REVIEW: ‘Pathologic 2’ Is The Oddest Game You’ll Play This Year (PS4)

Pathologic 2 is a story-driven, dramatic thriller game developed by Ice-Pick Lodge and published by tinyBuild. If looking at this game has you questioning why you never heard of Pathologic, don’t fear, you’re probably not the only one. Pathologic was a Russian game released in 2005 that was arguably hard to play in part due to its bad translation to English. The developer intended to remake the game, but due to great crowdfunding, Pathologic 2 turned into an entirely new game. So, when giving this game a chance, don’t feel pressured to also play the first game.

In Pathologic 2, the player takes on the guise of Artemy Burakh, a surgeon, at a time when the medical profession is still immature. For the past few years, Artemy has been abroad learning the ways of medicine. However, after receiving a letter from his father asking for Artemy to return to his hometown due to the hard times approaching, Artemy drops everything to return home. But his journey home is a tumultuous one, filled with strange visions and even stranger characters.

To make matters worse, upon arriving home, three of the locals attempt to kill Artemy. Unbelievably, Artemy not only survives the assault but also kills all three men. After the incident, a few orderlies in plague doctor suits inform Artemy that the locals attacked him because they suspect him of killing an important figure in town. Wounded and unwelcome in his hometown, Artemy must figure out what’s going on, where his father is, and prove his innocence to a town that’s going insane.

Although described as a story-driven game, there are plenty of survival mechanics to be dealt with. Bars for hunger, thirst, health, and so on need to be simultaneously managed to survive the demented world of Pathologic 2 for 12 days. The day and night cycles are long and arduous, demanding players to always be aware of time. But don’t fret, there are plenty of wells to drink from to quench your thirst and you can always invade people’s houses and steal scraps of food to sate your hunger. But what’ll really get you are the disease, paranoia, and mob justice that are rampant in the town.

If you are not into stealing, which can change the way people perceive you in-game, the game does have a rather detailed barter economy. Many of the ways you’ll get items to barter are through mistrustful and illegal means. The more you steal, the more hostile the townsfolk get, but you also need to eat. It’s a no-win situation that describes this entire game. Every action or inaction has a consequence, and often, the consequence is not apparent.

As a surgeon, you have a specific set of skills, one that lets you heal people but also butcher them. You can extract organs from corpses but also from some living. Just be careful who you kill. The organs can be sold to garner useful items from shady characters and the blood can be fed to esurient tree roots. Pathologic 2 is a truly macabre game.

To add to the troubles of just trying to stay alive, when you do die, which is honestly an inevitability, the game punishes the player. Every time you die, you’ll be cursed with a permanent ailment, such as a health debuff. All these factors make this game extraordinarily hard. To suffer is to know what it means to live, and this game will make you suffer. Thankfully, the developers are planning to add in a sliding scale for the difficulty settings, allowing for some control on how punishing the game gets.

I was pleasantly surprised to find a decent amount of voice acting in the game. It was not apparent this would be the case from the trailer, but the voice acting is well done and really adds an extra layer of intrigue to the game. On top of this, I did not expect to get dragged into intricate dialogue trees when speaking with people. The game already has a rich, if odd, story, and it only gets more detailed with the more you speak with the townsfolk and apparitions wandering the streets.

The atmosphere is really what drives the thriller aspect of the game. The dark, dingy streets, the uninviting faces of the townsfolk, the apparitions wandering the roads, and the macabre sights you’ll stumble upon all piled on top of the hard decisions you have to make. However, the atmosphere is disturbed by the use of repetitive house interior and exterior models, rigid and similarly repetitive character models, and a first-person combat system that is rather clunky and hard to control. There were also times when I had to wait on unbelievably long loading screens and, even after the loading was done, wait for the textures to load.

Pathologic 2 is odd and very unsettling. Just to make sure you never get a breath of fresh air in a town that’s going insane, the game is extremely punishing, and your 12 days of hell pass by sluggishly. Although the game will be getting a difficulty setting, the adversity of the game was personally enjoyable. The only true downsides were the arguably unusable combat system and repetitive models.

Pathologic 2 is available now on PS4, Xbox One, and PC.