Pathologic is a genre-breaking game created by Russian developers Ice-Pick Lodge. Released in 2005, the game received quite a substantial amount of praise and acclaim in Russia but only managed a small cult following outside of its home country. The studio has stated in the past that their efforts began as an “attempt at a cultural experiment” and it really shows in Pathologic. To put it simply, there is nothing else quite like it.
The setting for this game is a remote and isolated town in the Russian Steppes where a mysterious plague is taking the lives of the residents. The town itself is extremely bleak and dreary, with a colour palette consisting largely of browns and greys. It is not a criticism, however as it contributes very heavily to the atmosphere the game seems to have been going for. The surreal and intriguing design of the town along with the interesting people inhabiting it prevents the game from being ‘boring’ to look at. You play as one of the three characters; the Bachelor, the Haruspex, and the Changeling. Each of them has the same goal of ridding the town of the plague but their storyline goes into different directions as a result of the differing methods, priorities, and reputation of the characters.
As it turns out, curing a plague is not an easy task. The act of surviving in the town itself is a struggle and is inevitably going to turn a lot of the people off the game. You will have to juggle between dealing with your health, immunity, hunger, exhaustion, and infection. Items required for basic survival are hard to come by and only become rarer and more expensive as the plague spreads. On top of that, trying to improve one of your needs can hurt another need. Taking painkillers to improve your health will increase your exhaustion. Go to sleep to reduce your exhaustion and it will worsen your hunger and infection. There is no item to magically heal you of everything so you are going to have to struggle to survive. On top of it all, you will also have to continue taking part in quests in order to find a cure for the plague or all your efforts will be in vain. It is an immensely frustrating experience on the whole and just not fun to play. It is not trying to be either, nor does a game absolutely need to be.
One of the most noticeable thing that sets the characters of Pathologic apart from ones in other games is the way they lie to you, avoid your questions, make mistakes, and even treat you very differently depending on the character you’re playing as. Everyone has an agenda and the player is going to inevitably find themselves cajoled into various schemes. There are a lot of twists and turns in the story by the end and it will lead you to different endings achieved through different ways to tackle the plague. The plague itself is not just a nebulous threat to push the player forward but is tied impressively into the themes, narrative, and mechanics of the game. Certain reveals towards the end of the game even recontextualises the way you look at the town presented in the game. It would be spoiling the game to go into details about the narrative of the game but rest assured it is quite a ride.
The world and characters in the game are also dynamic and change noticeably as the days pass and the plague worsens. Characters die, alliances shift, betrayals occur, new characters appear, and the economy of the place changes. It provides the town with a sense of authenticity that is hard to come by, in spite of how surreal and otherworldly it can be.
As interesting as the game is, Pathologic is a flawed experience. The character models often repeat, and the animation is janky. The combat is underwhelming to say the least and the slow movement speed will undoubtedly contribute to the already present frustrations. The voice acting as well as the translation leaves much to be desired as well. You are also likely to encounter glitches and crashes at unfortunate times. Even for the year it was released, these flaws were still noticeable. However, what it lacks in mechanical polish, it more than makes up for in its thematic and narrative depth.
The developers behind Pathologic attempted to make a game about disease and they succeeded. It is a fascinating look at the effects of a plague in way that is simply not possible in any other medium aside from video games. The experience of playing Pathologic is confusing, frustrating, bleak and exhausting but also rewarding enough in its depth and uniqueness that I heartily recommend it. The sheer amount of creativity that was put into the game is well worth sitting through the faults.