You have to escape the looney bin! You can pick up and throw various items at the clinic staff. Each item has its own damage power. You can increase your strength by killing enemies and therefore pick up and throw big items. Hold UP or DOWN when throwing to affect the direction. Use madness to break through the enemies. Note that madness makes you invulnerable and stuns enemies, however you cannot kill enemies in madness mode. Be careful, your madness reserve is limited. Use items to destroy doors.
Arrow keys to move, A to activate madness, S to pick up and throw things, Space to jump. Up/Down arrows affect direction of objects thrown.