Uncertainty Is the Normal State in Pathologic 2

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.