STAFF REVIEW of Pathologic 2 (Xbox One)


Wednesday, January 22, 2020.
by Adam Dileva

Pathologic 2 Box art I’ve never really played anything quite like Pathologic 2 before. While I’ve not played the first, the setting and plot of the sequel really intrigued me. When you think of horror games, you usually think of killers, blood and jump scares. Pathologic 2 does the genre quite differently though, as its “horror” is more based on a depressing and dying world around you as a plague sets in, one that you’re not immune from. While the world sucks you into its narrative, it’s very rough around the edges, making it hard to stay immersed in this decaying and desperate world.

You begin as Artemy Burakh, also referred to as Haruspex, a doctor whom has been away from his village for many years to complete his medical training. One day he receives a letter from his father, pleading for him to return home as there’s something he needs to help with urgently. You hitch a ride on a train only to be greeted by another stowaway that emerges from a coffin. This is where the weirdness begins to set in.

You start having visions, but they seem so real; are they actually visions? You are attacked as you exit the train, so in self-defense, you end up murdering the three assailants. You arrive back in your village, only to find out your father has been murdered, but how, by whom and why? There are mime-like creatures, plague doctors and other odd characters you'll meet in this remote rural village. These are only some of the questions you’ll need to solve, but there’s a much bigger threat that’s consuming everything in its path; a plague.


This deadly outbreak starts out as a small nuisance, but now that you’re the only healer in town, people will want your help as well. But no one is immune, including yourself. Is self-preservation more important than saving others? Because this small village is so secluded, food, medicine and even water are resources in high demand, but low in supply.

You’ll need to constantly manage your own thirst, hunger, exhaustion and stamina, but what if a group of kids are starving and ask for help? Do you help them instead of hoarding your supplies for yourself? What if bottling someone’s blood could save others but turn people hostile against you? These are just some of the situations you’ll come across during your unfolding journey full of suffering and death. It quickly becomes apparent that you can’t save everyone, oh, and you only have 12 days to do so.

12 days isn’t a lot of time to save yourself and a town from a deadly plague, so there’s no time to waste. Time is your biggest enemy, as you’ll need to determine what to do with your time, who to help and who to ignore, as you simply won't be able to help and save everyone. While you’re given a map of the town and markers of quests you’re currently on, you’re completely left open to play however you wish. You’ll talk to a number of characters, each with their own personalities and backgrounds.

Some simply want help, whereas others will have their real motives hidden. There are usually numerous dialogue choices for each conversation, of which you can choose however you wish to respond, affecting the outcome of that relationship. It’s not as simple as good versus bad choices though, as there’s going to be a lot of morally gray area, and what you do to help one person may upset others or even hinder yourself.


The hardest aspect for me to become accustomed to in Pathologic 2 was its survival elements. This is where you’ll need to manage your hunger, thirst, exhaustion, stamina and more. This is a small village, so finding resources isn’t as simple as checking every canister and shelf. I personally really dislike games where I need to worry about aspects like this, but in this setting where the world is succumbing to a plague, it’s eerily fitting. Thankfully there are a ton of settings in the options that can be adjusted, like how hungry and thirsty you become, the quickness of exhaustion and much more. At nearly every point when adjusting these values though the game tries to remind you that Pathologic 2 is meant to be challenge and you’re meant to die, so tinkering these parameters changes the intended difficulty, but you’re certainly welcome to do so if you wish.

You might find more than enough food and water during your first day or two, but resources diminish as time passes. What do you do for water when the water supply becomes tainted? If you steal food from someone’s house that was infected, do you risk eating it? Would you trade your only gun and bullets for a simple drink? It’s not too harsh in the beginning, but as days pass and people die, your situation becomes ever more desperate. This is where the ‘horror’ element starts to sink in, as you won’t always know what the best course of action is or should be when you and others start to become fraught.

This is where the high difficulty starts to kick in. 12 days seems like a lot in the beginning, but time becomes much harder to manage as you progress. Certain quests are only available at certain times, or maybe you absolutely have to complete one before another event happens. You’ll never know for certain what’s going to happen beforehand, so every decision you make through dialogue and choices affect other outcomes as well. Some will really enjoy this difficulty and challenge, whereas others will find it hard to even sit through the first day of gameplay.

Sometimes you’ll need to defend yourself, and in the beginning, this is done with your fists. Hand to hand combat is how you’ll experience most combat in Pathologic 2, as you will eventually gain access to a pistol, but bullets are a rare commodity just like food and water. Fighting in Pathologic 2 is, simply put, horrendous, most likely due to playing in first person view. You can punch, charge an attack to break an opponent’s guard and block, but it feels so janky and never rewarding.


Even after a handful of hours, I was still losing fist fights quite often; it simply doesn’t work well, and if you’re fighting off more than one opponent, you’re sure to lose. At one point I was hated so badly in town that everyone basically tried to kill me on sight, though to be fair, that was my fault for harvesting organs from someone I defeated earlier. I knew I was going to lose a fight to four thugs, so I ran away, but they found me and knocked me out. Turns out I respawned right beside where I died and they were still in the area, so they instantly started attacking me again. I was basically in a death loop where they were spawn camping me until I was able to flail about in combat and eventually defeat them between deaths.

If you purchase the bundle with the included DLC or separately, The Marble Nest, this puts you into the shoes of a different doctor also trying to save the town from the deadly plague as well, but in a much more self-contained story that only lasts for a single day. It’s an interesting DLC that shows a different perspective to the overall narrative, adding some more gameplay for those that enjoy the overall narrative.

Most of the audio is quite decent. Some of the soundtrack is perfectly fitting for a plague backdrop and when voiceover is used, the performances are quite decent. The only issue I had was that many one-liners are used, especially when it comes to combat, and I really wish all of the dialogue was voiced, not just a few lines here and there. Graphically, Pathologic 2 does look quite dated, especially when it comes to the combat animations and bland backdrops, but the world is so dark and grim and the character models in conversations quite decent, so it gets a pass at best.

The world and narrative does a great job of immersing you into a bleak and desperate world, only to be constantly taken out by long loading times, pop-in textures and terrible combat. While I wasn’t a fan of the survival elements, those that enjoy their challenging games should thrive with the difficulty. You can’t save everyone, sometimes not even yourself, but Pathologic 2 surely is an experience unlike any other, for better and worse.




Overall: 6.5 / 10
Gameplay: 6.0 / 10
Visuals: 6.5 / 10
Sound: 7.0 / 10

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