You'll be in combat quite often, so you get to be a connoisseur of creatures like giant, two-headed babies.
For all the mobs of enemies and constant item-ferrying, the game takes about 10 hours to complete on normal difficulty. You will receive one from a possible four endings that are based on a combination of what condition your apartment is in by the end of the game and how the character you had to escort about has fared. Finishing the game once allows you to get an additional weapon and alternate character outfits, though there are not many of these extras. Most people who go through the game again will likely be trying to get the best ending possible rather than shooting for a nurse outfit, anyway.
The PlayStation 2 and Xbox versions of this game control and play virtually identically. The Xbox version has a slight edge in graphical clarity. Its visuals are a little sharper, and the detail and depth is ever-so-slightly richer. Aside from that extra bit of polish, the experience is the same across both consoles.
Survival horror games often indulge themselves in graphical detail, and Silent Hill 4 is no exception. The game looks its best in corroded, bloody, gritty environments, like the damp, steel halls of the water prison or the subterranean subway layers that, at one point in the game, are walled in living, moving flesh. There are only a couple of areas in the game that employ any of the notorious Silent Hill fog, and those seem to do so as an homage to previous titles by accenting a long, spiraling climb or blocking your progress when you're carrying a cursed item. The characters in the game are often very well detailed facially, though their movements seem somewhat stilted, and the animation is not quite as smooth as it could be. The room itself sees some great effects, from the warping of a small section of paint in the shape of a face, to a cluster of wailing demon children plastered to a wall, to a spirit crawling out of a dark, dripping portal. There's certainly no lack of unsettling imagery, which stays true to the Silent Hill formula.
The gameplay may have changed around, but the horror is still there.
The ambient and creature sound effects are often very important to horror games as well, and the sound in Silent Hill 4 is great, for the most part. Creatures all have their own distinct calls, footfalls, and death rattles, and the environments are peppered with nice ambients like dripping water and gusting wind--or even something as simple as an object clattering to the ground. The voice work in the game is uninspired but solid, with the exception of Henry himself, who has an incredibly milquetoast delivery and seems to never get emotional about anything, despite the fact that his apartment is horribly cursed. The haunting main theme is one of the only pieces of music you'll ever hear in the game, and the times that it plays are few and far between. That's fitting, though, for a horror game that seeks to create mood through subtle sounds in the environment rather than through music.
Silent Hill 4: The Room is an interesting sequel that attempts to branch out in several areas of gameplay and setting while remaining true to the psychological thriller-style that's always set the Silent Hill series apart from more action-oriented scares. While not all of the changes made necessarily serve to enhance the series, the dark, gripping storytelling is what allows this game its Silent Hill credentials. If you're an existing horror fan or a Silent Hill fan, Silent Hill 4: The Room is certainly worth looking at--if not for purchase, at the very least for rental.