Chapter 2, titled "Second First Breath", is the second chapter in The Cat Lady.
In an office, a doctor briefly talks to Susan about his appreciation and interest in fine art, and begins Susan's mental health evaluation. As a former nurse, Susan knows the procedure well, and she is anxious to go home and take a long shower to unwind.
The scene transitions to Susan lying in a hospital room with a breathing mask. A nurse dressed in blue alerts a doctor who introduces himself as Andrew. the player can choose the response Susan gives when asked if she can remember her name. Andrew says her condition is stable and tells her to ask the nurses if she needs something. Before he leaves, Susan starts to mumble something and Andrew answers, "Don't worry, Ms. Ashworth, your arm is fine. No, no, no, there's nothing wrong with your arm, darling. Now calm down."
Susan sleeps, and is later awoken by a nurse. She is extremely friendly and starts chatting with Susan while taking her blood pressure. She expresses her dislike of being overworked in the hospital. After the dialogue, Susan again sleeps, until the lamp above her animates and burns her alive. However, this is a nightmare which ends abruptly with Susan awakening to the company of the nurse. The player has the option of telling the nurse about the dream. The nurse, whose nickname is Liz, listens to Susan talk about her suicide attempt and a dream of the events of Chapter 1 (If the player chooses to talk about it). Liz says that it might not be a dream - she believes in the supernatural.
Liz tells Susan that her daughter apparently saved her life by entering her apartment. Susan says she doesn't have a daughter and the person who called the emergency line must have lied.
Liz talks about Doctor X, a doctor who will talk to Susan before she is released from the hospital. She warns Susan about his flirtatious attitude and his affair with another girl who was supposedly paid to leave the scene. After a minute of talking about the mysterious Doctor, the player has the opportunity to ask more about Liz herself before asking to be left to sleep.
The scene transitions to Susan talking to the psychiatrist from before, who is actually Doctor X. The player has the freedom to craft Susan's childhood story line from different options concerning her parents, resulting in some variance.
Back in the hospital room, Susan gets up and decides to attempt leaving the hospital. After leaving her room, Susan can walk right to find an occupied toilet and left to discover drug charts for both herself and the patient beside her - Ann Burton. It reveals that Ann has checked herself into the ward, and is on several medications to recover from heroin abuse.
The player has several options from here; You may talk to the receptionist who is unhelpful and impatient. Alternatively, you can look at the discharge letter on the desk belonging to Ann Burton, or the other files further to the left on the desk. All of these result in the receptionist telling you not to touch the confidential documents and telling you to go back to the ward to receive your medication. You can go further left down the hallway to talk to the security guards who only confirm that the only way to get out of the hospital is with a discharge letter. Upon going back to the ward, Susan meets another patient who will come out of the bathroom into the hallway, presumably Ann Burton. She is unsteady, confused and haunted by her mother. To gain her trust, the player must guess the name of Ann's mother. However, none of the names on the list will work at this point. Ann will tell Susan to leave her alone.
This time, Susan may enter the bathroom. Here, Susan can search through the bin for a medication pot, and grab a shard of glass from the broken mirror. Susan also has the option to use the toilet, which results in nothing but an explanation that she had been wanting to use it since she woke up. The player must turn on the hot water until the steam reveals the letters "EIL" on the mirror above. Susan then rings the bell beside the mirror in order to call the nurse from the reception. As long as Susan answers with an option other than "I'm sorry, I pressed it accidentally", the dialogue results in Susan being given drugs, and being told to return to her room to relax and sleep.
[NOTE: The player can choose to return Susan to her room to sleep after taking the drugs, but this results in Susan reaffirming her desire to leave, and resets the situation.]
While Susan is on the drugs, she hallucinates, seeming to reappear in an alternate dimension. Two of the bathroom mirrors now show the letters "SH" and "A". Together with the letters from the mirror that are revealed by steam earlier, they combine to form the word "SHEILA" - the name of Ann Burton's mother. Susan, now breathing heavily, leaves the bathroom, and heads for the reception area. There, a huge pulsating narcotic heart dominates the room. She uses the mirror shard and medication pot on the heart to collect red liquid. Susan then returns to her room to sleep off the drugs. She wakes up feeling better, but reaffirms her desire to leave the hospital.
