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  • Writer's pictureJon Richter

Pathologic 2: The First Truly Literary Video Game?

Anyone who reads my blog regularly will know about my lifelong quest to achieve recognition for video games as a ‘legitimate’ art form, deserving of analysis and respect equivalent to literature and cinema. Sometimes this seems not just like a pretentious crusade, but a pointless one; after all, the video game industry is already worth around three times as much as the film industry, and hundreds of millions of gamers around the world already passionately agree with me. But, until there are worthy, late-night TV shows discussing the best new game releases with the same gravity as Mark Kermode affords the latest movies, I will remain frustrated by the lingering perception that video games are primarily made for kids, or at least not for 'grown-ups'.

Lots of them are for kids of course, in the same way there are lots of kids’ movies – but there are also games aimed at adults, with weightier subject matter, higher ambitions and important things to say, and I feel that too many people are missing out on these often incredible interactive narrative experiences.

The video games industry often doesn’t help itself. The vast majority of ostensibly ‘adult’ games seem targeted at teenagers, riddled with guns and gratuitous violence, often cynically designed to milk players for extra money via in-game microtransactions instead of being created for artistic purposes. The concept of gameplay itself is often at odds with the unfolding story of many plot-driven games, meaning that time is spent undertaking frustrating busywork between plot advancements rather than these activities adding to the narrative, actively undermining your immersion. Games heralded as true masterpieces of plotting and character development are few and far between, and technological limitations mean that it’s now harder than ever to revisit these (for example, the only way to experience a bug-free version of the best psychological thriller of all time, Silent Hill 2, is to get your hands on an archaic original PlayStation 2 to play it on).

An obscure Russian video game called Pathologic falls firmly into the latter category. Often hailed as ‘the best game you’ve never played’, Pathologic was released in 2005, and for a decade was available only as a badly-translated and bug-ridden PC game (a remastered version was released in 2015 but is still limited to Windows only). I had heard of this game and its growing cult following, and was fascinated by its description as a role-playing and survival horror game about a town in the grip of a terrible plague, but assumed that as a console gamer I would never get the chance to experience it. Happily, the original developer was able to successfully crowd-fund a remake, and announced that this would be made available on consoles. Pathologic 2 is therefore not a sequel, but an overhauled reimagining of the original, closer to its creators’ vision, and was finally released for PlayStation 4 in early 2020.

It is a surreal and horrifying game, and sitting down to play it during a real-life global pandemic only served to intensify the experience. But, within a couple of hours, I realised that the game is incredible, and is also the best-written, most truly literary game I have ever played. With apologies for the spoilers ahead (I’ve tried to keep them as minor as possible), I want to try to explain what makes it so unmissable.

A mind-blowing opening

The game is set in an unnamed, fictional town situated in a desolate steppe in what might be Russia in the early 1900s. It is connected to the rest of the world by a single train track, and it is via this umbilicus that your character, ‘the Haruspex’ Artemy Burakh, first arrives. You are returning from years spent in ‘the capital’ where you trained as a surgeon, complementing your knowledge of the traditional herbal remedies and medicines you learned from your father, the town’s beloved and longstanding chief doctor (or ‘menkhu’ in the local parlance, a fictional language that permeates the game and is one of many devices used to enhance its sense of authenticity and otherworldliness). Your father, Isidor, has summoned you to return to your hometown via a mysterious letter that alludes to a great challenge which you may be able to help him overcome.

But I’m already jumping the gun. This backstory is delivered only after the game’s baffling initial sequence, where you materialise on a stage in front of an empty theatre. Here, an enigmatic director berates you for your dreadful performance in one of the lead roles of a play, and informs you your acting services are no longer required. The lights then fade, and when they rise again the auditorium’s vacant seats have been replaced by a theatre of a different sort: the playhouse is now full of hospital beds, each occupied by a staring corpse. The director has vanished, and two other mysterious individuals now loiter amongst the dead: these are the Bachelor and the Changeling, who were actually playable as alternative characters in the original game, and are destined to play a large part in the unfolding drama. The only other observers occupy the theatre’s upper galleries, dressed in terrifying plague masks and dark clothes that make them look more like carrion crows than the orderlies they purport to be.

