Future Press game guide description: "A familiar face with an unfamiliar body, Patches will make his presence known once you've entered the Forbidden Woods, from which point he will take every possible opportunity to force the Tonsil Stone upon you and lure you into the clutches of his illegitimate god, Amygdala."
Patches is the creation of Hidetaki Miyazaki, the director of Bloodborne, and has appeared in Demon's Souls as Patches, the Hyena, Dark Souls as Trusty Patches and as a spiritual successor in Dark Souls 2 as Mild-Mannered Pate.
To truly get at Patches' role within Bloodborne we must take a look at the institutions he is associated with. Byrgenwerth was a once a place of reflection, where scholars learned of history and archaeology, but the lecture theater is now adrift in the nightmare. The scholars at Byrgenwerth were driven by the desire to ascend, beyond their humanity both physically and mentally. They developed two unique schools of thought, the first, which was developed by “young Byrgenwerth scholars” under Laurence is that the blood of the Great Ones and their descendants will enable humans to ascend:
Alfred, Hunter of Vilebloods dialogue:
“Byrgenwerth is an old place of learning.
The tomb of the gods, carved out below Yharnam,
should be familiar to every hunter.
Well, once a group of young Byrgenwerth scholars
discovered a holy medium deep within the tomb.
This led to the founding of the Healing Church,
and the establishment of blood healing.”
The discovery of blood made their dream of evolution a reality. Metamorphosis, and the excesses and deviation that followed, were only the beginning. The scholars discovered blood in the tombs. The Healing Church traces its roots to Byrgenwerth, and is therefore aware of the ruins' true importance.
The other school of thought was developed by the leader of the institute Provost Willem:
Great One's Wisdom description:
At Byrgenwerth, Master Willem had an epiphany:
"We are thinking on the basest of planes. What we need, are
Willem believed that having more eyes was the key to ascending and surpassing his humanity.
One Third Umbilical Cord description:
Provost Willem sought the Cord in order to elevate his being
and thoughts to those of a Great One, by lining his brain
with eyes. The only choice, he knew, if man were to ever
match Their greatness.
The Great Ones are inhuman beings that might be described as gods, who function on transcendental planes of thought. They are described as “slumbering” in the Isz Chalice descriptions. The fact that the majority of the Great Ones slumber indicates that this sleep allowed them to transcend their current plane, and achieve existence in the Nightmare realms. Perhaps their bodies remained in what became known as tombs to be guarded by the servants of the Great Ones, superhuman beings known as Pthumerians. The bodies of those who occupy nightmares can certainly be left behind, as we see from the mummified remains of the School of Mensis. In game we only encounter legitimate Great Ones in Nightmare realms, excepting Ebrietas, who we know for certain was “left-behind” by the Great Ones, indicating that not all the Great Ones ascended to the Nightmares (or Dreamlands). We know that more than one Great One was left behind which may account for the Amygdala Great Ones. The pursuit and interest in Nightmares may be what the School of Mensis was focused on.
Simon, the Harrowed dialogue:
“Ahh, yes, I see…
You sense a secret within the Nightmare,
And cannot bear to leave it be.
As if the spirit of Byrgenwerth lives on within you!”
The School grew out of Byrgenwerth, we can see this from the attire of Micolash. It is unclear whether the actions of the School are what led to the Lecture Theater becoming adrift in the Nightmare, but it is a logical leap that preliminary attempts at trying to facilitate contact with the Great Ones dragged the entire lecture theater into the dreamlands. This is where we get to Patches.
Patches is almost certainly a scholar from Byrgenwerth and perhaps a member of the School of Mensis. Because of this, he must fit into the events we know about. In his interview for the official Game Guide Bloodborne director Hidetaki Miyazaki spoke about Patches:
“There are a lot of other spider-men in the game apart from Patches.
But all the others have long since gone insane.
Patches, despite being exposed to enough of the world's mysteries
to be transformed into a monster, has still retained his sanity
and is still continuing with his research.”
