The Evolution of Silent Hill’s Nurses and Where They May Go – GameRant

Silent Hill is filled with monsters that represent the deepest fears, regrets, and traumas of those who are unfortunate enough to be trapped inside. Of all the monsters, one of the types that has stuck with players and have presented themselves to the most protagonists is the Nurse.

Most people have been in a hospital at some point in life. It may have been to visit someone, to go to work, or even receive treatment. Due the many different types of memories people have in hospitals, the perception of nurses is different for every person.

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The Nurses of Silent Hill have appeared since the very first game on the original PlayStation. Because of the constantly changing protagonists and the different themes of each Silent Hill, their appearances are different in most Silent Hill titles. Some changes are more obvious while others are more subtle. Players should note that there will be spoilers for the majority of Silent Hill games below due to plot elements being related to the symbolism behind these Nurses.

Far different from the Nurses commonly known by fans, the very first Nurses in Silent Hill are known as Puppet Nurses. These monsters appear are normal human female nurses that have parasitic growths on their backs. Puppet Nurses have a variety of different hair colors and clothing colors. Despite their appearances however, they are still very dangerous.

They are capable of ganging up on protagonist, Harry Mason, with one Puppet Nurse able to grab him while the others attempt to stab him. Puppet Nurses are additionally the only type of Nurse that has a male counterpart. These are known as Puppet Doctors. They are stronger, but slower than the Puppet Nurses.

Unlike other Silent Hill titles, the monsters in the original are not based on the protagonist, but are rather based on the traumas and memories of Alessa. Alessa Gillespie is a girl who was tortured by a cult known as the Order in Silent Hill so that she would give birth to their god.

The Puppet Nurses represent how Alessa saw the nurses in the hospital while she was kept alive after being burned alive. While the nurses weren't members of the Order, they were still being puppeted around by them through keeping Alessa alive. It is also possible that this is how Alessa saw herself with the Order's god being a parasite on her body.

The Bubble Head Nurses from Silent Hill 2are the most famous of the Nurse types and have influenced the designs of all later Nurses. These Nurses appear to have their heads wrapped in a wet vinyl that completely covers their faces. The bottom of their vinyl masks has the shape of the face of a baby, but this is sometimes blocked by one of Silent Hill's prominent Red Squares. As they walk, they are always twitching, giving a very unnatural look to them.

Bubble Head Nurses also have another variety that can be found in the Otherworld where their clothes are far more dirty with spikes driven through their masks. They additionally also have a fleshy protrusion coming out of backs and shoulders.

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The Bubble Head Nurses have many meanings to them involving Silent Hill 2's protagonist, James Sunderland. The most obvious example being with how the vinyl masks covering the Nurses' faces causing them to unnaturally convulse referencing James killing his wife, Mary, by suffocating her in her hospital bed with a pillow. The masks also give the effect of how Mary's head was swelling while sick.

Another meaning to them is the sexual frustrations and possible adultery of James Sunderland. Due to not being able to be sexual with his wife while she lay dying in the hospital, it's very possible that he ogled the nurses that were taking care of Mary in the hospital. However, he did not see them as just beautiful women, he simply saw them as objects without a face, explaining the Bubble Head Nurse's covered face and exposed body. In development, the Bubble Head Nurses originally wielded a blood transfusion stand, but it was changed to a steel pipe as a callback to the weapon most used by Harry Mason.

Silent Hill 3combines the more human appearance and the sexualized outfit for their take on the Nurses. These Nurses are simply known as Nurses and all share the same black bob haircut, purple eye shadow, and purple lipstick. Their eyes are always shut and have a red stain around their mouths that is similar to the red squares of the Bubble Head Nurses. The Nurses here can carry iron pipes as in Silent Hill 2, but they can also use a revolver against protagonist, Heather Mason. They not only can shoot, but they are also capable of performing pistol-whips if too close.

Due to Heather being a reincarnation of Alessa, these nurses represent Alessa's memories in the hospital once more. However, their dark hair may serve as a reminder to Heather of what her original hair color was. The sexualization of the nurses could possibly represent Alessa's fears of becoming pregnant with the Order's god. According to designer, Masahiro Ito, the red stains around their mouths represent madness. These Nurses can also be seen as upgrades to the Puppet Nurses, due to there being a large red stain on their upper back where the parasite could have been. Their movement also suggests their movement being controlled by some sort of puppet strings.

Silent Hill 4: The Room didn't have any nurses of any kind, but the next evolution of the Nurse appeared in Silent Hill: Origins for the PSP and PlayStation 2. These Nurses are similar to the Bubble Head Nurses, but have stockings with garter belts, high heels, and a surgical mask that appears to be melted to their faces. The arsenals of the Faceless Nurses is similar to that of the Puppet Nurses with their only weapons being scalpels and syringes. They twitch a lot more than any other Nurses as well.

