The Evil Within guide: Chapter 4 - The Patient
It's time to run from the hideous spider-woman.
Follow Jimenez through the gap and go through the closed door on the right. There's a mirror here that will take you to the hospital where you can upgrade your character in the chair and save the game. When you're done, find the mirror and come back to the shack and Jimenez.
Again, follow Jimenez until he sees his brother, and when things get a little out of hand use some well-placed headshots.
Go into the room and interact with the body to find a key the patient swallowed. There's a bit of loot around here so have a good look around, then go out of the house and up the street. Go left to where a cart is parked on the left-hand side and into the walkway. Kick the door and go down two flights of stairs. Check behind doors for some small loot items as you go, then continue going forward.
You'll find Leslie in the back room and be attacked by an invisible enemy. There's only one, so swing a melee attack and when you strike it you'll be able to briefly see it. Quickly aim the shotgun and go for the kill. Once you've killed the enemy backtrack and you'll start a cutscene. Follow Ruvik and you'll work through another cutscene.
When you're back in control you're in a pit full of blood. On one of the pillars is a lever that will drain all the blood when you pull it and reveal lots of loot on the floor. Pick it all up and climb onto the walkway, dismantling the trap. As you approach the bigger door Revik will appear briefly before disappearing. At this point a horde of enemies will attack.
Don't panic and keep your distance. In the side room are two explosive barrels (you can kick them close together). Lure the enemies in and when they are close enough shoot the barrel and you'll burn the majority of them. There's also a level/booby trap you can take advantage of. Be sure to pick up all the loot before going through the big doors.
At the end of the corridor you'll encounter a spider-woman who climbs up through the door. Don't fight, just run back to the previously locked door and keep moving. You can harm her with fire, but at this stage you're wasting ammo in return for a few seconds so it's not really worth the trade.
You can only go one way here. There's a ladder and a button in the end room. Pushing the button will close a door and give you a few seconds to loot the room - or you can just get your ass down the ladder.
Keep going through the doorway and duck under the traps. Don't stop to dismantle them as there's not time. Get in the elevator and ride it down, but once the doors open run out again as the spider-woman isn't far behind.
Run through the door on the left and then under the door before it closes and traps you for good. You're safe for now. Walk down the spiraling metal staircase and you'll see Ruvik ahead of you. Don't approach him or he'll kill you outright, just head back up the stairs until the cutscene kicks in and you've finished the chapter.