I finally decided to do a fourth Echo Night speedrun attempt. The inspiration came from the fact that I had recently learned that you could speed up the walking and camera movement significantly through the menu screen. I was able to shave 8:02 off this run from the previous which was 1:26:00. I did a whole bunch of subtle optimizations this round to shave off every little second I could. Unfortunately, towards the end, I got a little confused and disoriented and wasted about 11 seconds going down the wrong end of the red hallway. I don't know how much can really be shaved off this time other than those 11 seconds and the time it takes me to get and consume the optional health item in the hospital area. Whatever it is it probably isn't worth another run, but, we'll see.

Side Note: Nevermind the red time losses at the end. I accidentally had the timer set to compare all my times to my Best Segments (some of which were wildly inaccurate) instead of my Previous Run times.