Pathologic 2 is a one-of-a-kind narrative experience set in an atmospheric world, but a few cumbersome quirks and atrocious combat get in its way.
A reimagining of Ice-Pick Lounge's fifteen-year-old game, Pathologic 2 uses the advances of the medium to mark players with an even more unique experience than the original. Whether it's because of persisting limitations or developer intention, this far-removed remake (not to be confused with the actual HD remake of Pathologic) still manages to retain much of the clunkiness and imperfection that stood in the way of the main premise of the original. Staying true to the first game's time-limited, open-world survival focus that blazed trails in 2004, it's ironic that shoddy, unresponsive combat is the mechanic that's aged the worst in the 2019 sequel. However, what Pathologic 2 lacks in polish is made up for in Ice-Pick's raw, twisted creativity, which delivers a level of defamiliarization and genuine mystery that few games have ever achieved through story and setting alone.
Pathologic 2 thrusts players into the role of recently trained surgeon Artemy Burakh, who was born in the Steppes of Pathologic 2's pseudo-Russia and is otherwise known as Haruspex, one of three playable characters from the original game (the other two are being added sometime post-launch). Pulled back into his superstitious hometown of Town-on-Gorkhon after receiving a letter from his father urging his return, Burakh arrives back home just as things are getting their worst and most strange. Immediately attacked by a trio of townsmen and seemingly framed for his father's murder after stepping off of his train, Burakh must scrape by on what shelter, food, and water he can find while trying to juggle the crime that killed his father and a mysterious plague that's ravaging the town.
While the next twenty hours or so in most open-world, narrative-driven games of this style would have players retaking the town and setting everything right through their choices and gameplay, Pathologic 2 would rather teach players the lessons of despair and harsh fatalism. Granted, there are more than enough impactful player choices to be made that alter the course of events and final outcome to put even Obsidian's Fallout: New Vegas to shame, but Pathologic 2's central themes of hopelessness and inevitability ensure that not everyone can be saved and that Burakh's efforts will only further catalyze the town's suffering.
This is done mostly through conversation with the game's vast pool of unique NPCs, which puts players face-t0-face with characters in a stage-like void that brings to life models and animations that are otherwise unimpressive and stiff in the game world. Though far too many NPCs share the same faces and clothing, there is an absolutely ludicrous amount of branching dialogue in Pathologic 2. This coupled with the game's timed event windows, sizable and absurdly dense world, and (sometimes frustratingly) slow movement speed make separate playthroughs play out wildly differently.
The crux of moment-to-moment gameplay is to be found in survival mechanics, tasking players with managing their hunger, thirst, exhaustion, and immunity to the plague. Unforgivably and purposefully difficult, these meters constantly threaten the player with death until they discover a steady supply of resources to help manage them. Though these well-worn hallmarks of the survival genre actively hinder the flow of similar games like We Happy Few, the original Pathologic helped to pioneer them and made the mechanics one of its central gameplay pillars, so they actually fit right into the harsh and unforgiving setting of Pathologic 2. Though they feel tacked on in other titles, the need for life-giving resources serve to keep players moving to new areas and taking actions that they might otherwise avoid.
Saying that a rough-around-the-edges indie like Pathologic 2 nails survival gameplay already feels wrong, so it's all the more ironic that the game's most glaringly awful feature is the combat. Like almost everything else present in Pathologic 2, combat is present in the game because it was also presnet in Ice-Pick's first attempt. Unlike the unique premise, moody setting, and emergent gameplay, though, the combat hasn't been changed in any meaningful way to make feel better than it did fifteen years ago - in fact, it actually might be worse. Downright unresponsive and half-baked, every fight is frustrating and wholly lacking in any sense of satisfaction or value. Getting spotted by members of a disagreeable faction will immediately wash players over with a sense of dread, and not in the way the developers intended.
Though combat will leave a sour taste in any player's mouth, it thankfully isn't the normal state of things in Pathologic 2. Luckily, it's largely overshadowed by the game's stellar setting and atmosphere, which are all-at-once familiar and yet wholly unlike anything players have experienced before. A non-stop fever dream that feels ripped from the mind of David Lynch, deranged killers in masks haunt the nighttime streets, the toxic blooms of a staple crop drive the locals mad annually, and a theater opens every night to recap another chapter of Artemy's life. Beyond the fascinating weirdness, a deep lore, vocabulary, and interconnectivity are shared between Artemy, other characters, and the town to make the twisted location feel real and lived-in.
Like an experimental art house film re-shot to more fully realize its original creative vision using modern technology and techniques, Pathologic 2 brings the tense, enigmatic streets of Town-on-Gorkhon to life like the original never quite could. It iterates and adds on top of what once was to great effect in nearly all but one particularly baffling area, and any gamer with a penchant for single-player games with a strong narrative focus should play through Pathologic 2 at least once for the one-of-a-kind experience that only it provides.
Pathologic 2 is currently available on PC, and it will release on Xbox One at a later date. Screen Rant was provided with a PC code for review.