This theatrical framing device is used throughout the game, and enables the game’s characters to occasionally break the fourth wall to address you, the player, directly. This is utterly unnerving when it happens, and raises a host of questions: your character’s sanity, whether the events of the game can be taken at face value, what point the play’s director (or the developers themselves) are trying to make… the whole experience is founded upon layers of obfuscation that mean you never quite trust what you are presented with.

Suitably perplexed, you leave the theatre, and are confronted by scenes of devastation: a town in its death throes. Night has fallen, and the illumination of the street lamps (that look remarkably like stage spotlights…) is supplemented by bursts of fire from the flamethrowers of the masked soldiers that wander the streets, picking their way amongst stacked corpses and screaming plague victims. People approach you, beseeching, and then die immediately, and amidst this chaos the only hint you are given is that you must proceed to the Cathedral. Inside this forbidding structure you receive further admonition, this time from a military general and an imposing Inquisitor, who dismiss your pleas for more time to work on your panacea; your miracle cure is too late, and the town is destined for bombardment.

At this point, the action freezes, and the play’s director reappears to offer you another chance at your starring role. Accept, and you are finally transported backwards in time by twelve days, to Artemy’s arrival in his stricken hometown.

Confused yet? I’m not surprised (and I haven’t mentioned the part where the person sharing your train carriage clambers out of a coffin to offer you a game of dice during the journey…) – this mystifying introduction serves to completely unsettle and disorient you, making sure you share the protagonist’s feelings of bewilderment as he arrives at a town transformed from the one he once knew. Upon disembarking the train, Artemy finds himself attacked by three men at the train station, who have assumed that any outsider must be guilty of a recently-perpetrated murder.

The victim? His father, Isidor.

You finally begin the game proper as the bell chimes midnight, surrounded by the corpses of your attackers, battered and bleeding and in desperate need of medical attention, heading towards a town that suddenly seems very far from welcoming.

Into the guts of the game (literally)

The game is spread across twelve days, and starts as a murder mystery. The main goal of the first couple of days is simply to survive and clear your name, and to begin the investigation into your father’s murder. The first forty-eight hours also allows you to familiarise yourself with much of the town and its denizens, and the genius of the game begins to reveal itself.

One of many, many mysteries the town presents is in the naming of its districts, which are named after body parts (you’ll visit the Gut, the Marrow, the Spleen and many more). Similarly perplexing are some of the town’s buildings; as well as a town hall, the afore-mentioned theatre and a mysterious and gigantic abattoir where bulls are slaughtered as the town’s sole export, there are impossible structures like spiral stone staircases leading to nowhere, and a bizarre edifice on the town’s western border known as ‘the Polyhedron’, which seems to have been taken over by some of the town’s children.

You are given a map to help you navigate, and are free to go wherever you please, although the narrative will push you in certain directions and towards certain characters; for example, on the first day you must rely on an old childhood friend – now the head of the town’s petty criminal underbelly – to help harbour you while the townsfolk are on their vigilante rampage. This individual, named ‘Bad Grief’, is only one of an enormous cast of incredibly well-fleshed-out characters you will encounter; the town really does feel alive and inhabited, as though you are trapped inside in a particularly bleak soap opera. Bad Grief speaks in riddles, and you realise quickly that almost everyone seems to communicate in these contradictions, half-truths and philosophical musings. The dialogue is absolutely fantastic, the best I have ever seen in a game, and credit must go to not just the developers but to the translators, who have done such a remarkable job with the original Russian.

