The Medium review: This is how it runs on PC

I’ve played quite a few messed up games in my time, but none have come as close as The Medium. If you had warned me what kind of themes it would be exploring, I’m not so sure I’d want to play it. But I did, and now I’m here, to talk to you all about one of the first console exclusives for the Xbox Series X and Xbox Series S.

Haunting themes aside, The Medium impressed me in terms of graphical fidelity. Additionally, its engaging mystery and satisfying problem-solving mechanics kept me going the whole way through. However, it did drag on a bit with the serious lack of puzzles, and it could have looked better in some places, especially with the facial animations.

Overall, I liked The Medium, but it did feel like there was a lot of unseen potential. I'm not so sure it makes our best PC games list.

The ominous trigger warning

It’s rare that I get enough time to finish a game in its entirety before I write the review, but I did with The Medium, and wow, this game is ten kinds of disturbing. I mean, the opening of the game even displays a trigger warning, which states:

“The Medium was designed and developed by a diverse team of various beliefs, political views and ideologies. It touches upon highly sensitive subjects with the intent of treating them seriously. Despite this, some players may find certain scenes and themes triggering.”

I don’t think I’ve ever played a game with that kind of warning, but it’s well-deserved, because holy crap. The two more obvious triggering themes include The Holocaust and child molestation. With that knowledge, it’s understandable why you’d want to avoid this game. I won’t discuss these themes in the review, but rather analyze the overall story and writing.

Nothing bad ever happens at resorts

As you might have guessed, The Medium is a psychological horror game heavily baked in trauma, and the entire game is about dealing with the manifestation of that trauma. I won't speak to how well it handles its themes, but the overall mystery about how this resort turned into a playground for evil spirits is interesting.

As the game states multiple times, it all starts with a dead girl. Marianne, the protagonist and a medium, has a recurring dream about a girl getting murdered. However, it's not until she gets a phone call from a stranger named Thomas about the dream that it gains more significance. Thomas told her to go to the Niwa resort, which is where all the bull crap begins. To The Medium’s credit, it only used one real jump scare throughout the entire game, so if you hate getting spooked, you'll be fine. 

Throughout the entire game, you’re trying to piece together what happened at the resort. One of the best things about this game is its ability to entice the player to read all of the notes on the ground. You all know the notes I’m talking about; those carefully placed nuggets of expositional flotsam you find in almost every RPG or mystery game imaginable. I felt like a damn detective trying to make two plus two equal five.

As I previously stated, this game is very much about dealing with trauma, not running away from it. Marianne isn’t defenseless, she has badass psychic abilities to not only defend herself but also send spirits to the beyond. Although, the spirits in the game aren’t just wayward souls. They’re pieces of people’s souls that represent either dark desires or traumatic events, and combating these demons is more symbolic than it is artificial in a game like Devil May Cry where you fight demons for style points.

As a result, the horror doesn’t really come from visuals or jump scares, but rather, the thought-provoking reasons why these demonic-looking beings exist in the first place. The Medium leans into the psychological horror more than I’d like, but I suppose that’s the point. However, did The Medium have anything worth saying when it comes to its disturbing themes or does it use them as a simple catalyst for the story? I genuinely can’t say. I also can’t really say that it went too far with its themes, as it doesn’t explicitly show anything, but I also don’t have any authority to speak on those subjects.

Outside of those scenes, the game is generally well written, despite there being some obvious plot twists. One thing that really bothered me about the story was the ending. Without spoiling it, I’ll say that the developers wrote themselves into a corner. It seemed like a decision was made to open room for a potential sequel, but not enough room for it to be a given. The entire ending felt like a cop-out.

Problem solving and cinematic combat

The best way to describe the gameplay of The Medium is to compare it to the Resident Evil franchise. It’s basically the same minus all of the combat. The goal is to get from point A to point B and figuring out how to do that by collecting items and putting them in the right place. That’s essentially it.

Ironically, there aren’t many puzzles, which was disappointing. In total, there are probably around three real puzzles, and while they’re fun, they’re very few and far between. The Medium could have used some hardcore, mind-bending puzzles to raise the bar because let’s be honest, you’re just running around doing mini fetch quests. It can be oddly satisfying, but it also gets tiring after 10 hours without any shift in gameplay.

However, the coolest thing about the gameplay is playing in two realms simultaneously. Marianne exists in two worlds: the real world and the spirit world. When spiritual activity is high, her body is split between worlds and she has to walk two lives at the same time in order to get anywhere. If one way is blocked off, that means the other is too. These two worlds are displayed on the screen at once, and sometimes it can be difficult to figure out which one to focus on, but ultimately, you have to be vigilant. This does make the problem-solving sequences much more interesting. 

Of course, there’s also the combat portions, and I use the term "combat" loosely. Your spirit abilities can block and parry spirits, but in nearly every instance, these scenarios are scripted, so it’s not like you’ll have to instinctively react with your abilities. You’ll almost always know when you have to use them, and you’ll even have to prepare to use them by gaining energy from certain places in the game.

