in the collapsing cave. He awakens in the basement of the Riverside Institute, a suspiciously large mental hospital, under the care of Dr. Fuller. He is drugged and suffers more nightmares and hallucinations, including visits from an otherworldly voice that seems to be directing certain events. Eventually, he escapes with the help of Dr. Marie Colden. Along the way he discovers evidence of strange experiments by Fuller. He also encounters Francis Sanders, who had been given a painting by Sarah. Francis is another patient/prisoner of Fuller, and after speaking to Pierce about "The Shambler", he is brutally killed by an unseen force. Once back at the Hawkins mansion, Pierce, Colden and a suddenly alive Bradley (who has a broken recollection of his supposed death) decide to visit the widowed Mrs. Sanders and learn more about Francis and The Shambler. At the Sanders house, he also finds Cat once more, there to help the widow sell her late husband's art collection. The Shambler was a painting by Sarah that she gave to Francis after much resistance. Pierce examines the painting, which comes to life and pits him against the physical manifestation of the creature. He manages to banish it by slashing the painting with a ritualistic dagger from the Sanders art gallery. His investigation then leads him to a bookstore owned by Algernon Drake, a friend of Sarah Hawkins, where he discovers the Necronomicon in a safe. Upon reading the book, he has an out of body experience that places him into the mind of Marie Colden, seeing events at the Institute through her eyes. After discovering numerous patients exhibiting signs of mutation, Colden confronts Fuller about his experiments and is knocked out. Upon returning to his body, Pierce is confronted by Drake, and the two form a shaky alliance. Pierce rushes to the institute to save Colden, but after suffering more hallucinations and taunting by the voice in his head, finds her dead at Fuller's hands. Exploring further, he discovers Sarah Hawkins, imprisoned but alive. The two run, but are stopped by the monstrous Charles Hawkins, who claims he was trying to protect Sarah from the cult due to her gifts as an "Oracle". Pierce and Sarah defeat and kill Charles, before escaping back to the mansion, leaving the Institute in flames. In their fight with Charles, a strange liquid, responsible for a gas that causes hallucinations and mutations in