A 'pain simulator': gameplay mechanics that actually support and enhance the story

As you explore, you will also rapidly learn that you must manage a dizzying number of statistics simply to survive. Unlike most video games, Pathologic 2 is not an empowerment fantasy – it’s the polar opposite. Multiple additional gauges (some visible, some hidden) supplement your main health bar: let’s start with thirst and hunger. Failure to drink or eat allows these meters to fill up horrifyingly quickly, which in turn causes your health to rapidly deteriorate, resulting in your death. Food can be obtained by bartering with the local townsfolk or spending money with shopkeepers, but in the early stages of the game the populace are convinced that Artemy is a patricidal monster, and refuse to trade with you. This leaves you no choice but to scavenge in bins, rely on handouts or even burgle houses just to feed yourself.

A hidden meter that charts your reputation in each of the town’s districts is the key to unlocking the ability to buy items, but given that it starts at rock bottom this is easier said than done. As the days progress, certain acts and behaviours can boost your standing in the community, but it only takes a botched burglary to turn you back into public enemy number one.

Add to this an exhaustion meter that can only be reduced by sleeping – which requires a bed, which requires someone to offer to take in a wanted criminal – and you can already see that keeping Artemy alive, never mind unravelling a whodunit, is a major challenge in itself.

The final measure, ominously visible from the game’s start but only coming into play when you make it to day three, is the immunity meter. Day three is when the ‘sand plague’ first appears in town and reveals itself as the game’s true villain, and all thoughts of apprehending your father’s killer are quickly pushed aside as you struggle to simply not die. From this point, your immunity becomes the most important metric of all; it must be managed with drugs and protective equipment, all of which are scarce and expensive, and you will repeatedly encounter terrible dilemmas as the outbreak worsens. The crisis causes inflation to skyrocket, making money almost worthless, and I remember the crushing moment when I had to sell the pistol I had spent two days saving up to buy just to get my hands on a meagre loaf of bread. In another soul-crushing instance, I had to allow an infected child to die because I couldn't afford to part with the drugs I could have used to treat (but not cure - there is no cure) his condition.

These are not gameplay mechanics for the sake of giving the player something to do, and neither are they mechanics that jar uncomfortably against the story the game is trying to tell. This gameplay - this stressful, exhausting and constant battle to stay alive - IS the story. Or at least it's a major part of it, and a part that simply couldn't be told as effectively through a non-interactive medium.

As the presenter of one of the small number of excellent YouTube analysis videos of Pathologic 2 brilliantly put it, this is not a game. This is a pain simulator.

The sands of time

Did I say immunity was the most important stat? I was wrong. The true yardstick of Pathologic 2, the scarcest resource of all, the meter whose flawless management is the only way to make it through the game’s macabre mincer is, in fact, time. If you waste too much of it running errands for the people you meet, or pursuing wild goose chases in an attempt to solve the riddle of your dad’s death (or even chasing the noble goal of curing the plague) you are likely to find you have neglected Artemy’s wellbeing enough to undermine his survival. Agree to work shifts in the hospital to earn money to subsist, and you’ll find missed side quests and storylines progressing without you, moving on inexorably, regardless of whether you were there to experience them.

Pathologic 2 doesn’t wait for you. Its terrible engine keeps ploughing forwards, regardless of what you do. The game feels gruelling, realistic, a harrowingly accurate depiction of an exhausted doctor battling fatigue as he tries desperately to save lives.

Even death is not an escape

As you may have gathered, Pathologic 2 is hard, and you will die. A lot. Yet even your demise is not dealt with in the same way as in other games. Instead of presenting you with a ‘game over’ screen and insisting you try again, death transports you back to the theatre, back to the stage of the inscrutable director’s ill-fated production. Here he explains the punishment that will be inflicted upon you, piling hardship upon hardship as he cranks up the suffering for each new iteration of Artemy Burakh in his evolving masterwork. On one occasion, you find the director absent, replaced by the mysterious man from the train carriage, who has arrived to make you an offer you can’t refuse… (my advice: REFUSE IT!)