From this we can see that Patches is one of the scholars who eventually became a 'spider-man' after being exposed to enough of the “world's mysteries”. What this means is, of course, ambiguous but there are some clues as to why Patches is a spider. If we examine the Amygdala Great One's we can see that they have 8 arms and 2 legs. Also, their heads are very spider-like in that they have many eyes closely grouped together. The other 'spider-men' known as Nightmare Apostles that we encounter in the Nightmare of Mensis resemble Patches. Some still have human heads, and also wear the same necklace as Patches, while others have completed the transformation into a spider and do not wear necklaces. Their presence in the Nightmare of Mensis associates them with the School of Mensis, which was based out of Yarhar'gul. Within Yarhar'gul there are many Amygdala clinging to the walls. We also know that the presence of a Great One can cause humans to undergo physical changes, often manifesting physical characteristics similar to a Great One. This is shown in the Fishing Hamlet with the villagers there and with the Moon Presence or 'Paleblood', which when beckoned closer transforms the citizens of Yharnam into beasts. When Patches dies, he will drop a Great Ones Wisdom, the wisdom only given to those who have had direct contact with a Great One. The word “apostle” is closely associated with religion and indicates that the Nightmare Apostles along with Patches were worshipers of the Amygdala Great Ones. With all of this evidence, and considering what we know about Patches' contact with Amygdala, it seems very likely that his transformation into a spider is due to his interaction with Amygdala Great Ones, and this accounts for the Nightmare Apostles as well.
In the case of the Nightmare Apostles, despite some of them retaining their human heads, none of them save Patches have retained their sanity. It's possible that Patches, or one of his Nightmare Apostle colleagues was the one to discover the Amygdala Great Ones. We know that with enough insight these Great Ones can be seen. The symbol for insight is an eye, and it represents eyes in a hunter's head. We also know that Willem believed that lining his brain with eyes would allow him to elevate his being and thoughts to those of a Great One. By putting these facts together it is clear that the scholars believed in the use of eyes and that this would likely have facilitated contact with the Amygdala Great Ones.
Patches worships Amygdala as his god. Perhaps to further his research, as is mentioned by Miyazaki, or perhaps as a means of worship, Patches offers sacrifices to Amygdala. From Patches' dialogue it is implied that the sacrifices Amygdala seeks are hunters.
“…Oh, a hunter of beasts, are you? Glory be. You know not the value you possess.”
Amygdala might seek hunters because they contain the blood echoes of the Great Ones, though we are never told this directly nor given a reason behind it. It may be that Patches will trick you as a means of survival. His line “Throw yourself to the wolves!…Heh heh heh…” implies that if Patches doesn't find a sacrifice for Amygdala he may be next.
The player will first encounter Patches in any of the Yharnam residences after entering the Forbidden Woods. He tells the player he is doing them a “kindness” then will give them a Tonsil Stone and tell them to “Step lightly round to the right of the great cathedral, and seek an ancient, shrouded church. …The gift of the godhead will grant you strength…” The Tonsil Stone is a “latticed, deformed rock, or perhaps a meteorite.” If we examine its appearance it clearly resembles the head of Amygdala. We know that Patches worships Amygdala as a god, so when he says “the gift of the godhead will grant you strength” he may be referring to his gift to you, of his god's 'head' (the Tonsil Stone). It is also worth noting that Tonsil when translated to other languages like Spanish (“amígdala”) and French (“amygdale”) resembles the word “amygdala.” Patches encourages the player to seek an ancient, shrouded church. This Church is located at the entrance to the Unseen Village of Yarhar'gul and contains an Amygdala Great One who will transport you to the Lecture Theater (a different plane of existence) when the player looks into his eyes.
