http://www.polygon.com/2014/8/12/5996537/silent-hill-ps4-hideo-kojima-guillermo-del-toro tomb raider died so silent hill could live
Pyramid Head as a tanky bruiser with an executing ultimate. Nurses are assassins carrying leadpipes. Heather has a katana and her princess beam thing outfit. Murphy Pendleton the fire axe tosser marksman. James Sunderland with projectile pillows and toilet searching ability. Baron Nashor replaced by the dog.
It's actually just a loop of Pyramid Head violating those weird nurse things (Obviously Pyramid Head himself can solo it np)