Pathologic 2 Review: Survival Horror at Its Most Challenging and Rewarding (PS4)

Pathologic 2 is survival horror at its most challenging and rewarding. A horror game which plagues you both literally and psychologically. It certainly isn’t for everyone but it is a testament to what games can be at their best. Story telling gold. Whilst it isn’t fun, it isn’t meant to be.

Pathologic 2 Review: Survival Horror At Its Most Challenging And Rewarding (PS4)

Perhaps Survival Horror at its most challenging and rewarding, but more importantly at its most immersive and poignant. Surviving the 12 days as a plague ravages a town is a challenge not all will manage, but suffering through offers a horror fiction story unlike any other.  It’s essentially a streamlined remake of the orignal cult classic Pathologic.  If you think Dark Souls was a challenge and are looking for something a bit different, Ice-Pick Lodge‘s Pathologic 2 is for you. And maybe after COVID, you want to try your hand at being a doctor searching for a cure.

Pathologic 2 can be bought for your regional pricing on the PS store, Steam, GOG, and the Microsoft store.

Pathologic 2 - Launch Trailer | OᑌT ᑎOᗯ! 🔥

Story – Trace the Lines

Pathologic 2 is set in an unnamed rural town deep in the Russian steppe, around the time of the Russian Revolution of 1917, but this is not specified. You play as ‘The Haruspex’, a local called Artemy Burakh who left the town to study surgery but returned home after receiving a letter from his father. After being attacked upon arrival, you learn your father has been murdered and you delve into the mystery. The story begins with a strong and mysterious opening, showing you the fate of the town should you fail, with bodies piled in the streets and the military burning buildings and civilians alike. You learn that this is the 12th day and are given the option to return to the beginning to try again by Mark Immortell (Perhaps too on the nose there).

Before long there is a deadly outbreak of a plague (topical I know) that strikes the town and you must now race to find a cure as time ticks away and your surroundings decay and crumble around you. You, as well as Burakh himself must grapple with the science and superstition of the situation, carefully choosing how to spend your time and which story threads to pick up on, and ultimately, who is worth saving. Is this just a deadly disease, or a malevolent entity? Should you help the local kids, old friends or new strange and unexpected allies such as the Bachelor (one of the few other medically trained people in the town). The game is makes even seemingly mundane decisions into difficult choices. There is a whole other level of story telling involved, with the theatre showing plays of the days events and a blend of the real and unreal. But that must be left for you to find out.

Organs can mean medicine or cash if you know where to go

Organs can mean medicine or cash if you know where to go

The game’s story stands apart from most games, with a pervasive sense of dread and hopelessness, masterfully or frustratingly, accentuated by the gameplay. Morality is complicated here, people are untrustworthy and you are not a hero. You are a recently graduated surgeon attempting to stop a plague. You massively out of your depth, and you will feel it.

Gameplay – Embrace the Suck

The gameplay is where this game will lose many would-be players, and honestly you can’t blame them, this is definitely a challenging survival thriller. As the game says when you start, it is meant to be almost unbearable. And oh my, is it. The basic gameplay has you explore the town, talk to people and make tinctures that slow infection while you attempt to find a cure. It is familiar loop with a fascinating writing style that is enigmatic in many ways but keeps you hooked into the dialogue. A menu will contain your thoughts, allowing you to keep track of what you need to do with markers guiding you around the town.

Now, where the suffering really begins is in the survival mechanics. You have 5 meters to manage. Health, Hunger, Immunity/Infection, Thirst (stamina) and Exhaustion. Keeping all of these in check is a daunting task, especially as you have numerous threads to pick up and limited resources, made all the more difficult as prices sky rocket and you deal with the realities of a collapsing society and your own bodily functions. It is a constant risk reward decision making process that keeps you racked with anxiety.

Do you steal from a house risking infection or risk starving? Do you get sleep or go to an encounter? You must even be careful with what you carry as your limited, but expandable, inventory space prevents hoarding everything you need. Even then, resources are scarce and one of the meters will always be very low. You will need to buy, trade and steal to keep yourself alive.

Take in the haunting art throughout the town

Take in the haunting art throughout the town

You will never be comfortable which will turn some people off, but this is the point of the game. The mechanics are key to getting the intended experience. You cannot save everyone. Furthermore, do you consider yourself more valuable than those you steal from? You might not even be able to make a cure, but if you do maybe it was worth it? I can’t answer that for you but the mechanics force these thoughts onto you.

