How to Unlock - Keep your health as low as possible, don't discover Dar-Ma's journal, find the Revolver in the abandoned car on West Sandford Street and then the single Revolver Bullet on Sarah's corpse.

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The car and its occupants remained a mystery to him, for the little thought he gave to it in his current state.  His struggle through the town had been far more tortuous than he expected, unable to heal himself.  But how much of it was due to the town not giving him the chance, and how much he refused it, was unclear.  James was breathless, his wounds piling up with blood-streaked jeans.
He noticed the revolver in the seat of the car.  Desperate for survival, more than he should have been, he quickly grabbed it without a second thought.  It felt strangely warm, almost comforting against his scaled palm.  The leather did not chafe, so smooth and oddly calming.  There was however no ammo within, making him sigh with near-defeat.
	"What do I do?  ...maybe I can...find...hhhh...oh...god."
He was barely able to stand, breathing harshly as his nanos struggled to repair his wounds.  They would have little time to allow him to recuperate, when he heard the sound of quaking huge footsteps.
It was only when he felt them within the ground, that he was motivated enough to run.  He would barely survive running all the way to the Lakeside Amusement Park, his heart almost bursting with agony by the time he did.  The only reason he did not stop, was because he never considered it an option.

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In his weakened state, the fight against Sarah had been far more tortuous than it should have been, if that was even possible.  His body was numb from the anguish in his heart, and with little motivation to heal himself back to full capacity, his mind slipped further into sorrow.  He had wanted to heal himself before, but the series of events and encounters within Silent Hill had left him wanting.  Aching.  Disoriented.
He remembered the revolver he had taken from the abandoned car on West Sandford Street, finding one single bullet left in Sarah's dismembered gun.  Perhaps it would be useful for a more dangerous foe, as he took it and loaded it into his revolver.  If he ever felt the need to survive, it would prove useful.  He remembered where it had been, and what purpose it had served before him.  Was it even a weapon fit for facing monsters?  Another thought opened up to him.
I can't...I need to stay strong.  I-i have to.  But how can I...ohhh god I'm...I feel so weak.  I want to sleep so badly.  I haven't had a good sleep in...i-in ages?  ...I...can't remember anymore.  ...s-someone...help me.  I don't...I don't wanna do this anymore.
Had he been able to find at least one single memory of good within the town, he might have been able to stave off his weakening despair.  But he never did.  Not even the pendant around his neck would comfort him.  Its black dull surface no longer reminded him of love and courage.  Now, it made him think of slipping into a numb darkness, where he would feel pain no more.

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He had done the best he could.  Nobody could tell him otherwise.  He had struggled all the way to the top of the school, he had faced his demon, but found nothing in resolution.  The mist had not cleared, and he was unable to leave the town.  Something stopped him from doing so.  His wounds were many, and he felt no desire to heal them.  Blood dripped sorrowfully from his cheeks and legs.
He was somehow at the very edge, and yet something had made him turn back.  He didn't want to keep going anymore.  Even after Tara's reunion with her brother, his body was far too tired to keep going.
He walked back into the town, down the school stairs, out of the door, and headed southwards.  The town did not stop him.  No monsters, no cracked roads, no radio.  The town had finally accepted his choice, just as he had accepted his.  He had been thinking about it ever since passing along that street.  How easy it would be, for how weak he had allowed himself to become.
He walked past the lighthouse, and past the amusement park, back towards the new part of town.
He was not lost.  He was no longer confused at what had to be done.
For once he had nothing to say.  His tears and screams had taken everything out of him.  Not even a single curse came to him as he soon found what he was looking for.  All he wanted right now, was that he didn't want to be alone.  There was only one place upon the highway where his misery would enjoy company.
He stared at the dull revolver in his hand, now loaded with a single shot.  He had only picked it up because he had a gun to fit it.  Yet he had no idea why he had not used it against any of the monsters, not even "Daisy".  Until he realised that it was not fit for such a purpose.  It had been tainted long ago for another agenda.
He approached the car.

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A breeze softly flew through the town.  It slipped seamlessly between alleyways and byways, snaking towards the main street and up towards the main road.  The lake was as still as death, as it always had been.  An observer laid to the west of it, sitting and staring towards the fog blanket across the water.
Five bodies now occupied the inside of the car.  The raptor sat listlessly, his warmth fading into the mist of Silent Hill.  The gun had fallen onto the floor between the seats, directly underneath his hand.  Blood and saliva oozed upon the snubbed warm barrel.  His head sat back against the now-comfortable driver seat, blood seeping freshly into the fabric.  A new hole was made through the head of the seat.  His eyes stared beyond the lake, never to close again.
He answered his own question on what happened to the fifth passenger.  He just hadn't shown up yet.