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1* The long line of cows waiting to be slaughtered in Zone 1. Although it should be expected once you're inside the slaughterhouse, the sound of the cows' deaths off-screen can be a bit jarring. And when you know who exactly is murdering them...
2* The [[spoiler:Elsen Butcher]] inside of the slaughterhouse. Right when you reach him, [[spoiler:he murders an Elsen ''right in front of you'']]. His theme is quite unnerving, as well.
3** His backstory doesn't help either. [[spoiler:He was once Pentel, the friendly butcher of Zone 1, but when the spectres came, he slowly went insane and became a deranged Burnt murderer.]]
4* Though he may not be the player character this time, the Batter still leaves signs of his presence in bits and pieces along the way. Once you come out of the sugar vault in the treatment rooms of Zone 3, all of the Elsen will be dead. The description mentions that "a blunt object has ended this worker's life".
5* In Area 4 of Zone 3, there's a room at the very end of a corridor containing [[spoiler:nothing but a dead Elsen]]. Already scary enough, but if you're in [[HardModePerks Hard Combat]], [[spoiler:once you leave the room, a [[AxCrazy deranged Elsen]] will leap out of the room and chase you. Touching him will trigger a boss battle against three incredibly strong Burnts at once]].
6-->[[spoiler:Elsen]]: [[spoiler:You look tasty...]]
7** Mercifully, [[spoiler:defeating him]] leads to [[MoodWhiplash a rather humorous dialogue exchange]].
8-->[[spoiler:Elsen]]: [[spoiler:Nevermind. [[TooSpicyForYogSothoth You taste awful]].]]
9* [[spoiler:The plagued realm of Zone 4]] is where the game finally heads full-tilt into the dark and disturbing side of things. For starters, [[spoiler:there is a nigh-incurable sickness spreading around the zone]]. There's apparently [[spoiler:a cure in the library, but AxCrazy Militant Elsen block the inhabitants from reaching there]], and there are [[spoiler:mysterious, powerful shadows roaming the place]]. And that's not even mentioning [[spoiler:[[EldritchLocation the tenth floor of the library...]]]]
10** [[spoiler:The [[https://images-2.discordapp.net/.eJwFwdsNwyAMAMBdGADzEo8sE1mAIFLACNyvqrv37is--xWX6MzrXADlOZl2kYdpY6uyEbW34nqOzDQAmTH3UScfMFqloLUP1lqnffIWjPNOKRVCiElbF12ETqPeHWer5R44jVyzid8fT6cmCg.OZwR-6EaBm5E63-RioiHN90na-E Hanged Man]]. He's a [[HardModePerks Hard Combat-exclusive enemy]] that appears after you leave the room with the hanged Elsen in Zone 4's hospital, which is already a JumpScare of its own. He shuts the door very loudly and suddenly, and chases you around at insanely fast speeds, which is guaranteed to take any player who never played in Hard Mode by surprise.]]
11*** The fact that his overworld sprite is [[spoiler:a black sillhouete of an Elsen]] may make it [[FromBadToWorse even scarier]] or [[{{Narm}} just Narmy]] depending on your interpretation.
12* The [[spoiler:Plague Doctors. The Secretaries were bad enough, but Plague Doctor is now its own horror niche and is a fantastic choice to scare anyone that fears doctors or masks. Like the Secretaries and Burnts, they all have designs unique to their zone, but thanks to the art style, they look much more detailed. It doesn't help that many of their attacks appear to involve diseases, blades, and needles. It's horrifying to imagine them wandering around silently in the blank, white void.]]
13** [[ArsonMurderAndJaywalking They also give crappy credit amounts]] [[ComicallyMissingThePoint if you're not in Zone 1.]]
14* During [[spoiler:The Jury chapter of the courtroom, when you're chasing Hugo, you suddenly start getting ominous error messages, which seem to be trying to make you turn back. After those error messages, the courtroom suddenly glitches out, with weird, glitchy enemies wandering the hall. The music that plays only makes things worse.]]
15* [[spoiler:The WombLevel in The Judge's section of the Courtroom. It's inside a giant Elsen that has a virus deep inside of him with Antibodies guarding the way through. There are green streams of bile, muscles you have to walk on, and the music doesn't help one bit.]]
16** Within the same place, [[spoiler:there is an antibody blocking the way, who tells the Judge to head to a side path and [[FetchQuest collect a virus strand]]. By the time you get back, the antibody is just ''[[ParanoiaFuel gone]]''. A couple of rooms ahead of the path it blocked, you find the Batter]]. Considering how [[spoiler:the antibody mentioned it wouldn't fight the Judge since he didn't pose a threat to the giant Elsen, it's quite likely the antibody tried to fight the Batter [[TheWorfEffect and lost]]. Really goes to show how wicked the Batter is when the antibody outright detects the Batter is a threat to the organism]].

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