In the hallway, Susan approaches Ann again, who tells her that if she really is a friend, then she will know her mother's name. Susan answers "Sheila" and wins the woman's trust. The woman appears to be very obedient and trusting of the hospital. She says that in her dreams she sees a spider's heart full of a red drug. She implies that the red medicine is a sedative that calms her down, takes the pain away and makes her happy. She says it is "something you can only get in the world of dreams". The resulting dialogue leads to Susan finding out about Ann's self-abusive behaviour without the drugs and her assumption that she is dying, mentioning a man only referred to as "HIM", presumably Doctor X. Susan then gives her the cup of red medicine in return for swapping name bands.
Susan creates a distraction to draw the nurses away from the reception in order to take Ann's discharge letter; she flushes some rubber gloves gathered from her bedroom down the toilet. After taking the letter and passing by the security guards at the end of the ward, Susan moves down the hallway only to be intercepted by Doctor X, accompanied by the nurse and a security guard. Susan is told that she was given the wrong medication and that she will have to stay another night in the hospital.
The scene switches back to the Doctor's office, presumably the next day, and the Doctor continues to question Susan about her daily life. The player then has the opportunity to continue making up Susan's life story by choosing different options with the exception of the last question when the Doctor asked if Susan had any children where Susan became evasive and refused to answer that question. Between the questions, a flashback enacts of Susan following Liz up to the hospital's roof; Susan attempts to convince Liz not to jump, and the player can answer questions based on Susan's first and only interaction with the nurse. But Liz jumps, regardless of the player's actions (If the player manages to answer all of Liz's questions correctly, this will award the achievement I Listened. It will also award the player additional options to reach the Golden Ending, as well as to flee from Doctor X's hidden basement without killing Doctor X). After telling the Doctor about this event, Doctor X proclaims Susan is just imagining things and that Liz is fine; he spoke to Liz that morning. The Doctor diagnoses Susan with depression, and after the evaluation, corners her in the locked room. He viciously stabs Susan dead several times, leaving Susan to wake up in a limbo environment.
The Crow in the Theatre
Susan awakes in a creepy theater, and after inspecting a tasseled cord to the left of the stage, a massive eyeball appears on a screen, proclaiming itself as The Crow. The Crow's raspy voice tells Susan that he will help Susan get out of there. Two dolls guard two doors; one door will take Susan to where she belongs, and one door has a reward behind it. Susan is allowed to ask one question from the dolls regarding which door to open. One doll will always tell the truth, one doll will always lie. If Susan takes the door with the reward, she enters a dark room with a vase of flowers in the middle of the room (This will also award the achievement The Great Reward and allow the additional option of reaching the Golden Ending). She exclaims that she hates flowers and the crow lied to her. The massive eyeball appears again and asks her if she really thought that the reward would be something precious. A second door appears at the end of the room and she goes through it. (Taking the non-reward door will land you in the same place.)
She finds herself in the room with the candles in the Queen of Maggot's house. She has no choice but to blow out another candle, witnessing an old lady die in a hospital room.
Susan walks in a dark alley until she comes across a writhing black body bag. Unzipping the bag reveals Susan's bloody, stabbed body. The body suddenly opens its eyes and sits up.
Doctor X's secret
The same bloodied Susan awakes in a cushioned room containing two other female corpses. She screams in despair and condemns Doctor X for stabbing her in cold blood. She realizes that the Queen of Maggots' gift of immortality was real. She exits the chamber and discovers several of Doctor X's horrifying "artworks"- bodies of women strung and hung and positioned to resemble real-life famous paintings such as The Girl With The Pearl Earring and the Mona Lisa. Meanwhile, she hears the pained screams of Doctor X's newest victim down the hallway.
Susan discovers Liz's corpse, pinned to a gate. If Susan answered Liz's questions correctly on the hospital rooftop, Susan will retrieve a key that unlocks the exit to the underground torture facility. She contemplates how she could just leave and forget about it or stay behind and kill Doctor X, saving innocent lives. The player can pick either one.
If Susan chooses to stay, she must assemble and craft any of two weapons using the workbench from items obtained in the facility. She then slays Doctor X, completing her revenge (This will also award either achievement Sharp Scratch or A Lady with a Mace depending on the weapon Susan uses to slay Doctor X). The rescued young woman profusely thanks Susan. Susan tells her to get out of there and call the police, as she is going to go home. The player has the choice to remain anonymous, give Susan's name, or proclaim Susan as "The Cat Lady".