Painkiller trip
Sometimes David has a terrible time
Painkiller trip 2
through the painkiller. While suffering with the addiction he has bizarre hallucinations and nightmares. These levels consists of "his mind", as it is not unusual to think of strange things. The first few levels take place after he passes out in the
Hallucination 2
bathroom and then returns to the twitcher-infested hospital. Sometimes David's mind slips from the realistic settings within his mind, and finds himself in a twisted world not his own. He will spot twitchers, visions, cages, and a hellish embodiment of a real terrible sight.

Markland Hospital


Markland Hospital at Night

Markland Hospital is the first area revealed in Afraid of Monsters. When first visited the setting is generally peaceful and unthreatening, even bright from sun shining in through the windows. After David Leatherhoff awakens from passing out on the floor of a bathroom, he realizes that the hospital is now abandoned with only a few lights left on. Strange creatures, some human, others not, roam the hospital, all of them sharing the same goal. Killing David. In the Director's Cut Version however, once David shuts off the generator to the hospital, the main enemies, Twitchers, spill out from the darkness.

Markland Hospital is only visited once after escaping, in the sequence, 4mother, in which David moves on to combat his addiction. In this sequence the hospital has become an abstract maze, with upside down rooms and hallways that are angled at certain degrees or even spin uncontrollably.

Common enemies in this area are, of course, the Twitchers. The only other enemies that appear are Spitters which appear rarely, and a good supply of Handcrabs in the original version.


The city is visited after leaving the hospital. It's a regular city, but with almost no inhabitants. The city has a few apartments, and leads the player to the sewers and the alley levels. This location has quite a few common enemies, such as abominations, Launcher Ghost, and Twitchers .

The city has few intimidating areas, such as an area where a zombie hangs dead (following a specific path) in a water well, with a text message displaying "Don't let the Devil torture the God. Kill the Devil, and let the God show you the way". Depending on the ending the player is headed towards, this can be scribbled out in blood and the words "Kill Me" can be written on it. The rest of the level is generally dark, with some areas that are impossible to navigate without lights. It also contains a complex sewer system readily accessible throughout parts of the map.

Other places include apartments, abandoned establishments, elevators, public telephones and a metro area.



The Forest is considered to be the darkest level of all. Heavy use of the flash light is necessary to get by the monsters that appear to pop up from absolutely nowhere. A few parts of the Forest consist of going to wood shacks in the middle of nowhere. This location has quite a few monsters, and it's not rare to find all kinds of monsters in this level, especially Twitchers and Bleeding Specters.


Heaven is the last area of the game, it is identified by it's lumber walls that bleed and a present sound of a heartbeat. The player can take two different paths. One path will take him to a nightmare sequence reminiscent of the beginning of the game where he can continue using a numerical password, while another path will take the player to a maze like structure where he will fight Twitchers, Handcrabs and Launcher Ghosts.


  • The hospital is modeled after an experience the lead developer, Andreas Rönnberg, had at a younger age.
  • The opening area of the game is considered one of the most frightening by fans. Many tricks are used by the developers in the hospital, including appropriately placed ghost "children" and even twitchers busting into the room through seemingly secure areas.
  • At some point in the countryside there's a house reminiscent to the one that main protagonists Heather and Mike find at the end of the 1999 American horror film "The Blair Witch Project".