Pathologic 2 Review

PC / Psychological horror adventure

Pathologic 2

Psychological horror adventure with survival elements and character drama

Developed by Ice-Pick Lodge, Published by tinyBuild Games

Available for PC, Macintos, Xbox One, and PlayStation 4 on

The Basics

In Anxiety Simulator, you are Artemy Burakh, a surgeon. Your mission: travel to your hometown, find your father's killer, cure the plague, meet many weirdos, and sell a few organs. In order to survive your 12-day stay-cation, morals must be suppressed as to not interfere with your burgalry and murder of the local populace. The town becomes an increasingly hostile environment as it is overtaken by a pervasive sickness, pushing the limits of your sanity and tolerance for walking long distances and refilling status bars.

While the game is called Pathologic 2, it is less of a sequel than it is a do-over of the original Pathologic from 2004. As such, you will see a lot of design choices from that era mixing with modern sensibilities and conveniences. The game itself occasionally has some fourth-wall breaks or references the first game. While slightly distracting to someone who never played the previous installment, it is consistent with the game's tone and themes.

The Story & Flow

Though originally the story of Pathologic was segmented by three different player characters, Pathologic 2 is setting off with just one, Artemy Burakh the surgeon (also called Haruspex), with additional characters supposedly arriving in the future. The general plot sees Haruspex arriving home and dealing with the death of his father and many other townspeople by a mysterious assailant, as well as a lethal disease spreading through the population. Many different plot threads can be in motion, which the game thankfully handles for you with a web-network of important events and people, whose locations are typically marked on your map. There is a palpable level of tension as you attempt to traverse the town to follow different stories before time runs out or you die from the elements. 

The world is realized and features a lot of depth behind its initially impenetrable surface. While the setting is moderately recognizeable with 1900-era machinery, fashion, and decor, strange humanoid beings live among the normal human populace, and there is a thick sense of spirituality and interconnectedness with the Earth that looks to be the status quo rather than unknown magical forces. Some people are even stranger than the strange creatures, like the semi-nude druidic women running around holding animal skulls. You will experience a lot of discomfort from interacting with the world and its characters.

The vast majority of your time in Pathologic 2 will be spent wandering around, scavenging trash bins and such for money, food, and knick-knacks. Money operates as money usually does, letting you buy things from shops. However, bartering is how most people in the town conduct trade, with every person wanting different items. Some items are only available on certain days at certain times or for a certain period. Your actions also affect your reputation around districts, which causes the hapless peons to stop trading and eventually turn hostile if you've been particularly bad. Most of the time, you will be alerted to whether something will result in negative reputation, though plot events often wildly drive it up and down without warning.

Combat is inevitable, as regular citizens occasionally want to murder you, and aggressive thugs wander the dark streets at night. Weaponry is limited and liable to break quickly, and usually have dual purposes that need to be saved for, like scalpels and lockpicks being necessary for surgery and illegal entry. The act of fighting is very standard, with regular or heavy strikes and a block. As healing materials are difficult to get and resting eats up precious time, any amount of combat can prove to be deadly. 

Graphics & Sound

Characters have quite high levels of fidelity and crispness, which the game loves to show off during dialogue sequences by shoving a face right into the camera with disturbing lighting. There are a large variety of unique models to fill out the population, and a number of incredibly strange non-humans. Other than that, the entirety of the town is defined by drab color palettes and frequently repeated architecture and structures, though more important places definitely have unique designs and assets.

Voices, while limited, have strong direction and mostly match the character they are portraying; a big issue I had was just how quiet they are compared to other sounds. As the environment is quite dystopic, you won't hear much hustle or bustle, so the ambience is made up of atmospheric rumbling and weather sounds. For a game with this much walking, it's a real shame that footstep effects are so limited in variety and play at such low frequency as to make your already slow move speed feel practically lethargic. Music tracks compound the tragic and unsettling tone of the setting, which really sells the nature of the game's reality.



If you want to be thoroughly creeped out and filled with a toxic unease, then try out Pathologic 2! In spite of the certifiably dated feel of its survival mechanics and its slow, unforgiving nature, they serve to immerse the player in the game. I recommend Pathologic 2 to anyone looking for a highly unique experience and whom isn't afraid to be afraid. You really won't find a better way to experience a cultish indie foreign horror game than this.

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