First decide whether you are escaping or fighting

Your situation Actual objective What the sources support
Medical Center (Different), collecting bags Get the keys and bags, then release both ward exits Avoid its patrol; contact is lethal in the supplied enemy guide
Late-game stalking route Reach and operate the required controls A flare can create a temporary opening to pass
End of Part 6 Defeat the final boss Flare stun followed by weapon damage is documented

Game Rant’s description of an unkillable pursuer has a final-encounter exception. That exception does not make the Medical Center encounter a normal boss fight.

SILENT HILL: Townfall shows The Weight framed in a tiled Medical Center room.
Thumbnail for Amilton’s Medical Center escape video; the instructions here use the linked written guides. Image source.

Medical Center: finish the bag route and release both wheels

The blood puzzle takes you through Ward S/W and then D/P. The last retrieval, Matthew Clark’s bag, closes the nearby exits. Use the room 02 vent to reach the upper floor, then turn the release wheels in rooms 05 and 10.

PowerPyx advises waiting until the pursuer is on the other side of the room before operating a wheel. Nearby hiding places can give you space to wait, but walking straight into one while clearly being followed is not a guaranteed reset. Track where the threat is before committing to the interaction.

Once both releases are operated, leave by the reopened route and return to the main blood door. Your success signal is the open exit, not the creature falling over.

Use the Flare Gun to make time, not to assume an early kill

The Flare Gun is obtained from CEG locker 75 in Clara Woods after scanning its barcode and entering 184. That timing matters: it is not an item you should expect to have in Simon’s earlier medical pursuit on the normal route.

Game Rant and PowerPyx describe a flare temporarily stunning The Weight. When a later stalking objective requires moving past it, use that opening to reach the next safe route or control. The supplied sources do not establish an early-kill method, a permanent stun or one universal stun duration.

Final fight: stun, damage, then move

PowerPyx’s ending guide describes this combat pattern: stun with a flare, approach for two Shotgun shots, then move away. Circle the arena to collect more flare ammunition and create another opening. It is a reported pattern, not a promise that two shots finish the entire fight on every difficulty.

If you are aiming for Justice, avoid killing the smaller enemies simply to clear the room when you can keep moving instead. In the community-reported ending model, Simon’s kills reduce the point total. A later run with the Pistol-3000 unlocked through Sci-fi changes the weapon options; it is not equipment a first-run player should already have.

Continue to the ending conditions if you are preserving a point-based route or prepared an NG+ secret ending.

Sources & scope

Written September 30, 2026 from the linked sources captured in the supplied research. AI assisted compilation and wording; no hands-on gameplay test is claimed. The capture date is separate from a game patch or source publication date.