The Player can then meet Patches in this Lecture Theater and talk to him through a closed door he hides behind. He will tell them “What a joy it is, to behold the divine” referring to the player's recent encounter with an Amygdala Great One. He then encourages the player to “take the plunge! Throw yourself to the wolves!” which is his way of telling them to traverse to the Nightmare Frontier and seek out Amygdala.
The Nightmare Frontier is part of the Dreamlands and appears to be situated above the Fishing Hamlet which in turn is above the Hunter's Nightmare, a fact extrapolated from the presence of the fishing masts that can be seen amidst the mist when looking into the horizon of the Nightmare Frontier. It is also the home of Amygdala, and a tower that appears to have been built to worship Amygdala, based upon the 'Amygdala's Chamber' lamp room and the Amygdala statues in said room.
Patches is clearly able to traverse the nightmare realms with ease. From the player's vantage point early on in the Nightmare Frontier, they can see Patches on a wall, quietly observing the player's progress. If the player falls into Patches' trap, which is just like the traps of Patches, the Hyena and Trusty Patches from Demons' Souls and Dark Souls respectively, he will tell them:
“Hah hah hah! Don't dally, you lucky scamp!
The gift of the godhead cometh!
Heh heh heh… yes… Ha hah!”
Indicating that he has set you on the path to the 'gift' that awaits you. This is the last the player will see of Patches until after defeating Amygdala (or Patches can be encountered again without defeating Amygdala if the player defeats The One Reborn and interacts with Micolash's corpse).
Patches is shocked that the player has defeated Amygdala, indicating that the fate of previous hunters who were tricked by Patches was a little more macabre. He will explain that the player was a “lamb as to my god” confirming that they were a sacrifice for Amygdala. He will also mention that what he shared with the player was a secret that he would not usually share.
“I shared with you a thing most secret”
“Well, you weren't to know, and it wasn't for you to know”
His words are reminiscent of a lore note found in Oedon Chapel:
"The Byrgenwerth spider hides all manner of rituals, and keeps our lost master from us. A terrible shame. > It makes my head shudder uncontrollably."
This note may refer to Rom or Patches. If it refers to Patches then the rituals mentioned could be how he managed to retain his sanity and traverse nightmares with ease. The lost master in this case would be Amygdala, since we know that other Apostles exist and that the Amygdala are worshiped. If this is the case it may be a window into Patches and how he operated while conducting his research. The line “it makes my head shudder uncontrollably” is very reminiscent of eyes writhing on a brain, and the heads of the Amygdala Great Ones. That being said, this could just as easily refer to, and is perhaps more likely to be referring to Rom. Rom hides the rituals of the School of Mensis and there are a number of lost masters it could be referring to like Micolash, Mergo, the Wet Nurse, the One Reborn or even the Brain of Mensis.
After defeating Amygdala, Patches will begin to consider what he should do next. He will tell you he feels “a profound thought occurring, on the good grace of a certain god, and the way he meted out his love.” This is possibly referring to Amygdala, who meted out his 'love' by accepting offerings and sacrifices, perhaps even by sharing his blood with his servants. Patches will then tell you he is departing, now that his god, Amygdala, is lost to him. He says that he is going away to find another god, indicating he is searching for another Great One to research and worship. This gives meaning to his line “sooner still if you take the leap” which may refer to the player becoming a Great One if they continue down the path they are on. He does not seem at all perturbed that the player killed his god but rather tells you to “think not of poor Amygdala” and that they “bestowed salvation” upon him by killing him. This strongly indicates that Patches is not genuinely religious, but much more interested in scholarly research.
Patches' search takes him to the Chalice Dungeons (or the 'old labyrinth', or 'tomb of the gods') where he can randomly be encountered in a root chalice dungeon. The reason he goes to the Chalice Dungeons is because he seeks a new Great One to study. He knows that the Chalice Dungeons contain the remnants of the Great Ones through his scholarly research at Byrgenwerth. The dungeons contain “much more than mere hunter trinkets, indeed they hide the very secrets of the old Great Ones, sought after by those with the insight to imagine greatness…"