Platforms: PC (reviewed), Xbox Series X|S

The Medium is a game fascinated by the concept of duality; of events happening simultaneously in different places at the same time. This idea is featured heavily in the marketing, acts as a focal point of the gameplay, and is foundational to the story. Beyond the thematic focus of the game though, I kept feeling like this concept of bifurcation extended to the experience of playing the game as well.

On the one hand, The Medium succeeds with truly extraordinary visual fidelity, art direction, and scene composition. On the other, those achievements are undermined by gameplay that is simplistic at best, and downright adversarial at its worst.

Gameplay Basics

The Medium is a cinematic horror game. It’s not survival horror; there is no resource management or any combat worth mentioning. It’s mostly focused on exploration, with simple environmental interactions that usually involve single button presses to proceed, such as shimmying across a ledge or pushing a box out of your path.

To continue in the tradition of horror gaming there are puzzles, though calling them that is fairly generous. The majority of the puzzles involve simply finding an object and using it in the right place, and rarely require any real deduction. This makes much of the game feel like a glorified fetch quest, even when the trappings of that fetch quest are visually compelling. 

To make the puzzles even less engaging, there are times when progression is limited by strict on-rails design. One example of this excessive hand-holding involved deducing who sat in a certain chair after being given a series of fairly straightforward context clues. I came to the solution quickly, but could not figure out how to proceed, despite knowing the answer to the question that was being asked. 

To continue, I had to check a piece of paper, run to the chair, find a clue with my detective vision, head back to the piece of paper, find the next clue, and so on until I was finally allowed to proceed. I wasn’t allowed to solve the puzzle and move on; the game had to walk me through every step, depriving me of any of the satisfaction I might have gleaned from solving it myself.  This lack of confidence in the player is frustrating, and with a few clever exceptions, is present throughout most of the game.

Better Stay Hidden

There are a few variations in the gameplay outside of object collection and exploration, but unfortunately, they are not very thoughtfully implemented. A particularly egregious example consists of a creature that pursues you through both worlds (think Resident Evil 3’s Nemesis, but much chattier). You are virtually defenseless, and if it grabs you, you are dead, and it’s back to the last checkpoint.

There is nothing that undercuts horror faster than repetition and having to repeat a stealth sequence because you guessed the AI pathing incorrectly is not scary, or tense, it’s irritating. None of the gameplay variations are mechanically very interesting, and most detract from what sets this game apart: the environment and art direction.

Two Environments

In The Medium, there are two worlds; ours, and a Clive Barker-esque afterlife where the dead live as strange masked abominations and evil souls are corrupted into horrible monsters. Our main character Marianne is a medium, meaning she can cross between these two worlds. Sometimes this shift happens at random, other times you initiate it, and sometimes, and usually, when the game shines the brightest, you can explore both worlds at the same time. 

When this happens the screen splits in half, either horizontally or vertically, and you explore both environments simultaneously. This happens infrequently enough to never really lose its novelty and continues to be a highlight throughout the eight or so hours it takes to complete the game. I particularly enjoyed the cutscenes that would show Marianne reacting to events in both dimensions, really driving home the surreal nature of what she is experiencing. The concept of parallel dimensions is hardly new to video games, but I don’t know that I’ve ever explored two different universes at the same time. It’s a genuinely interesting trick. 

Though this is a visually splendid experience (and a technically demanding one, my creaky GTX 1080 was struggling to hit 30FPS in 2560x1440 during these sequences) it’s never really brought into gameplay in a way that is super inventive or meaningful. There are some interesting moments; one puzzle stands out where you have to move a mirror around a dollhouse to access the other world at different points, or a clock that rewinds time to allow you entrance to different rooms, but for the most part, the back-and-forth puzzle-solving is fairly simple and acts more as a visual showcase.

The Great Outdoors

But what a visual showcase it is.

The Medium takes place in Poland, in an abandoned hotel resort still scarred by World War II. The building, and the surrounding wilderness, are as close to photorealistic as I’ve seen, even on my aging hardware. Particular standouts are the outdoor environments and a gorgeous garden maze inside a painting that you’ll explore at various times of the day. I wish more of the game took place in these fascinating and gorgeous spaces, but instead, like so many horror games, it ends in a dingy, lab-like fallout shelter that eschews natural splendor or the decrepit aesthetic of the decaying building for a bog-standard horror environment.  

The other world, the world of the dead, is equally fascinating. It seems to be made of skin and bone, and strange lumbering beasts tower over the horizon. It’s a truly unique (and bleak) take on the afterlife that continued to be mesmerizing the longer I was there.

This attention to detail in the environments made me wish The Medium leaned more toward straight exploration and stripped away the unnecessary puzzles and stealth. The environments are where the game shines, and it’s at its best at its most surreal. Whether exploring a dimension made from crumbling filing cabinets or a truly gruesome slaughterhouse, these were some of the most unique locations I’ve explored in recent memory.

The Horror of Influence

The Medium wears its influences on its sleeve. Though there are original elements, including the flesh and bone aesthetic corruption of the afterlife, and some of the character designs (Sadness, in particular, stands out) so much else can be traced back to other media.

At times it feels like a horror checklist. Creepy children’s drawings? Check. A rusty wheelchair? Check. Moths? Oh yeah. Most of what is here I have seen before, and while that’s not unique to this game, it’s a shame when what original elements are here feel profoundly creative. 

It’s also impossible to talk about The Medium without mentioning Silent Hill. A game should be judged on its own merits, and not by a decades-old franchise that’s all but dead, but there are such clear parallels between the two that it would be disingenuous not to mention them. From the fundamental concept of our world being corrupted by another to the themes of emotions like anger and guilt manifesting physically, to the fact that they brought in famed Silent Hill composer Akira Yamoaka and featured him prominently in the’s clear that they are leaning into that comparison. 

This is not a spiritual successor to Silent Hill, and should not be judged as such even if they seem to want to be. Leaning into the differences might have been a better strategy, because it never reaches the heights of that franchise, despite trying to emulate it in occasionally blatant ways.

At its best, The Medium bravely walks its own path and does not need to rest on the laurels of other horror media.

An Identity Crisis

When I think about my time with The Medium, two things come to mind. That seems fitting given the themes of duality the game explores. There were certainly highlights; some of the set pieces, especially running through bleak landscapes as reality twists and bends around Marianne. The photorealistic environments that oozed originality and the stellar cinematics were all remarkably unique and compelling. 

But those highlights were tempered by the frustrating stealth sections, puzzles that were too simple, and a story that never figured out quite what it was trying to say.

As a next-gen showcase, and as a fairly straightforward horror experience, The Medium is competent, and in some ways excels. As a visually splendid artistic showcase, it’s absolutely worth experiencing. As a mechanical horror experience, it’s more difficult to recommend. The gameplay is too simplistic, and too often gets in the way of what the game does well.