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Due to the protagonist, Travis Grady, possibly being a serial killer, the Faceless Nurses could represent his victims. The twitching of the Faceless Nurses could be representative of Travis's victims shaking in fear before dying. Even their names could be referencing that Travis saw the victims as faceless.

The Silent Hill movies had their own variety of Nurse based on the Bubble Head Nurses. These Nurses are known as Dark Nurses and were portrayed by dancers in the first Silent Hill film in order to get across their inhuman movements. Their faces seem to be made of of deformed flesh with each Dark Nurse having a unique and organic face. There are signs of burns or rotting in some of them, while others have faces that appear much smoother.

The Dark Nurses use pipes, knives, scalpels, and syringes, making these the Nurses with the largest variety of weapons. Dark Nurses additionally seem to be in larger clusters than in the games, making them extremely dangerous. Their movement appears mechanical with them being very sensitive to any light. It's possible that the Dark Nurses symbolize how Alessa saw her nurses as faceless, while additionally feeling self-conscious about her own deformities due to being burned alive. The Dark Nurses would be seen as beautiful and sexy women if it weren't for their monstrous parts, after all. It's also possible that Alessa felt jealous toward her nurses due to them being able to come and go as they pleased while she remained trapped.

In the sequel movie, Silent Hill: Revelation, the Dark Nurses make a return. Due to Heather's circumstances in the movie being similar to how they were in the games, it's possible that the Dark Nurses represent Heather's feelings on growing up into womanhood. They could also simply be the remains of her old memories coming back to haunt her.

Using many design parts from the Dark Nurses as well as the Bubble Head Nurses are Silent Hill: Homecoming's Nurses, which are known as Demon Nurses as labeled in their concept art. These Nurses have deformed and fleshy faces with sexual nurse uniforms made out flesh. They additionally wear high heels and can be seen growing a fetus inside them when lit up by any light source that isn't a flashlight.The DemonNurses react to light violently and are capable of making very fast slashes with their knives that can catch players off guard. However, they can be avoided completely if the player turns off their flashlight and passes by them quietly.

With the Demon Nurses being the first enemy that players will find while playing as protagonist, Alex Shepherd, in Silent Hill: Homecoming, they have a lot of roots within his character. Due to Alex Shepherd being institutionalized within a mental hospital for four years, he was stuck with only his sexual fantasies while also being surrounded by nurses. While there, Alex fantasized about being part of the military and in a military hospital instead.

He would write in his journal about how the military only hired attractive nurses with sexual uniforms to make the stay better, when it was actually what he wanted in the hospital. These Nurses likely represent a dark and twisted version of his fantasy with them being only faceless and sexual beings. Demon Nurses are additionally the only Nurses in Silent Hill to have jiggle physics.

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The Demon Nurses being pregnant could symbolize a couple of things. They could symbolize Alex wanting to have sexual relations with women without care. They could also symbolize how Alex's life changed when his mother became pregnant with his younger brother, Joshua. With Alex killing the fetuses by killing the nurses, it could also symbolize how Alex killed Joshua.

Many players are waiting and hoping for a Silent Hill announcement from Konami for the PlayStation 5. While there is nothing confirmed as of now, it is interesting to think about what form the Nurses could take in the next title.

Based on the symbolism and analysis of all the Nurses above, it's probably best to have a new fresh Nurse. Most of the Nurses are based on the Bubble Head Nurse, and while it is an iconic design, it is limited in what kind of symbolism it can have. Not every protagonist of Silent Hill has to have a past involving sexual repression. There are so many possible things a Nurse could be to someone, so it might be time to let the Bubble Nurse and her sisters go on a well-deserved vacation.

Nurses can be mother figures to those who've been in the hospital at a young age. They can also be saviors to those who have survived terrible things. These thoughts can become twisted in the realm of Silent Hill into truly frightening monsters. A monster that believes that its healing when its actually harming can be very dangerous as well as scary.

New nurses don't necessarily have to go back to looking like humans, but there is so much variety in the monsters inhabiting Silent Hill that the Nurses can be changed. If the next Silent Hill wants to get into mind game territory with leaning on the fourth wall, the nurses could take on the faces of those players' galleries or something crazy like that.

There could even be Nurses that subvert the expectation of the look of Silent Hill Nurses by incorporating even more body horror, creating a very uncomfortable monster to look at. While some of the changes made over time, such as Homecoming's fetus, are very neat and add something new, the next Nurse should be completely new.

There is currently no new information on when or if a newSilent Hilltitle is coming out.

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Sam is a guide writer for GameRant, as well as an independent game designer. Sam loves horror games most of all when it comes to making and playing. She however plays games from all genres and loves playing games most when it's with friends and family. Readers can follow her on Twitter @IceWoodrick

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The Evolution of Silent Hill's Nurses and Where They May Go - GameRant