the Key of Lock: One of the doors in the Hive has a lock with keypad buttons that produce individual musical tones.
• Surreal Horror: The game takes place in an asylum that gets increasingly stranger and disturbing. In-between are other strange worlds with juxtaposed deformed visuals, creepy characters and unnerving atmosphere. Subverted near the end when it turns out it was All Just a Dream, which explains away all the outlandish stuff.
• Theme Naming: All of the cyclops have names beginning with "GR."
• Time-Shifted Actor: Frank Schurter plays Adult Max while Paul Crocker plays him during his childhood flashbacks.
• Token Evil Teammate:
  • While the other player characters tend to be on the nice (or at least polite) side, Olmec really isn't, especially considering one of his puzzles is solved by threatening a grieving father.
  • Dennis in Chapter 2. Unlike the other children of Genet, he seems completely aware of what's really going on and has no problem with it.
• Town with a Dark Secret: Genet, the setting of chapter 2. The first thing that seems out of place for the town is that no adults are around, and all children are somehow physically mutated. Then you dig deeper, and find out [[spoiler: an alien has wiped all adults out after the beloved town priest,

• Unusual Euphemism: Grimwall's favorite exclamation, "Grap".
• Unwitting Pawn: Arguably Dream World Morgan. He believes that he and Real World Morgan are the same person and doesn't realize that his fighting Max and enabling the poison to work its way through his veins will actually kill him along with Max. The example has the oddity of both the pawn and the manipulator being unaware of the manipulation due to Real World Morgan being unaware of Dream World Morgan's existence.
• Villain with Good Publicity: Morgan and Gromna.
• Waking Up at the Morgue: The 7th chapter begins this way, with the air turned lethally cold.
• Walking Spoiler: The player characters other than Max are difficult to talk about without revealing that Max starts shapeshifting in the middle of the game, and Max's sister Sarah ties to his Dark and Troubled Past.
• Wicked Cultured: Morgan.
• Withholding the Cure: Morgan cuts the funding to Max's department, sabotages his department and even tries to poison Max who is in coma in order to stop any possibility of development a cure for DNAV.
• Womb Level: The Hive is unpleasantly organic, with beating veins as floors and walls meshed with machineries.
• You Are Number 6: In a blink-and-you'll-miss-it cutscene, Max's patient number is "8675309".

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