Here are all of the major differences between the HBO show The Last of Us episode 4, Please Hold to My Hand, and the video game.

Differences Between The Last of Us Show Episode 4 & the Game

The Last of Us episode 4, “Please Hold to My Hand,” features precisely zero infected, but that doesn’t mean the show has parted company with the game — some of The Last of Us Part I’s best moments are entirely fungus-free. But how else does it measure up to the game? Let’s discuss all the major differences between the HBO show The Last of Us episode 4 and the video game.

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Among the Major Differences Between The Last of Us Show Episode 4 and the Game: The Action Relocates to Kansas City from Pittsburgh

The biggest geographical change is that the episode, which sees Joel and Ellie running afoul of hunters, takes place in and around the Kansas City Quarantine Zone. In the game, the relevant section is set in Pittsburgh. But that’s not all that’s changed between The Last of Us episode 4 and the game — here are all of the other notable differences.

  • Joel confirms that he’s partially deaf in one ear, which happened prior to meeting Ellie. He suggests that it’s down to shooting guns without using ear protection. This isn’t mentioned in the game.
  • Before reaching Kansas City, the pair stop at a gas station, where Ellie familiarizes herself with the gun she took from Frank’s.
  • The pair go camping in the woods to rest up, where Ellie tortures Joel with a book of bad jokes. The book (and Ellie’s jokes) are in the game, but the gas station and camping stops aren’t. In The Last of Us Part I, they’re shown driving from Frank’s all the way to Pittsburgh.
  • We also get to see Joel siphoning gas from abandoned cars. In the game, Bill gives him a hose to use, but he never uses it on-screen.
  • Joel tells us more about Tommy, who is still out of contact. He calls him a “joiner,” joining various groups / organizations but leaving them later. Joel confirms that Tommy joined the army, something that was never confirmed in-game.
  • We meet the Kansas group, the ones who try to rob Joel and Ellie, and learn a lot more about them.
  • In particular, we meet their leader, an original character, Kathleen. The group overthrew FEDRA (or FEDRA just ran) and took over the QZ, but she’s got a personal beef with Henry. Rightly or wrongly she thinks Henry, who’s on the run with his brother Sam, informed on her own brother to FEDRA.
  • We also see that she’s ruthless, killing a doctor when he refuses to cooperate. In the game, the group’s leader remains unseen.
  • Kathleen hypes up Henry as some kind of bogeyman, suggesting that Joel and Ellie, who’ve killed at least two of their number, have been brought to the city by Henry.
  • This also explains why the Kansas hunters are after Henry, whereas in the game they don’t have a specific reason (other than robbery) to be after them.
  • The show also changes an element of the pair’s backstory. In the game, they came to the city and were set upon by hunters. In the show, they were there when FEDRA was still in control. This suggests they were regular Quarantine Zone inhabitants before FEDRA was ousted.
  • Ellie uses her pistol to shoot a Kansas city hunter, who’s choking Joel to death by pressing his gun barrel against his neck. In the game, the hunter is trying to drown Joel and it’s Joel’s pistol she picks up.
  • However, while she outright kills the man in the game, here her shot paralyzes him. Joel is the one who, with the man begging for his life, finishes him off.
  • Joel takes Ellie’s gun off her, but gives it back shortly after. In the game, Joel gives Ellie a pistol when they reach the University.
  • Kathleen is led to a store room where she’s shown something pulsing underground, something strong enough to raise the concrete. We don’t know what it is at this point, but we could be looking at the creation or emergence of one of the game’s bloaters. In the game, the bloaters’ exact origins remain a mystery.
  • Finally, when we do meet Henry and Sam, we’re introduced to them in a slightly different manner. In the game, Henry attacks Joel when he climbs through a window, but Joel quickly gets the upper hand. In the show, Henry and Sam sneak up on the pair while they’re sleeping and draw weapons on them.

That concludes all the differences between the HBO show The Last of Us episode 4, “Please Hold to My Hand,” and the video game! Like with the previous episode, the creators are making changes thoughtfully, where they think it will better serve the narrative for the TV show.


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Chris McMullen
Chris McMullen is a freelance contributor at The Escapist and has been with the site since 2020. He returned to writing about games following several career changes, with his most recent stint lasting five-plus years. He hopes that, through his writing work, he settles the karmic debt he incurred by persuading his parents to buy a Mega CD. Outside of The Escapist, Chris covers news and more for GameSpew. He's also been published at such sites as VG247, Space, and more. His tastes run to horror, the post-apocalyptic, and beyond, though he'll tackle most things that aren't exclusively sports-based. At Escapist, he's covered such games as Infinite Craft, Lies of P, Starfield, and numerous other major titles.