The Suffering is certainly one of this new breed of Midway game. Set on a prison island, gamers will need to explore and survive a harsh, gritty environment where blood and dirt cover almost every area. The characters are similarly seedy, free to swear and kill. Even worse are the enemies, whose level of aggression often borders on extreme. Behind this is an ever-present foreboding, as if the dark history of the prison has suddenly come to life. This is certainly not a bad thing though and The Suffering portrays this violence well and in an appropriate sense, as opposed to the try-hard adult themes in a game such as BMX XXX.

The Suffering is set on Carnate Island, a small island that is home to Abbott Penitentiary, a prison with a long and violent history. While that may sound limiting in terms of game design the island actually turns out to be quite diverse. Various buildings and features surround the main prison facility to ensure that the environment stays consistently interesting, and each of these has its own history for players to discover. Traveling around the island is a fairly linear affair. While the environment is huge and has quite a few ways to go around it the player is allowed to go in certain areas at certain times. Paths that are presently locked may become unlocked later in the game, either by the player or by something else, and vice versa. While this can sometimes feel like being herded around it does help to provide a more cohesive narrative for the story.

Players take the role of Torque, a new prisoner on Death Row. Once Torque is imprisoned the island suffers an earthquake, and someone or something kills off most of the other prisoners and guards. Still alive Torque must find a way out of the prison and off the island while surviving whatever killed the others. It's a great premise for a game, and one that is executed well. As the game progresses players will learn more about the island, its inhabitants and about Torque's own past, creating a narrative that is quite absorbing.

Taking the role of the anti-hero creates a few choices throughout The Suffering. As a prisoner on Death Row Torque would seem to have a natural tendency towards being bad, and players can certainly act on this through the game, killing the various other survivors he meets on the island. Alternatively players can choose to be good and let the other survivors live. This sets the game up to play quite differently, and if he chooses Torque can go some way to redeeming himself by protecting and saving other people on the island, sometimes leading to a reward for Torque, other times nothing. Often helping others puts Torque in more danger, so there is a nice balance in each type of game. These different choices also set up one of the multiple endings in The Suffering, and are a great way to extend the life of the game beyond just the multiple difficulty levels.

To create a very real feeling of dread The Suffering is portrayed quite realistically. Both the cut-scenes and in-game action are quite detailed and life-like. Torque is very well animated and has quite a physical presence onscreen. Over the course of the game he will become increasingly covered in blood from those he has killed. The look of both the prison and the island is fairly bleak, covered in blood and dirt. Its reasonably detailed as well, showing some nice touches. Light and dark play an important role in the game, and the use of lighting is well done with flashlights and film projectors playing off the environments well. The shadowing could have been a little better though, but with the amount of prison bars or wire fencing this would have been some feat.

While there are only a few types of enemy they are also very well done, each containing a lot of detail. Most are representative of a type of execution or death at the prison. For instance there are the Mainliners, creatures riddled with syringes from lethal injections. These creatures throw syringes at Torque, as well as a more frightening attack where they jump on Torque and try to stab him. The enemies do have a few drawbacks though, and this really stops The Suffering from being a great game. Firstly, there are too few varieties of enemy. Most types will be seen multiple times around the island. Secondly, their attacks and tactics are far too standard. For example the mainliners have only a couple of attacks, and they will use these repeatedly right throughout the game. The challenge in The Suffering comes from meeting multiples of these creatures, as well as meeting different types of monster at the same time. This is not to say there is no challenge or fun in the game, but it can become a little too uniform as the game progresses.

To complement the dark look of The Suffering there is a similarly creepy soundtrack. Ambient noise from around the rest of the prison or the island adds to the atmosphere, as does the creative music. A lot of the time, especially in the limited confines of the prison creatures can be heard before they are seen, adding to the atmosphere. Voice acting is generally very good, although there are some characters that appear rather stilted. Perhaps luckily Torque remains silent in typically staunch fashion, letting his physical presence and actions speak for themselves. Overall the sound of the game works well with the rest of the game, and it's definitely worth turning up.

Many games in the survival horror genre get their scares from what players can't see. Instead sound or suggestive visuals provide fuel for players to let their imagination run wild, often to a greater extent than what could be portrayed. The Suffering tends to go the other direction, with a more overt sense of danger. Enemies will quickly make their presence known, leading to more fighting than other games in the genre. Players looking to be scared may not necessarily find what they are looking for. Instead the game tends to become a more standard action-adventure, where danger often comes from the volume of enemies rather than their individual scariness. Even so playing the game in the first-person view as opposed to the default third-person camera, does add a lot in terms of tension and player involvement and harks back to some early first-person shooters FPS).

The game itself tends to play like a FPS, with a similar control system using the dual analogue sticks. In both first- and third-person views this seems to work well, and soon feels quite natural. Switching between weapons is easy enough, as is targeting and firing. The weapons themselves are also fairly similar to shooters. Players start out with a shiv, and progressively find pistols, shotguns, Tommy Guns and others. Different weapons have differing effects on creatures, so switching weapons and knowing the effect of each weapon is often a crucial skill. As well as the action there are puzzles to work out throughout The Suffering. These are generally fairly rudimentary, involving pressing a certain button or performing a certain action. There are enough though to break up the combat parts well and can occasionally get tricky, especially if the player has decided to go the dark route and kills all the other survivors, who often give tips on how to get from place to place.