Out of chaos, one of the most unique games ever was born. We return to the surreal world of Sanitarium

At the end of the 1990s, when adventure games were fading from the mainstream, a title emerged that stood out with its surreal atmosphere and a storyline shrouded in mystery until almost the very end. Sanitarium was a passion project - born from a love for gaming and created by developers determined to deliver something truly original and distinct from DreamForge Intertainment’s earlier works.

Looking at the studio’s portfolio, we can see that the first half of the ’90s was dominated by RPGs / dungeon crawlers developed under the Dungeons & Dragons license. Working on similar titles set in licensed worlds could eventually lead to creative fatigue for some developers, which in turn became a catalyst for the creation of Sanitarium.

Sanitarium. DreamForge Entertainment.

Everything started with lukewarm cheeseburgers

The best ideas often emerge unexpectedly, and that was likely the case with the concept that eventually evolved into Sanitarium. As screenwriter Chris Pasetto recalled, it all began with a casual summer conversation among burned-out developers over burgers. Discussing their favorite films and the types of games they dreamed of creating, the team eventually reached a bold conclusion - spurred on by Creative Director Chris Straka - that they should combine all these ideas into a single project.

This marked the birth of Sanitarium - a project brought to life in just 16 months by developers who, as they later joked, "no longer felt any pain." Despite the grueling development process, one of Sanitarium’s most criticized elements turned out to be its story. The game’s later stages felt disconnected from one another, and the abundance of dialogue options often overwhelmed players. Chaos ensued, which, as Pasetto later noted, mirrored the state of the studio at the time:

As a result, the team decided to work on the dialogues, trimming them. The change benefited the game, as it restored a better balance between dialogue and gameplay, making the story feel much smoother. At the same time, the team managed to preserve what mattered most to the developers: the emotional impact remained intact throughout the gameplay, which had been the core goal of Sanitarium from the very beginning.

Sanitarium. DreamForge Entertainment.

A journey into the human mind

The story of Sanitarium is largely shrouded in mystery, gradually revealed to players alongside the protagonist. There are no moments when we learn something more than what the character knows. If Max, who must even find out what his own name is, is unaware of something, the player is equally kept in the dark. The only thing we know from the opening cutscene is this: Max learns something significant, calls to report it, and then drives off a cliff in the rain.

He then wakes up in a psychiatric hospital, a place consumed by chaos. His face is all bandaged up. He doesn't remember what happened to him and who he is. Our task is to remember everything. As Max, we explore not only the hospital - which already feels suspicious in itself. We also end up in strange, otherworldly places - like a world full of mutated kids with no adults, a circus on top of a flooded city, or a nest of insect-like creatures where we play as a cyclops warrior.

Every time we return to the hospital, we uncover more of its hidden secrets. We also learn more about Max - his past and what’s motivated him throughout his life. All of this builds up to the finale, which finally puts the whole story into place. It’s not immediately obvious, though sharper players probably guessed what was going on - that Max is teetering on the edge of his own mind, unsure what’s a dream and what’s real.

Sanitarium. DreamForge Entertainment.

A hero who can barely move

At its core, Sanitarium is a point-and-click adventure, but instead of a side view, the gameplay unfolds from an isometric perspective. By holding down the mouse button, we guide Max as he gradually uncovers what’s happening around him and pieces together more about his past.

It definitely isn't an easy journey. At first, Sanitarium didn’t make things easy for players and offered no hints at all. The game was so tough that even ASC Games’ publisher, Dave Klein, went to DreamForge Intertainment to talk about making it easier.

The negotiations worked, and as a result, Max began talking to himself, dropping hints for the player - for example, suggesting that the metal cross sunk in the river could be fished out with the right tool. In Sanitarium, we solve puzzles using items from Max’s backpack, which sometimes means clicking through the entire inventory to find the right combination.

This is not the only type of puzzle. Sometimes you have to talk to the right people in the right order, since picking certain dialogue options can unlock new things in characters you’ve already spoken to. On top of that, the developers included puzzles that take place on a separate screen. Sometimes it’s about finding a hidden message in the text on a board, other times it’s about activating the right symbols on a cosmic panel.

On top of that, Sanitarium is an adventure game that features boss fights. There are a few encounters that might catch players off guard, especially if they’re used to the purely adventure-focused gameplay. Luckily, even if we lose a duel, we don't lose progress (except for the final one). We're just sent back to the start of the arena. The boss fights are all different from one another, which helps break up the monotony of exploring the areas.

However, one of the biggest challenges comes from the character’s movement system. Because of technical limitations, Max can only move in eight directions, which sometimes makes him get stuck and makes navigating narrow passages tricky. According to the developers, if they’d had more time and addressed it earlier, this aspect of movement would probably have been more polished.

Sanitarium. DreamForge Entertainment.

A title that deserves a remaster

Just by looking at and playing Sanitarium, it’s obvious the game was made in the ’90s. The gameplay and puzzles still hold up and don’t frustrate, so even players who’ve never tackled adventure games before should be able to complete it and get a feel of the genre. At times, the surreal atmosphere ramps up the sense of mystery, making the adventure feel like it’s been stitched together from random elements almost until the very end.

The game could definitely use a remaster or remake, as one of the designers, Mike Nicholson, pointed out. With today’s programming tools, the characters in Sanitarium could be given a whole new level of depth. The storytelling could also be expanded, covering a wider range of themes and details. For a potential second part, Nicholson has two games in mind that Sanitarium 2 could draw inspiration from:

How to play Sanitarium today?

Sanitarium is a classic adventure game - and thankfully, it’s still easy to get your hands on. A few years back, the game was even given away for free on GOG, and now you can grab it on all the major digital platforms. Sanitarium costs little: $9.99 on GOG and $12.99 on Steam.

Best of all, Sanitarium runs straight out of the box - no extra apps to download or folders to dig through. Once installed, it launches right away, letting today’s players dive into Max’s gripping story - written almost 30 years ago.

Sanitarium

March 30, 1998

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• Overview

• oldschool / retro
• point-and-click adventures
• horror (games)
• Retro Gaming