You must also keep an eye on your reputation. Different parts of town will treat you differently. If they like you, then you can barter or trade for items, sometimes even getting gifts. If not shops will not serve you and you may be attacked. You can increase your reputation by helping others or trading away goods for less than they are worth.

Combat is an area that has seen a lot of criticism. It is janky, clumsy and a trial. Fighting one person is a chore, and fighting multiple is a death sentence. You’ll need to be careful at night as you will have a number of times where your heart will be in your throat as a knife wielding mugger chases you through the streets. There are guns but you won’t be swimming in ammo, so pick your encounters carefully. Whilst the combat is a gripe many have with the game, it is again a gameplay aspect which serves a purpose. You are a surgeon in horror fiction, and so you can’t expect to John Wick your way through scenarios.

Don't engage in combat lightly, you aren't John Wick

Don’t engage in combat lightly, you aren’t John Wick

The last aspect to be mentioned is the death mechanic. Death in this game is the best I have seen in a horror game. A major problem horror games have is that dying alleviates the tension. Get killed in Amnesia and you just respawn but now you know what you are running from and where it spawns. This kills the mood. Pathologic 2 finds a solution to this age old problem.

Every time you die you receive a penalty. This could be less health, getting hungrier faster or needing more sleep. It can also be more insidious, for example one prevents you from hugging a loved one, which carries more impact than you expect in a game as oppressive as this. You will do whatever you need to to survive to avoid these penalties and this keeps the tension ramped up with no respite.

Overall the gameplay is masterfully blended into the themes of the story and, whilst more punishing than Dark Souls, serves a narrative purpose. This isn’t so much a game as it is an immersive experience. It is survival horror at its most punishing, soul crushing and rewarding.

Graphics and Audio – Bad views, Beautiful sounds

Graphics are a low point for this game. It is a drab brown setting with repeated buildings and very few character models. It is far from striking visually other than a few buildings and it is a shame, as an ethereal beauty would serve the game well. Whilst you will see a lot of repeated faces there are more intriguing visuals such as the masked and bodysuit wearing Tragedians who aid you in cryptic ways, and the dialogue page which shows the speaker staring, glaring and peering at the player. Overall whilst the visuals do not undermine the game, they could certainly be improved upon. The stylisation does fit the game though and keeps it feeling unique

The soundtrack is another area where the game excels. The beautiful yet haunting music of sympathies and choruses create a unique atmosphere of oppressive and scary music, mixed with vocals that evoke the traditionalist steppe society you are immersed in. At other times you will have the relieving and peaceful sounds of your base. Go listen to the song ‘Darkness’ from the soundtrack to get a taste.

The sound design works well, with the unsettling gurgling of the earth hinting there are harvestable plants near by, and screams echoing through houses giving you shivers if you dared to go inside. However the town is largely silent which, whilst it makes sense for the game, could have been used to better effect to show the town deteriorate

Development – Developing Hell (in the good way)

Released May 23rd 2019 on for Windows and Xbox one and on March 6 2020 for PS4, the game was published by tinyBuild. The game will, if all goes to plan, be a 3 part series, each focusing on the main characters of the original, along with extra content such as ‘The Marble Nest’. With a Kickstarter receiving over $330,000 dollars, Pathologic 2 was funded. However don’t hesitate to support the game and the developers if you wish to see more content from them and a continuation of the series. Ice-Pick Lodge have a reputation for atmospheric, difficult and depressing stories and they certainly hit all those points in Pathologic 2, and I hope we can see more from them.

Pathologic 2 was reviewed on PS4.

Pathologic 2 is one of the worst gaming experiences you can have, but in the good way. You can embrace this unique, crushing, anxiety fueled nightmare and gain a truly remarkable ride from it. It is utterly masochistic but rich with detail, style and thought. You won’t have a good time, but you aren’t meant to. It is the furtherest thing from a power fantasy. Pathologic 2 pushes the boundaries of what video games can be if used as a method of interactive story telling. The visuals are somewhat underwhelming but it’s flaws are part of the point and the journey. It isn’t for everyone, and there’s nothing wrong with avoiding the title if you a looking for a good time.
  • Intriguing story with complex moral problems
  • Great mesh of narrative and gameplay
  • Phenomenal soundtrack
  • Intense challenge
  • Underwhelming visuals for the town
  • Difficultly will turn some away

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