Choices abound in Baldur's Gate 3, making up a significant portion of what makes your character special to you as you play through the game. From how you interact with the characters and environment around you to how you complete a certain puzzle, your choices will matter in how your story unfolds. And these choices come early in the game to get you in the right headspace.
The first choice you will have to make in the game takes place just minutes from starting your adventure, as you wake up on a Mindflayer ship and try to find a way off of it before it crashes. The Intellect Devourer is stuck inside the skull of a deceased person and is asking for your help in getting out. This situation does not take long to unfold, but it does a good job of setting up just how you will be making plenty of choices throughout your time in the game. And don't worry: this brain is just the first of many weird things you will talk to in the game.
Updated by Shane Black on August 13, 2023: This article was updated to make it easier to navigate and provide links to more resources.
The Brain Choice
When you interact with the brain you will learn that it needs your help to get out of the skull that it is currently stuck in. After going through a few dialogue options with the Brain, then you will be given the choices of how to proceed with the situation.
Investigate the Brain
Your first choice will be to investigate the Brain and see what exactly it is that you are working with here. Doing so will lead to a new option which is to use your Medicine stat to remove the brain from the skull.
If your level is high enough to remove the brain with Medicine, the Brain will begin referring to itself as Us and will become a temporary ally for you throughout the rest of this tutorial section. Unfortunately, once you leave the Mindflayer ship and this area, Us will leave your side and at the time of writing, will not return.
Remove The Brain With Strength Or Dexterity
Right away, you can skip the Investigation option and go straight to using your Strength or Dexterity stat to remove the brain. Doing so will bring about the same outcome as using Medicine where Us will become your companion for a brief time in the tutorial section of the game. There isn't much of a difference besides which stats you use to remove them from the skull.
Destroy The Brain
But if you want nothing to do with this talking brain, you can choose to destroy it instead. This gruesome option is pretty straightforward as your character will reach in and squeeze the brain until it's dead. That's all that happens and there isn't really any effect that comes as a consequence for this action. You just don't have to worry about helping put a talking brain into the world.
Mutilate The Brain
So, after you have removed the brain from the skull (if that is what you have chosen to do), then there will be one more option that you can do which is to mutilate the brain to make it less dangerous. This requires a Dexterity check of at least 15. Should you fail, however, Us will attack you in anger and initiate combat, which leads you to killing them.
If you go this route, the fight is not that difficult, given how early on in the game it is. You simply have to attack it once or twice and the brain will go down without any issue. It would be pretty wild for Larian Studios to hit you with a complicated fight right off the bat.
Successfully mutilating the brain, though, doesn't show much of an advantageous outcome, at least at the time of writing. So do what you will with this, and maybe just choose to keep Us as they are to enjoy their company while you can.