As you arrive the facility seems at first blush to have a lot in common with Dishonored levels past. Ascending a tower filled with guards is something Corvo did in 'High Overseer Campbell', 'Return to the Tower' and 'The Light at the End'. First time through I did exactly this, carefully picking my way along what seemed to be the critical path.
The trick is that the Addermire Institute is actually a porous multi-story jungle gym that you can explore any level of in any order. If you ignore the central path into the institute's ground floor, which is staffed by guards - some on duty, some playing cards - and hang a left, you can Blink your way up the outside of the building. If you forego the opportunity to do this, even when you enter your eye is drawn up - by the cables you need to follow to turn off the power supply for the Wall of Light, by the lighting coming from above, and by the fact there's guards to the front and side of you making "up" the path of least resistance. If you ignore the security systems and instead just keep Blinking and jumping upwards, you can again get all the way to the top of the institute.
Exploring halls, staircases and various rooms at will, flitting in and out of the institute and constantly changing elevation gives a feeling of empowerment and freedom. It is almost like a Batman power fantasy, appearing at windows to wreak vengeance or make off with what you came for before disappearing again. Approaching the level in this way makes the Grand Guard seem particularly defenseless and hapless, ill-equipped as they are to defend themselves from such a mobile foe. The non-lethal approach for taking down Dr. Hypatia needs you to visit multiple floors of the complex as well, which encourages this in-and-out parkour approach.
Even without powers you can do this. The entanglement of guards and security systems that many people will walk into first time around is completely optional, and they can be left oblivious to what is going on in the rest of the building throughout the mission. If you pick your way around the rocks from where the carriage stops, you can find a small shutter which will let you into the kitchens. Once you bypass the guards in the dining hall, you can reach the lift and again open up a decent amount of access to the rest of the building for yourself, especially with the conveniently placed light fixtures allowing you to platform back down and avoid the guards on the stairs.
Even without powers you can do this. The entanglement of guards and security systems that many people will walk into first time around is completely optional, and they can be left oblivious to what is going on in the rest of the building throughout the mission. If you pick your way around the rocks from where the carriage stops, you can find a small shutter which will let you into the kitchens. Once you bypass the guards in the dining hall, you can reach the lift and again open up a decent amount of access to the rest of the building for yourself, especially with the conveniently placed light fixtures allowing you to platform back down and avoid the guards on the stairs.
So you are exploring very much up and down rather than around and through like in the previous level. There are meta rewards for exploring the highest and lowest points of this level as well. If you get to the higest roof you can do a drop assassination on a guard far below (which presents as a trophy or achievement called Fearless Fall). Meanwhile if you slash the cables on the institute's lift it will crash down into the basement, providing access for you to explore down there. You will find treasure as well as an intriguing journal from a Void-touched patient in years past - don't you want to read journal entries that start with sentences like "I must get home to my collection of carved bones"? Even more interesting, it seems that this diary was written by one Vera Moray - better known to Corvo Attano as Granny Rags, who he encountered in Dunwall fifteen years earlier. Granny Rags seemed to be a destitute old woman, but she secretly had access to powers from the Outsider and was able to create runes. Her influence will continue to be significant to the events and lore of Dishonored 2.
Because this is a self-contained location, you have such access to all parts of it and are likely to go up and down a few times as you complete your objectives, you'll probably map out the institute in your head and have a mental floor plan to work from. This is interesting because the game is about to subvert this in the following level, where you won't be able to do this as easily at all - as your environment will be changing around you. Likewise you won't always have such easy access to the outside in that level where you're liable to feel closed-in for long sections of it, so it feels deliberate that 'The Good Doctor' allows such unfettered traversal.
There's also my favourite rune placement in the game, above a table where some guards are playing cards. I couldn't figure out a way to get hold of it on my non-lethal playthrough, so after I'd completed all my objectives and spoken to Billie, I burst back into the dining hall, grabbed it from above the table and sprinted out to the sound of complete uproar behind me; in true Dishonored Benny Hill style.
There are moments of horror to be had in the institute, and in fact the tension ramps up as you explore higher and the guards thin out. Dr. Hypatia is found in the Recuperation Area, behind a ward completely overrun by Bloodfly nests. Due to her detainment at the Duke's pleasure and her inability to see to her research, the Bloodflies have broken loose and there is a massive infestation on the fourth floor of the building. You'll need to find a way past them - either burning them out or Blinking past - and will pass their victims as you go. Eventually you'll encounter nest keepers, humans who live past infection and seem to be in some kind of communion with the creatures, but for now all you'll hear is the angry buzzing of wings as you navigate the ward.
If you go down and talk to Hypatia, who seems to be confused and unsure of herself, you'll then get a chance to explore around her. Talking to her assistant Vasco, who is terribly wounded and bloodied with a level of gore that is unusal for the series, reveals that Hypatia is the Crown Killer, driven to the murders by a serum that the Duke has tricked her into taking. It's a Jekyll and Hyde situation, with her alter-ego Grim Alex (so called by the Duke) in league with Delilah and her co-conspirators. You can hear an audiograph of her talking about how she is always there even when the doctor is cognisant, and as you talk to Vasco there is a fabulous jump scare when Grim Alex bursts through the wall.
Now you have to decide whether to do battle or find another way - as mentioned the non-lethal approach involves travelling around the institute to find the reagents for a cure and then manufacture it in the serum laboratory, before going back to the Recuperation Area and getting close enough to Grim Alex to administer it. It is a very involved, adventure-game style quest that echoes Eminent Domain from The Knife of Dunwall when Daud has to gather the items needed and plant letters to arrange for the target to have their house seized. The non-lethal solutions are almost always the best way to complete these levels and this is no different.
Also conveniently, the Recuperation Area, being what it is, has an entire crate of chloroform bottles. So if you want to go back and get that rune in the dining hall and you don't have Far Reach upgraded or another way to get it stealthily, you can hide in the library above the dining tables throwing chloroform down until everyone is asleep. Once you've found that crate, you have an easy way to put the entire institute down non-lethally if you want.
It also echoes the first game where a major inciting incident - Emily's capture - was actually resolved fairly quickly in the third mission. Here, also in the third mission, the Crown Killer is taken care of fairly early - leaving the player to further unravel the conspiracy.
With Hypatia dead or Grim Alex banished, you need to deactivate a watchtower so Meagan can pick you up. If you came in by the shutter you'll have seen a door opening onto the watchtower that requires the doctor's key as soon as you left the kitchen, essentially advertising your exit route, while players who've been flitting about the rooftops will have been likely to spy the watchtower from above. Right down to the moment you make your escape, the level provides a very clear trail of breadcrumbs to navigate its intricate and interconnected space.
With a lead on Sokolov and the Crown Killer taken out of the equation, that wraps up the first third of the game's plot and missions. Depending on your actions, Dr. Hypatia will become a passenger of the Dreadful Whale for a while, and bring a crate of her helpful solutions with her as well.
Non-lethal solution:
After Dr. Hypatia becomes Grim Alex you will have Vasco's safe code
Retrieve infected blood from a corpse in the Bloodfly nest on the way to his office
Open his safe to get the journal with the formula for the cure
Craft the cure
Do a non-lethal takedown on Hypatia/ Grim Alex to inject her with the formula
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