There are also portions where you simply have to run, hide or figure something out to escape a more threatening spirit. These parts are the most exciting and definitely ramp up the tension even if they aren't very challenging.

The biggest issue is that The Medium prioritizes the narrative above all else, so actual gameplay takes a back seat. That’s disappointing because there’s so much potential here to have more interactive gameplay that lets the player utilize Marianne’s abilities to the fullest. If there happens to be a sequel to The Medium, I’d like to see a major gameplay genre shift.

A gorgeous world that hides behind masks

For a game that’s only $50, I wasn’t expecting The Medium to look spectacular, but my expectations were crushed by a gorgeous, detailed world that fooled me into thinking that my poor old graphics card was capable of ray tracing.

From the reflections of the rain on the concrete pavement in the real world to the desolate, glowing monolith that is the Niwa resort in the spirit world, it’s hard not to get sucked into the enticing world design shown in The Medium.

However, when it comes down to the animations, The Medium acts like a last-gen game. Marianne’s face is the stiffest thing about this game. Don’t get me wrong, the face models look great, but it’s when they’re attempting to mimic human emotion while speaking where it falls flat. It’s like everything above her mouth is paralyzed during cutscenes.

If I didn’t know any better, I’d say that the poor facial animations are the reason why you don’t see many faces in this game at all. And while the reason for the spirits hiding behind masks isn’t lost on me, it doesn’t help that the few faces we do see fall short in regards to realism.

The Medium is very much an indie game, despite being an Xbox Series X console exclusive, so it’s understandable if this happened to be a budget issue (I’m just speculating). It would be nice to see better tech or more money thrown toward the facial animations if another installment of The Medium is to ever come about.

The Medium PC performance

I encountered one-too-many issues while playing The Medium. They weren't game-breaking per se, but there are at least two occasions where the game crashed on me and I had to make up the progress that I had lost. This wouldn’t be as frustrating if the game auto-saved frequently, but it doesn’t, so my anxiety is just artificially high at all times.

Additionally, there have been many occasions where the game would stutter, chug and occasionally slow down to a crawl. Needless to say, my review session has not been a smooth experience, but it’s not unplayable, just annoying. Then again, it’s understandable considering this game is one-of-a-kind in that it's a single-player game displaying two separate instances at once.

I’ve also experienced numerous death bugs. While performing an activity that would save my life, I was too late and the death cutscene played, but the activity was still happening in the background, which ended the cutscene and allowed me to live. On the flip side, I’ve had multiple scenarios where I did the right thing and died anyway, but the game carried on as if I were still alive.

As far as the settings go, there are quite a few things you can mess around with. The basic display settings include the resolution, HDR, Ray Tracing, overall quality, V-Sync and max fps. If you dive into the Advanced settings, you’ll find settings for antialiasing, DLSS quality, FidelityFX sharpening, shadow quality, texture quality, SSAO, SSS quality, separate translucency, LPV, effects quality, shaders quality, motion blur and lens flares.

There’s not an extensive amount of accessibility settings, but you can edit the subtitles to mess with the text size, background, speaker name, speaker color and to include bold text.

The Medium PC benchmarks and requirements

At first, I tested The Medium with my desktop Nvidia GeForce GTX 1070 GPU with 8GB of VRAM at 1080p on Medium settings, which got 62 frames per second. However, when the worlds split, and the game was technically running twice at the same time, I was getting a little over 30 fps.

I also tested it with the Gigabyte Aorus 15G, which has a mobile Nvidia GeForce RTX 3070 GPU with 8GB of VRAM at 1080p on max settings, and that got roughly 58 fps. Meanwhile, during the simultaneous gameplay, the laptop just got over 30 fps.

If your PC is a couple of generations behind, I recommend playing The Medium on the Xbox Series X, which will net you super-fast load times and more detailed graphics.

The minimum requirements for a system to run The Medium is an Intel Core i5-6600 or AMD Ryzen 5 2500X CPU, an Nvidia GeForce GTX 1650 Super or GTX 1060 or Radeon R9 390X GPU and 8GB of RAM.

The recommended specs are an Intel Core i5-9600 or AMD Ryzen 7 3700X CPU, GTX 1660 Super or Radeon RX 5600XT GPU and 16GB of RAM. If you want to go all-out on 4K settings, the developers recommend at least an RTX 2080 or 3060 Ti or Radeon RX 6800 GPU.

Bottom line

I felt like I was hit with a whirlwind of trauma. I mean, it’s kind of ridiculous how much trauma one person can experience. Even just in the few minutes of the game, we know that this is going to be a messed up story. Listen, if you’re into psychological horrors, The Medium will be right up your alley.

However, if you’re just interested in playing an Xbox Series X exclusive or something akin to Resident Evil, take a step back and ask yourself if this is really what you want. This is not a fun campy, spooky game. This is an amalgamation of some of the world’s most screwed up problems represented through the lens of creative video game design.

I can’t speak to how well it handles its themes, but as a narrative-driven video game, I liked it, despite its issues.