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The Medium is slow-burning psychological horror on the Xbox Series X

It can be clunky, but a chilling, gruesome atmosphere makes it work

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The Medium is a game about a person who is able to live in two worlds, experiencing the realms of the living and the dead at the same time. Developed by the same team behind the 2019 adaptation of Blair Witch, it’s not an especially original concept, as games have toyed with light and dark worlds as far back as the early Zelda titles. But it’s presented in a way that’s just about perfect for a video game: you can wander through both realms simultaneously, controlling two versions of the character as if you were in split-screen multiplayer. It’s a clever and fascinating way of experiencing the story, and — alongside a truly haunting atmosphere — it elevates what would otherwise be a relatively trite and clunky psychological horror experience.

At the outset, Marianne is mourning the loss of her adoptive father in a way specific to her particular skill set as a medium: she not only helps with funeral arrangements, she also guides his spirit so he’s able to cross over. It’s a great setup that immediately shows how she’s able to somehow be in two places at once. Almost immediately after, she receives a phone call from a strange man urging her to visit an abandoned hotel, where it’s rumored a horrific massacre happened. Totally normal request. Trusting her gut, Marianne decides to check things out.

At its most basic, The Medium plays like a third-person adventure game. You explore small, incredibly detailed spaces, collecting items and solving puzzles. It’s the kind of game where most doors are locked or missing handles, so you can’t get through until you find the right item. Many of the puzzles are fairly simple — at any given point, you only have a handful of items in your inventory — and movement can be clunky and slow, reminiscent of the original Resident Evil games. It’s also the rare big-budget game that’s light on action: even though you’re thrown into plenty of dangerous situations, you won’t have a gun or other weapons for defense.

It may sound a bit dry, but there are a few things that elevate The Medium. The first is the dual-world conceit. At times, you’re in the normal world, and at other times, you’re in the spirit realm — but when the game is at its best, you’re in both. The two worlds are mirrors of each other: the basic layout is the same, but the vibe is very different. A regular hotel lobby might be filled with pulsating tentacles in the spirit world or maybe there’s a door made out of human skin.

But while the two spaces are largely the same, there are some slight differences. This is where most of the puzzles come in, as you have to figure out how to bypass an obstacle in one world in order to progress in both. For instance, one of the earliest has you trying to get to the second floor of a hotel even though, in the human world, the stairs have been destroyed and the elevator’s out. In order to do this, Marianne has to gather up some energy from the spirit realm — she has a handful of very convenient abilities — and use it to power the elevator.

Things start out simple like this, but they get more complex as the game moves along. Later, you’ll be swapping between worlds, using magical mirrors and other mystical objects to manipulate the space around you. My favorite puzzle has you moving objects around a dollhouse to navigate the remains of a crumbling home in the real world. The Medium also uses the split screens to great effect in cutscenes, as you can see the story playing out in both worlds; sometimes when Marianne confronts a spirit or monster, her real-world avatar does the same actions without anyone else present, Tyler Durden style.

Really, the entirety of The Medium has this slow burn. For the first few hours, it verges on  generic, with a confusing story and simple puzzles. But as the narrative starts to pick up, the game becomes much more interesting. Marianne learns more about her past and the origins of her spiritual powers, and there are lots of great “ah-ha!” moments when things click into place. Likewise, the puzzles become more complex as you become adjusted to the reality of parallel worlds.

But while the story and puzzles take a while to get going, the one consistent in The Medium is its chilling atmosphere. This isn’t an action game where monsters are constantly coming after you. Instead, it’s more of a creeping dread. Almost all of the areas you’ll be exploring are small and oppressive — even the real-world versions. That could be the burned-out skeletal remains of a home, with only a few surviving objects — naturally, there are lots of creepy dolls — or an underworld with twisted bodies fused to the wall. 

It can be fascinating wandering around and seeing how the two worlds differ. Other times, it’s just gruesome. And adding to the sense of dread is the only real enemy, a giant monster that stalks you throughout the game, leading to a number of tense stealth sequences. (In a nice touch, there’s a button to make Marianne hold her breath and be quiet, and you can actually feel her thumping heartbeat through the controller.)

The Medium lasts around 10 hours, which is just the right length for the story to wrap up nicely. It even ends on an Inception-style cliffhanger, where what actually happens is fairly ambiguous. (I can’t wait to have people to talk about it with.) But in terms of gameplay ideas, it does end rather abruptly: just as the game starts finding really interesting ways to play with the dual-world structure, it’s over. The last few hours are far and away the most interesting, and I wish the rest of the game was as inventive. The multiworld premise isn’t quite a game-changer, but it adds just enough to make this psychological thriller worth checking out.

The Medium launches January 28th on PC and Xbox Series X and S, and it’ll also be available to Xbox Game Pass subscribers.