Pathologic 2 review

The grim reaper reigns supreme in the glum streets of Pathologic 2.

Our Verdict

A gruelling mystery game that smothers its big ideas with dour survival mechanics.

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What is it? A survival game set in a grim town beset by a mysterious disease.
Reviewed on Intel Core i5-2500K, 6GB RAM, GeForce GTX 970
Price $35 / £28
Release date Out now
Developer Ice Pick Lodge
Publisher tinybuild
Multiplayer None
Link Official site 

After years away you have returned home to your home village in response to an urgent letter from your father. Three men try to kill you the moment you step off the train. The town instantly knows about this and blames you for some other recent murders. You’re also struggling with visions off crow-like beings, a giant bison, and a wild-haired dandy who seems to be toying with your fate. To top it all off you’re also quickly dying of hunger, thirst, exhaustion, and blood loss. That’s just day one in this strange, gruelling survival game.

Pathologic 2 is “supposed to be almost unbearable” according to devs Ice Pick Lodge, who created the obtuse, near-unplayable original Pathologic and purgatorial horror game, The Void. Pathologic 2 asks challenges you to survive 12 in-game days in a town that’s going completely to shit. Disease, paranoia, mob justice, and paranormal happenings unfold in real time as you plod through brown, foggy districts, invading peoples’ houses for scraps and occasionally meeting important figures—a mob boss, a childhood friend, faction leaders for bands of roaming children. 

It’s a deliberately exhausting experience. An egg is not just an egg in Pathologic, it’s an “empty illusion of possible life”. You need to scoff many empty illusions of possible life to keep your hunger bar from maxing out and eventually killing you. Wells spread through the town help you quench your thirst regularly, but disease and exhaustion are persistent factors you have to manage all the time. The town has a detailed barter economy, and I eventually started to find semi-reliable ways to source food from kid gangs (they love sharp objects so hoard those scissors), but the survival elements have been harshly tuned. You’re going to die, at which point the dandy of fate will curse you permanent ailments like a health or hunger debuff.

The survival systems constantly get in the way of a fascinating mystery game. When you chat to key figures in the town, they drop motes of information that form a growing web in your journal. Empty nodes imply there’s more to explore in a given line of enquiry. It’s a great way to keep track of the abundance of leads you collect from day to day. There are so many threads I wanted to tug at. What happened to my father? What’s inside the floating tower where half the town’s children have gone to live? Who, or what, is locked inside the Abattoir?

It manages to be quite an atmospheric game, even in spite of rigid character models, static faces, sparse and repetitive interiors, and an extremely clumsy first-person combat system. The game is always pushing back against your attempts to explore, but there are delightfully macabre ideas hiding away in corners of the town, like gurgling tree roots that drink blood and give you herbs in return. As a surgeon, you can extract organs from any corpse and then sell them to a particular buyer for food and medicine. These opportunities open up organically during a day/night cycle that also serves as a doomsday clock pushing the town closer to disaster.

It’s a slog, and that’s the point of it. The suffering of your character and the townspeople is reflected in the torment of ever-hungry survival bars that drive you to theft and murder. One character talks about how her client asked her to design the town’s layout to be deliberately confusing and annoying to navigate, in order to stretch people ‘like a spring’ so that in a position of distress they might discover deeper wells of creativity.

The speech has the ring of authorial self-insert, but I haven’t experienced enlightenment yet, only annoyance. Health bar management is a tedious admin task that communicates nothing in the way of true suffering or even discomfort—the dissonant sound design does a much better job of this. Though I admire the way the game keenly rejects the idea that games should always be satisfying fun factories, I don’t see the worth in wrapping a good mystery in layers of irritant. The devs are planning to add difficulty options that should make the game a bit less crushing. Until then put off that spooky train ride home unless you’re sure you’ll enjoy Ice Pick Lodge’s original challenging vision for the game.

The Verdict
Pathologic 2

A gruelling mystery game that smothers its big ideas with dour survival mechanics.

Tom Senior

Part of the UK team, Tom was with PC Gamer at the very beginning of the website's launch—first as a news writer, and then as online editor until his departure in 2020. His specialties are strategy games, action RPGs, hack ‘n slash games, digital card games… basically anything that he can fit on a hard drive. His final boss form is Deckard Cain.