In the Otherworld of the Lakeview Hotel when James Sunderland sees the hotel like it really is, he may find headphones connected to a device that looks like a radio as well as a tape recorder in the Reading Room on the second floor. Using it reveals a recorded conversation that can be heard between James and a doctor who was treating Mary Shepherd-Sunderland during her illness. Because of connections between Silent Hill 2 and Silent Hill 4: The Room and Rachel, there is a possibility he worked at St. Jerome's Hospital.