As the NPC "guide", Al follows a set path which changes depending upon difficulty, along with the route to the hospital (among other locations). All regular characters can interact with him via-ad libs asking him to slow down or why he's going so fast. Al will not respond and just keep moving. The Green Zombies roaming the area will outright ignore him.
As the Axeman, he seems to be significantly larger than the PC's for some reason (even the playable version of Axeman) - most likely an oversight by the developers. Upon entering the hospital and walking forward from the entrance, Axeman will burst out of a nearby room and charge at the player and their allies with his namesake weapon. The players must either choose to run or fight him. If they choose to fight, Axeman will run away after taking enough damage. Using plenty of firepower is the best way to fight him. However, melee weapons can stunlock him if they're strong enough. Kevin and Alyssa can also stunlock him with repeated potshots. The axe is a decent weapon to use on him once the player obtains it, especially in the hands of Mark Wilkins or Jim Chapman which both benefit from melee weapons. Because of Mark's increased charge time for Big Swing introduced in File #2, he should have enough time to counter Axeman in melee swings before Axeman has the chance to swing first and do a large amount of damage in the process, especially when using the Axe.
On normal and higher, fighting him at close quarters is riskier because he has an instant death attack. He raises his axe with both hands over his head and lets out a cry before bringing it straight down. Any player or AIPC caught in this attack will die. There's enough time to move out of the way since there's a significant wind up however. The player should especially watch out for this attack if Axeman just put them into bleeding status with a previous attack as movement becomes slower. He can use this attack on Easy as well but it will only drop the target to danger status. In addition to using his Axe, he is also capable of doing a kick similar to Kevin. The kick does minimal damage but will usually knock the target back a couple of feet.
As a playable character
Four versions of Al can be unlocked as playable characters, giving him among the highest alternate costume count of any playable NPC character in the game. Interestingly, even Axeman is playable, making it one of the few instances a boss is playable in the main game rather than just a minigame. However, Axeman does not come with his namesake weapon, possibly for balancing reasons.
Al's costumes come in two sets. The first set is unlocked simply by clearing Flashback on any difficulty. It includes Al, which is the outfit he wears at the beginning of the scenario, and Al: C, which is him in his old Hospital director outfit. This set costs 4000pts to purchase. The next set which contains Axeman himself and Al:B, which is a shirtless version of Al, can be unlocked by clearing Flashback on VERY HARD mode. The set costs 8000pts to purchase.