Purchase the turret upgrade before the 8th day.
Reach chaos for the first time
Complete Act 2
Complete Act 1
Survive the pack of wild neighborhood dogs at the end of Area 1.
Equip 3 perks at once.
Steal enough candies from a kid to make him limp away.
Unlock this medal to learn its secrets!
Added to levels for Madness: Premeditation Feb 23, 2011.