Anomalies Guide
All 11 anomalies explained — detection methods, signs, and counter-actions
🔍 The 5-Point Detection Check
Look at the live patient at the window
Take and examine the printed photo
Check the camera monitor feed
Review the appointment clipboard
Listen to what the patient says
Three Eyes
Patient has three eyes visible. This is a clear anomaly sign.
Quick Tell
Count the eyes — if you see three, reject.
Signs:
- •Three visible eyes on the patient
- •Head twitching
- •Neck twitching
Mistake: Second-guessing because the patient 'looks otherwise normal'. The extra eye is the anomaly — reject.
Hollow Eyes
Patient has hollow or missing eyes.
Quick Tell
Look at the eye sockets — if they are pitch black and empty, reject.
Signs:
- •Empty eye sockets
- •Dark hollow areas where eyes should be
Mistake: Confusing hollow eyes with the patient's natural dark coloring on a dim patient. Zoom in on the photo to confirm.
Sharp Teeth
Patient shows sharp or human-like teeth instead of animal teeth.
Quick Tell
Open the photo and zoom on the mouth — sharp or human teeth are unmistakable.
Signs:
- •Visible sharp or human-like teeth
- •Unnatural grin
Mistake: Skipping the photo on Shift 1 because the visual looks clean. Sharp Teeth is often photo-only — always run the photo step.
Photo Mismatch
The photo taken shows different features than the patient in front of you.
Quick Tell
Side-by-side compare the printed photo against the live patient. Any single feature difference counts.
Signs:
- •Eyes don't match between photo and patient
- •Different number of ears
- •Missing or extra horns
- •Wrong mouth shape
Mistake: Assuming 'close enough' on a minor feature difference. Anomalies only need one feature off — if anything is different, reject.
Static Photo
The photo print shows static or is heavily distorted.
Quick Tell
If the printed photo has TV-static or grain distortion, reject — the patient is an anomaly.
Signs:
- •Grainy or static effect on photo
- •Distorted image
Mistake: Retaking the photo hoping for a clean print. The static is the anomaly signal — do not retake, reject.
Cursed Photo
Looking at this photo drains 10 Sanity. Best to reject without examining closely.
Quick Tell
Photo shows bloodshot eyes or a creepy grin. Do NOT stare — close the shutter immediately.
Signs:
- •Bloodshot eyes in photo
- •Creepy grin on photo
- •Dark background
Mistake: Staring at the photo to confirm it is cursed. The instant you recognize the bloodshot eyes or grin, reject. Every look costs 10 Sanity.
Camera Follower (Starer)
Patient always stares directly at the CCTV camera, regardless of angle.
Quick Tell
Switch CCTV angles — if the patient's face follows the camera every time, reject.
Signs:
- •Patient always faces the camera
- •No matter which CCTV angle you use
- •Patient tracks camera movement
Mistake: Trusting only the visual and skipping CCTV. Camera Followers look completely normal at the shutter — the CCTV angle is the only way to spot them.
Black Eyes
Patient looks normal at window but CCTV shows black eyes covering their face.
Quick Tell
Glance at CCTV — if the patient's face is replaced with solid black eyes, reject even if the visual is clean.
Signs:
- •Black eyes covering patient's face on camera
- •Patient appears normal in person
Mistake: Trusting the visual over the CCTV. The CCTV is the ground truth for Black Eyes — if it disagrees with your eyes, trust the camera.
Distorted Body
Patient appears normal at window but CCTV shows distorted body proportions.
Quick Tell
Compare the CCTV body proportions against the patient's frame at the shutter. Stretched limbs or distorted shapes = reject.
Signs:
- •Stretched limbs on camera
- •Distorted body shape
- •Green kitty stretch (common example)
Mistake: Dismissing the distortion as a rendering glitch. The Green Kitty Stretch is the most-cited example — if it looks stretched, it is the anomaly.
Black Figure
A black figure with red eyes appears on CCTV. Turn off camera if it zooms.
Quick Tell
CCTV feed zooms in on its own and shows a black figure with red eyes. Turn the camera OFF.
Signs:
- •Black figure with red eyes in CCTV booth
- •Feed zooms in automatically
Mistake: Letting the zoomed feed stay on to 'see what happens'. Each zoomed second costs Sanity — turn the camera off and reject.
Skinwalker
Skinwalkers are admitted anomalies that transform into hostile enemies. Must be neutralized with weapons.
Quick Tell
Any anomaly that gets past the shutter and enters the building. They transform within seconds and start hunting.
Signs:
- •Admitted anomaly that enters treatment rooms
- •Becomes hostile
- •Hunts patients and staff
Mistake: Hesitating to use weapons. Taser and Gun have low Sanity cost — do not save ammo 'in case'. Neutralize the Skinwalker the moment it transforms.
💡 Detection Tips
- →Always perform the five-point check: Visual, Photo, CCTV, Paperwork, Audio
- →If ANY layer shows discrepancy, reject the patient
- →Never admit a patient that looks suspicious even if you can't pinpoint why
- →Use the lobby camera for side view - check-in camera angle can be deceiving
- →Coffee restores Sanity - stock up before long shifts
- →Skinwalkers that enter must be shot with Taser or Gun