The point here is that the narrative does not simply end when you fail, with the game telling you you’ve played it wrong and should try again. Instead, the developers expect you to die, many many times, and have incorporated this inevitable outcome into their cryptic and ingenious storytelling. The brilliance of this cannot be overstated; games normally bounce between two frustrating poles, either made so easy that you almost never fail and soon find any tension dissipated, or made so difficult that the narrative experience and pacing is ruined by repeatedly having to try again, try again, try again.

In Pathologic 2, all of the elements of this game - even your failure - are masterfully woven into the experience.

You can’t save everyone

I won’t spoil the myriad twists and turns that Artemy’s story takes as the game progresses, except to say that there are some remarkable developments before the curtain closes on this catastrophic performance. The sand plague is truly a formidable adversary, and the callousness with which it dispatches beloved characters resonates even more horribly given our present real-life pandemic. Even if you discover the panacea, you will find yourself unable to administer it to all of your friends in time, and you must endure their slow decline into infection and death while you scurry around a disintegrating town overrun by desperate plague victims, trigger-happy soldiers, and opportunistic looters.

For those who manage to survive to the twelfth day, there is no guarantee of a satisfying resolution. On my first playthrough I managed to not only fail to stop the plague, but also completely botched the investigation of my father’s murder, leaving his killer’s identity still in doubt. The game does reward multiple attempts with more information and different endings, but you may be too emotionally drained after your first ordeal to want to revisit it, although some of the deeply-buried secrets are definitely worth the effort.

Realising the vision

I have focused in this article on the game’s setting, characters and story, because it is these that elevate it to unprecedented heights. From a more technical perspective, the game does have some flaws; although its graphics are bleakly beautiful, the console version is plagued (forgive the pun) by barely-tolerable loading delays and frequent frame rate drops, although the PC version apparently performs much better.

The voice acting is of a good standard, although I’m not a fan of the strange decision to have the characters utter random lines out loud at the same time as different dialogue is presented in text form – I’d have preferred them to either read out all the text, or just dispense with the voice performances altogether (but then, as with many aspects of this game, perhaps confusion was the intention…)

The music and sound effects are fantastic, underscoring the otherworldly feel of the town with a mixture of distorted instruments and haunting chants, and the screams and cries of the dying will make your flesh crawl. The plague theme that plays whenever you enter an infected district will stay with me for the rest of my life – listen here to experience the chilling soundscape for yourself.

Art doesn’t pay

Sadly, Pathologic 2 is not performing well commercially, at least at the time of writing. The developer has stated that their plans to make both the Batchelor and the Changeling characters available as additional quests might need to be shelved, leaving this game as a tantalisingly incomplete masterpiece. The limited budget, resulting in the aforementioned technical problems with the console port, will doubtless only further impact its sales and popularity, with many gamers understandably unwilling to look past technical problems to unearth the gem hidden within.

I would therefore urge anyone who has been intrigued by this post to go out and buy Pathologic 2, to support this fantastic developer and allow them to fulfil their vision. And yet, even if the game remains forever incomplete, it can already hold its disease-ridden head high. Not only is Pathologic 2, even in its half-finished state, already one of the best video games ever made; it is the closest game ever to attaining the status of true art.

Thank you for reading, and I hope you’ve enjoyed this plague-stricken post. If you’re interested in learning more about Pathologic 2, you can visit the official website here, where you can also check out the launch trailer.

I’ll be back soon with something a little lighter (I promise!) – until then, stay safe, and never trust a man who travels in a coffin…


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1 Comment

John Adam
John Adam
Feb 21, 2021

My dissertation tutor - a specialist in Russian music that spends half the year in Moscow - once told me he has a hobby of collecting Russian newspaper stories that report on people getting murdered in bar fights that start over disagreements about Russian philosophy and literature. I think the idea of your average person getting killed in a pub brawl over high brow stuff goes a long way to explaining why these sorts of games exist. One of the top sources to get all the news and updates about this game is which provides fantastic content about this upcoming RPG.

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