Full disclosure: I am acquainted with the localizer of Pathologic 2.
Pathologic 2 reminds me a lot of the time I was lost in Bratislava. Cold, starving, and in desperate need of any beverage besides boat-motel Danube tap water, or a warm bottle of Mirinda, on Christmas Eve. Searching down windy side streets, and across broad courtyards for anything that was open. The scattering of Slovaks out, bundled against the bitter wind, showing little interest in acknowledging me.
It reminds me of taking a short rest to have a cigarette at the feet of a large bronze statue of Hans Christian Andersen with a snail.
Despite the number in the title, Pathologic 2 is not a sequel. Instead it is a reimagining of Russian developer Ice-pick Lodge’s 2005 game that achieved no small level of cult status. Rebuilt fully in Unity with a revitalized script and translation, Pathologic 2 aims to bring the unnerving dread of the original back with a feverish, communicable vengeance—and god does it ever succeed.
Where the original Pathologic 2 combined three different player characters, each following the same story from their own viewpoint, this latest incarnation will be released episodically with one character per episode.
This initial entry focuses on Artemy Burakh. Known also as the Haruspex (a diviner of omens from animal entrails), Artemy is returning to Town-on-Gorkhon at the urgent request of his father after years of being away studying and practicing as a surgeon. Once he arrives… well, it’s easy to understand why he stayed away for so long. Nothing in the world of Pathologic 2 is remotely OK. This is a game that opens with the revelation of your father’s death and an entire town trying to kill you, and it just goes straight to shit from there.
Here’s your job: stay alive for 12 days.
It might sound easy, but this is a game that opens with everyone wanting you dead. Also you need to make sure that Artemy is well-fed, well-rested, and hydrated. It’s tricky but manageable at first, but you’re not in the middle of a plague at the start. That comes later. When you’ll also have to start contending with infection.
Stamina and health are majorly impacted by your ability to take care of yourself. Every action is depletive. Walking wastes time, but sprinting wastes stamina, and both are in short supply. And while you’re conserving your stamina and managing your time, you’ll get into often inexplicable conversations with townsfolk, do quests, barter—while also needing to be a doctor.
When the plague hits, you’ll have to pull up those surgical gloves and dig in. As characters contract illness, you’ll engage in a few medical minigames, from surgery, to diagnosing infection, pain management, and administration of antibiotics. You can fail, you will fail, some will live, some will die. It’s called medical practice after all, right? I suppose you could also just kill people.
For as simple as they are, the doctor modalities are a fun diversion from the gritty pressure of the survival aspects. In my ideal version of the game, their importance would be swapped and developed more fully as the need to eat, drink, and sleep is diminished. I spend most of every day trying to keep myself alive as is, but it’s not often that I get to engage in diagnostic medicine when the world is falling apart.
Survival = meh. Doctoring = fun. Death = well…death is kind of its own amazing thing.
Pathologic 2 isn’t a game that wants you to die. In fact, it explicitly cautions you against dying too much (trust me—don’t listen, the payoff is amazing). But it absolutely is a game that wants to kill you. Thirst, exhaustion, hunger, infection: These will all kill you.
You can also just straight up get killed.
And you will be killed.
All of these things will kill you, at least a couple of times.
Death fractures the reality of the game, leading to some truly marvelous writing and revelations about the nature of the world. Death will happen, yours, and that of townsfolk. Characters will die, major ones, quests will go incomplete, you won’t reach a patient in time (or you’ll botch their treatment). Time will march on, and the game will continue. But, oh, there will be consequences.
It’s this relentless forward momentum that almost makes me ignore and forgive the punishing and tedious survival mechanics.
I love Pathologic 2. But I love it in spite of the majority of its mechanics. I love it because it’s just so damn weird, confident, and taps into literary traditions like Epic Theater transparently and with tremendous bravado. Where the lockpicking minigame and survival mechanics alternate between frustrating and boring, every other aspect of this game is shot through with tension, menace, and wonder.
People look weird. They talk even weirder.
Buildings grow pustules. Everyone is hiding secrets.
There’s a Cow-God who might have created the world. I poured blood on a tree because a tity-out Steppe woman told me to.
There are Tragedians in all black clothes and unnerving white masks.
And a municipal theater director named Mark Immortell. I died once, and he got mad. I died a second time and he told me I’d never be allowed to hug anyone ever again. Don’t worry, it’s all in service of making me a better actor.
Pathologic 2 is a deeply weird game, with a Mayakovskian cast of characters, plopped into an apocalyptic Bertolt Brecht play set deep in the Russian Steppe. And while the actual gameplay maybe disappointing or frustrating to some (it was to me), I can’t help but be compelled by a game so enthusiastically bizarre.
Pathologic 2 was developed by Ice-Pick Lodge and published by tinyBuild. Our review is based on the P version. It is also available for Xbox One and PlayStation 4.
Dia Lacina is a queer indigenous writer, photographer, and founding editor of CapsuleCrit.com, a monthly journal dedicated to microgenre work about games. She tweets too much at @dialacina.