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This is a very well-made game. The environment is disturbing, the art is very well-done, and the doctor is creepy as heck. However, the puzzles were hard--Sierra Games level hard. The furthest I got was to the part where I got all four items and I got the following game overs in a couple of my attempts: I shot myself, and I tried to attack the doctor directly by going directly in front of his office and ended up getting caught. I couldn't find a way to give the beer to the guard nor could I find a way to untie him. 

You have one last ending that is kinda hard to find, you gotta get in bed and shoot your gun to surprise the doctor, hope solving the puzzles was satisfying !