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I…I don’t know where to start this review. Pathologic 2 is baffling as a game, a piece of art and just as a product. This game made my dreams go weird, and that’s not a “lol haha” joke to keep you reading, it truthfully, hand-on-the-bible made me dream some really, really weird stuff. Which I think just goes to show how strong, how impactful this game can be. Sitting down and playing Pathologic 2 will have an effect on you. This isn’t a game made for mass consumption, it’s not something that can be idly played while watching a movie in the background. It slams its fist on the table and demands your attention…and then punishes you for giving it the time of day.


Which I realise doesn’t necessarily sound like a good thing, and for many people, it won’t be. The first Pathologic game garnered a cult following for its bizarre, surreal and punishing content and fans of that original title will no doubt be drawn to the sequel. Except, it’s not really a sequel. Pathologic 2 is a reimagining of the first game with more context, gameplay features and changes made to the original’s inarguably shaky base. A first-person survival experience which tasks the player with surviving in a twisted town filled with strange mannequins and bird-people and, most horrifically, a deadly plague that is consuming the townsfolk. You’re a doctor, so you can help treat the plague. Or not.


See, Pathologic 2 doesn’t give a shit about you. The game takes place over 12 in-game days with one day clocking in at around 3 hours on our human real-world clocks. What you do in that given time is up to. Want to sleep it all away? Go for it. Rather track down your father’s killer? Yeah, pursue that narrative thread. Maybe you’d rather just spend your time preying on the sick and harvesting organs with a rusty scalpel to pawn off on less than moral tradesmen. The world of Pathologic doesn’t exist around you; you exist within it. The town will change, events will occur without you even knowing about them. The game world is totally separate from the player, existing in a realm all of its own. And it’s a grim, depressing space.


Everything feels just so slightly off, like you’re looking in a mirror but your reflection is split second slower than you. You recognise that it’s strange, but there’s a quality to the sensation that you just can’t describe. You have to survive in this town, monitoring your hunger, thirst, exhaustion and immunity from the plague that is growing more and more prevalent by the day. This is what I mean about the game not caring about you. Did you miss that event over the sinister Abattoir because you were scrounging for supplies in dustbins to make use of the game’s in-depth trading system? Too bad, that event’s done. All the characters have other things they’re attending to now, maybe you can find out what you need from them later. Hopefully.


The survival mechanics are incredibly punishing in Pathologic 2. Sprinting makes exhaustion expand faster and raises your thirst. Eating a dry meal makes you thirsty. Sleeping improves your exhaustion level but increases your hunger. There’re always consequences to your actions, and this affects the characters around you as well. People don’t like it when you do less than desirable things. The more hated you are, the less people will trade with you. There’s a lot of dialogue in this game, the vast majority unvoiced. Yet the texts it gives you are really beautifully written, with many similarities to themes seen in the works of many great Russian novelists like Tolstoy and Dostoyevsky. All the characters are bleak and hopeless, crippled by the acceptance of the end looming ever closer. Just like you, the game doesn’t care about them. Everyone is dispensable in Pathologic 2. It makes for a really inventive, creative experience. Yet, while I’ve been waxing lyrical about this game for so long now, I should problem mention some issues I have with it.


Despite the excessive freedom the game affords you, you’re never really able to explore it. The limitations placed on you by just trying to survive in the world means you’re always missing out on something. I get it, that’s the point of the game. Many people will no doubt enjoy that level of realism; as I said before, the world won’t pause so you can grab some shut-eye. But I found it frustrating having this incredibly interesting world all around me and being unable to explore it to the extent I’d like because I was trying to find a loaf of stale bread.

The combat is also less than polished with some strange hitboxes and really janky animations for attacking. While combat will become far more unavoidable later on in the game, I tended to avoid it as much as possible, especially when I was up against more than one opponent at a time. I was far more content to scrape by and explore the intricate narrative threads weaved by the game which for the most part are incredibly in-depth and engaging.


Pathologic 2 isn’t meant to be enjoyed. In fact, the developers have outright stated that their intention was to prove that games can be more than just fun. Pathologic succeeds on that front; every design decision was made to almost convince you to stop playing. When you die, you get an unavoidable stat penalty for the rest of the game. Characters sometimes talk nonsense and make understanding what’s going on nearly impossible. The town is designed in such a way that it’s daunting and time-consuming to traverse, the environments dull and lifeless to mimic the desperate state of the townspeople.

A difficulty setting is being added to the game which I am pleased about as it makes it far more accessible to many people that otherwise never have been able to understand what the experience is all about. As a game, Pathologic 2 is a solidly okay, challenging survival game but as an experiment to break the mould and challenge what video games can be it succeeds tenfold. Pathologic 2 is not enjoyable. To be honest with you, I don’t think I’ll ever play it again.

But I’m so, so glad I played it.

Last Updated: May 30, 2019

Pathologic 2
Pathologic 2 is a punishing, twisted game that is burdened by some intentionally poor mechanics that, while interesting to analyse, detract from the game itself
Pathologic 2 was reviewed on PC


  1. Admiral Chief

    May 30, 2019 at 15:47

    I get it. Some games are once-offs but leave a lasting impression. (Here’s looking at you Valiant Hearts, not to mention THAT scene in Spec-Ops)


    • Gr8_Balls_o_Fire

      May 30, 2019 at 16:15

      The one where you have to kill innocent people?


      • Admiral Chief

        May 31, 2019 at 09:02

        The WP scene


        • Gr8_Balls_o_Fire

          May 31, 2019 at 10:20

          I never played it, only read about it lol


          • Admiral Chief

            May 31, 2019 at 10:41

            Yeah dude, just, whoa

          • Gr8_Balls_o_Fire

            May 31, 2019 at 11:10

            Really wanted to play it but the PS3 broke and then got a PS4, so sad, missed out some good games

  2. null.wrom

    May 30, 2019 at 18:41

    Worth mentioning that two more story paths will be released later, effectively tripling the game’s longevity. Same twelve days, different characters, different story beats.

    And yeah, the difficulty slider is a nice concession from the devs, but if you’re doing things that would make you lose sleep just to survive another day, or even hour, then you’re already playing it right.


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