VI: Pathologic II

Recommended by: Special Polycule Observer ⍼

(Okay, so technically this entry is a bit loose, because what ⍼ actually said when picking my game was "a Pathologic game" since Pathologic III came out in early January. But I'd rather have played one that it had played already rather than gambling on a newer game, and what little I knew about this told me that it's an enhanced remake of sorts of parts of Pathologic I, so, II it is.)

Pathologic II is a 2019...video game...from Russian studio Ice-Pick Lodge. The previous sentence is intentionally vague: Wikipedia describes it as "a horror-themed role-playing game", which isn't wrong but isn't really right. The publisher's marketing copy uses "open-world survival thriller", the wiki uses "survival role-playing game", it's categorized as an immersive-sim most places.

Past Me described it thus:

Ammy — 2/22/26, 2:40 PM this is like the video game equivalent of a panic attack lmao. I hate this [affectionate]

I will be thinking for a while about why I not only found this compelling enough to finish, but actually really liked it. It is, on its face, almost every mechanic that I dislike in games bundled into one experience, often in extra-cruel forms. There's an always-advancing timer that is quite tight at times, and one of a small handful of things that the game explicitly tutorializes is "the game will never tell you when an event becomes inaccessible to you, figure it out". There's not only weapon durability but most-things durability; your shoes break from walking too much, your surgical tools and lockpicks wear out and need repair or replacing, etc. There is a penalty for death that persists across all saves for that character, and which applies retroactively; reloading if you die is thus still penalized. (The only way out of this mechanic is by accepting a Faustian bargain that locks you out of two endings.) RNG seeds for infections and deaths are calculated at time of save file generation, so if someone is destined to roll a metaphorical 1 if the game ever needs to check if they die, they will always roll that 1. There are no autosaves, and maybe eight or ten places in the entire world map that you can save. Every named character can die.

Pathologic II is one of those games that operates at such a consistently high level of friction that it could not exist at all but for its creators' specific vision. I was entirely unsurprised to know that not only does the developer's website contain a self-described "manifesto", but also that its second paragraph begins The deep game possesses the ability to bring out of the gamer what Aristotle called catharsis, which is the purification of emotion through the evocation of pity and fear. This phenomenon is characterized by a powerfully emotional explosion and a psychological shock, caused by the experience of new truths and touching upon hidden aspects of reality. Its result, a person’s moral regeneration. Neither passion nor any narcotic high can be compared to that feeling.. I believe that "the cruelty is the point" is an overused phrase, but it does absolutely apply here.

I wrote a bit about this phenomenon before in my writeups on Platine Dispositif C87 STG and Settlemoon, but it is somewhat unmooring playing a game in which the mechanics feel inaccessible at every level. For example, Pathologic II has seven specific NPCs that you're told very early are important, and their status is off in their own section of the menu under the heading "The List". One of the members of The List died on day four of twelve for me, simply because I hadn't figured out how making even a single dose of the actual cure for Sand Pest (the in-universe plague) worked, and despite vaccinating him, he lost his "doesn't die" roll. Well, fine, I am trying to play this as blind as possible and, as I would learn later, I couldn't save-scum him into surviving if I wanted to. (The in-game tooltip after you've vaccinated someone is "you've done everything you can", which is a lot more evocative when you realize that it's very literally true.) A couple of days later, one of the others died without even displaying a roll. Just straight "character portrait, they're dead now", and then a couple of days after that, the same happened to a third. I misinterpreted the choice being offered to me and a plot-critical NPC died instantly as a result, no checks, nothing.

In all of these cases, I was left with the same thought: at what point had I crossed that particular character's Rubicon? Take that last character mentioned. I was offered the choice of being infected or letting her die, and misunderstood, so she died. But: if I'd gotten infected, would she have died anyway? Was this a LISA-esque pair of choices that were terrible for different reasons, or was it "bad choice and worse choice" situation? Was she dead the second that I triggered that sidequest? Should I have done something different three days ago to avoid having been put in that situation, or resolved it differently, or, or... Multiply this across the entire game. What could I have done, when could I have done it, what would it have changed?

When I said above that playing Pathologic II is like playing a panic attack, this is what I mean. Everything is at maximum tension at all times: the entire game must be played while sitting under a tree with a dozen shoes tied to every branch, with every branch straining to avoid dropping those dozen shoes on you at once. Did someone infected walk up behind you and touch you for too long while you were looting a random cabinet? Get fucked. Did you forget that an NPC told you yesterday that she wanted to see you every day going forward? Did the person who sells you guns get assigned atrocious RNG at the moment you started your save file? Did you forget to stock up on food before the game hands you "oops you can't buy food for money anymore lol~~". Get baited into a troll quest chain that exists intentionally to waste your time? Walk into a building where you're told "she's upstairs" and look up and notice that the building you're in is eight stories and that you have no fucking clue where this plot-critical NPC is? Too bad. Tick tock, tick tock, make different choices next time. At one point an NPC walked up to me, stabbed me in the arm, and immediately despawned. This was obviously a bug, but it felt extremely on-brand in a way that still amuses me.

I guess another way to put this is that Pathologic II exists for me in the same creative space as The Substance or I Saw The TV Glow, in that I absolutely loved it, I will be thinking about what it taught me for a while, and I will never come close to recommending that anyone I care about play this, because it's a goddamn nightmare of a game that I would need to dislike someone to earnestly suggest. (Not that this is what you did to me, ⍼; I know we're chill :3) It is a very strange Doll Scale 4/5, losing out only on "would recommend to someone", and that is in part why it has the rest of the points.

So, yeah. Pathologic II. I hated this. [extremely affectionate]