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‘Pathologic 2’ – Playing through a pandemic

By Sean Cabot


When a player begins “Pathologic 2,” their character has killed three men in self-defense after being wrongfully accused of his father’s murder.


From then on they will likely spend the following in-game days scrounging for food and money, trying to avoid the law, and desperately running across town to complete quests – some of which are better left undone.


This is before the third day brings a plague to the town.


Ice Pick Lodge’s “Pathologic 2” will no doubt elicit many questions from even astute players. However, it raises one horrifying question in particular that hangs over the entire affair.


What does it mean to “do no harm?”


A partial remake of “Pathologic 1’s” second story, the game follows Artemy Burakh, aka the Haruspex, a destitute surgeon returning to his rural Russian hometown after years of medical school.


He is quickly given two missions.


First – finding a cure for the mysterious “sand plague.”


Second – managing the tensions between the inhabitants and the “Kin,” village natives with bizarre anatomy. But with the Kin being oppressed and forced to live in work camps, things are looking grim.


Did I mention the appearance of a floating polyhedron near the town church?


“Pathologic 2” tries as hard as it can to make the player feel as if they are trapped in a small, surreal, and diseased village.


For better or worse, it succeeds.


Burakh has to eat and drink regularly, and when the plague arrives, prices for food skyrocket. You can rob houses or mug villagers to survive, but robbery requires fragile and rare lockpicks, while fighting is clumsy and unreliable.


Not to mention the hit you’ll take to your reputation for either – and the need for sleep.


Thankfully, the game gives you unorthodox options to get by. Burakh can dissect corpses for organs to sell and experiment with or barter seemingly worthless items with villagers for valuable resources.


But in addition to surviving, you also have to make sure your friends in the town stay healthy.


Burakh must acquire or produce medicine to diagnose and treat the plague and keep the town alive. Trading for the elusive cure, known as the “Shmowder,” should be a significant focus in the early days.


Planning out your routes to make the most of your limited time is mandatory.


It is incredibly easy to mess up and die, and while that might tempt the player to reload a save, that isn’t always an option. Dying will give you permanent handicaps unless you begin a new game entirely, even if you reload saves prior to your death.


You will have a chance to stop this after a few deaths, but it will prevent you from seeing the true ending. And with how unexpected death can be, the message is clear – plan your moves carefully.


All of this is tied together by a biting wit in dialogue – Burakh’s interactions with the pompous Bachelor and the miracle-working Changeling being a particular highlight. Although the writing is obtuse and theatrical, it is strangely understandable and engaging.


And with so many questionably moral options to get by, the player is in turn asked to grapple about how much harm they are doing in their quest to heal the town.


Are you a good doctor if your path to a cure is littered with corpses?


“Pathologic 2” is a hard sell – with so many amazing nuances that cannot be easily described. But its intense difficulty and unwieldiness make it hard to recommend casually.


To those looking for an artistic triumph, however, look no further.


Grade: B, It hurts too good

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