- "Hey, you're that little shit priest's guy aren't you? His... witness or whatever. You must be exhausted. Let's take a break, huh, buddy? The old two martini lunch, have a little confab. Blah, blah, blah, blah..."
- ―Richard Trager
In the comic book Trager was the head of Business Development at Mount Massive Asylum for the Murkoff Corporation before being committed as a patient. During the Mount Massive Asylum Incident, he improvised himself surgeon and started cutting up staff members to "cut corners". While in the game this document shows that Trager was a former executive of the Murkoff Corporation Research Development at Mount Massive Asylum before he became an experimenting surgeon. He wears glasses, a machine-monocle, a bloodstained apron and a torn up surgeon's mask. He also appears to have an accessory on his left arm made from a patient's drip. This drip could be used by him as a blood transport to survive. Trager was also a close friend with Jeremy Blaire, as Waylon finds a note which proves that they were friends and used to play golf.
While investigating information leaks at Mount Massive, two agents are called in by Murkoff. The investigators are sent to meet with Richard Trager. When they meet him, he is acting jovially, claiming to be "a team player" and wanting the two of them to be on "Team Rick". Rick also harasses the female investigator multiple times. Trager is claiming that no one in his department is responsible for the leaks. During the conversation, the male investigator, Paul, secretly signalizes his female partner Pauline that he considers Trager, who is still desperately acting like everything is fine, to be "dirty as hobo shit". To get more information out on him, Pauline asks Trager whether the two of them could meet for dinner at his place. Trager accepts.
At dinner, Trager offers Pauline cocaine. When she declines they move to scotch instead. However, while drinking, Pauline recognizes a sour taste and realises that Trager spiked her drink with Rohypnol. To prevent Trager from raping her, Pauline pulls her gun on Trager and forces him to drink the rest of the drugged scotch. Trager passes out almost immediately. She then searches his house and finds a pamphlet about an abortion clinic.
After leaving Trager's house, she calls her partner and the two meet the pregnant Murkoff employee Michelle. They confront her as the source of the leaked information and Michelle reveals that Trager raped her and got her pregnant. Trager had then forced her to either get an abortion or to get fired. As the woman could tell no one without the risk of Trager firing her, and she could not take care of a child without her job, Michelle had decided to send the leaked e-mails with the hope that Trager would get blamed and fired. Paul then made sure a severance package was made for Michelle in exchange for her silence. This way, Michelle was able to keep her child and would be able to take care of it without working for Murkoff. Michelle agreed, but when she visited Jeremy Blaire with the investigators to revoke her security clearance, a furious Trager stormed into the room, calling the two investigators "lying bitches". Claiming that Michelle cannot prove anything, he grabbed a pair of scissors from a nearby table and viciously stabbed her in the stomach multiple times, severely wounding Michelle in the process.
Trager was tackled by the investigators immediately afterwards. In the hustle, Trager's long hair got caught in a paper shredder and was ripped out of his head. Trager was caught and was taken in as an inmate and used as a test subject for the Morphogenic Engine. Despite having been his friend, Blaire personally watched when Trager was dragged into the machine kicking and screaming, and sadistically smiled while watching.
Doctor Trager, much like the rest of the asylum's inhabitants, is a sadistic and mass-murdering psychopath, but his psyche and mental ability appears to operate in a highly functional way that proves he still has a grasp of reality, even if only slight. Because of this, he is more than capable of thinking, planning, and other things such as tricking Miles into entering the dumbwaiter so he can gain access to him (it is possible that that's how Trager lures his victims).
Additionally, he is capable of both intelligent and coherent speech (much like Eddie Gluskin), speaking to Miles in a friendly tone and addressing him almost mockingly, as "buddy." He either enjoys pretending to be a surgeon or has been driven to believe that he actually is one, and has a habit of collecting body parts from his "patients", e.g. a tongue because he was "tired of licking his own stamps", and Miles' ring and index fingers because he desired to sell them.
After Miles hears a voice and climbs into the dumbwaiter to escape his pursuers, he meets Trager. Despite initially sounding like an ally, Trager beats Miles until he is unable to walk, picks him up, and straps him into a wheelchair.
After rolling him down a hallway, Trager taunts Miles by offering him a chance to escape the asylum by walking out the exit door. Miles is unable to do so due to the wheelchair restraints, so Trager pretends that Miles wants to stay, taking him up an elevator and down a few more hallways. Along the way, Miles sees the bodies of other victims who had been captured. They finally arrive at a makeshift operating room; a bathroom covered in gore with a table that has various sharp tools on it. Trager takes the camcorder and sets it down on the sink before washing his hands. He then has a short talk with Miles about Father Martin and his religious viewpoints before taking a large pair of bone shears and cutting off two of Miles' fingers. Trager leaves the room for a short while, giving Miles the chance to escape.
Miles breaks out of the wheelchair restraints and navigates through other "operating rooms" where a patient talks to him and reveals that he is an executive like Trager. The patient then starts to shout Trager's name and he finally appears to investigate. Trager kills the patient before going back to the operating room to check on Miles, which reveals that he has escaped his confines, Trager then scours the place to find Miles.
After Miles retrieves the key and uses it to start the manually-operated elevator, Trager breaks into it from the floor below in an attempt to get to Miles, but Miles struggles and pushes him out. Trager's upper torso is still inside the elevator as it begins to move, and he is crushed to death in the process. Miles then escapes through a hatch in the elevator ceiling.
While Waylon passes through the Male Ward, Trager can be seen lying dead on the ground after Murkoff's Tactical Division had pulled out his body from the elevator shaft, who they mistake for one of the asylum's victims after seeing his distorted body.
Trager is a very upbeat and friendly man, always cracking jokes and never losing his composure. However, this masks his true persona: a sadistic murderous psychopath who takes great delight in torturing virtually anyone he comes across. His insane mutterings and notes reveal he is obsessed with making money, believing the only thing that really matters is making profit, and has a demented fascination with biology. He soothes both of these obsessions with his torturous occupation, learning about biology by cutting up his victims and gaining money by selling the severed parts. While he seems to maintain his polite and up-class personality even when torturing Miles, he mentally breaks upon finding out he escapes, screaming profanity filled rants and yelling that he cannot stand "quitters".
Despite only being in his forties, Trager appears as a very withered and boney, very thin elderly man, having only a few strains of grey hair draping from his scalp. All he dons is a blood-stained apron around the front part of his legs, which is just dark green patient sheets. He also has a patient drip wrapped/taped around his left arm and stabbing into his veins, a tattered surgeon mask, and strange steam-punk-esque monocles.
- The last name 'Trager' could be a reference to the Trager approach.
- Richard's email address is email@example.com, as revealed in a document that Miles can acquire.
- It is possible to stop Trager from murdering the Variant by distracting him. If done so, Trager will chase Miles instead of impaling the patient with his shears, however, this will prevent the player from acquiring the "Dr. Rick Trager" note.
- Trager's walking animation is bugged, causing him to move faster than his legs should carry him. This makes him appear to nearly float as he walks throughout the Male Ward.
- There's a bug in which Trager will not appear to see Miles if the player activates a checkpoint, and returns to where Trager is.
- In the game's configuration and on the soundtrack, Richard is dubbed as "Surgeon".
- It's implied that after mutilating his fingers, Trager would have gone for Miles' genitals and then his tongue, had he not escaped.