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While exploring The Hospital with Six, Mono is briefly separated from her when he enters a room to find a fuse for one of the doors. Exploring the area alone, Mono passes by a Patient strapped to a table. The hand of said Patient suddenly becomes active, breaking free from its restraints and begins to chase Mono. Mono makes his way into an air vent as the living hand pursues him, but is unable to follow when Mono passes through a grate in the vent. Despite this, the living hand continues to stalk Mono, moving through the ventilation system and intercepting him in a room further ahead. Mono battles the living hand with a nearby hammer and manages to kill it, retrieving the fuse for the doors.
When Mono and Six take the elevator down to the morgue, they are assaulted by two living hands, one of which Six temporarily attempts to contain in the refrigerator from which they originated. Six will be able to hold the second living hand at bay until Mono uses a piece of pipe to weaken the first. After defeating both living hands, Mono must assist Six in removing a wooden board from a door to progress to the next area.
Unlike the Patients, the living hands are not immobilized by light. They will give chase to Mono and, if one of them catches up with him, it will lunge and grab the boy's face, leading to a game over. In most cases, when encountering a living hand, there will be an object nearby that can be used to kill it, such as a hammer or a pipe. The living hands are capable of dodging Mono's attacks, so it is best to strike them right before or after they jump (this is telegraphed by the hand raising three of its fingers before jumping). In order to defeat the living hands, they must be struck three times with a weapon.
- It appears that the living hands once belonged to living patients, as they do not look like the prosthetics scattered throughout the Hospital.
- Mono may continue to strike the living hands even after defeating them.
- Additionally, hitting a living hand three times after its death earns the player an achievement.
- Though it is tricky, Mono is able to flee from the first living hand he encounters alive, through the vents.
- An official source that states the name hasn't been found yet, or the citation was invalid.