Pathologic is a weird and miserable Russian game from 2005 about getting the plague and dying. It’s slow, and frustrating, and off-putting. The English voice acting is awkward at best, even in the re-cast Classic HD version. The town and all its houses look awful, everything is grey and brown, it takes you an hour to cross the street and you halfway starve in that time, the combat sucks, your hits inexplicably fail to register half the time, and you hear terrible crying children sounds whenever you commit crimes. I like it a lot.
Alternatively: It is a first-person CRPG with a day-night cycle and three playable characters, which tasks you with surviving 12 days in a small, remote town (set maybe in the early 1900s, but with a lot of backward local superstition) while managing health, hunger, exhaustion, and your keeping your immune system strong, none of which is trivial to a new player.
To get some potential misconceptions out of the way, let’s start with what it’s not (besides “not fun”). It’s not a hugely fulfilling challenge to overcome, as it’s frankly more tedious than hard, especially when you lean into the incentives to save-scum any time you actually catch the plague, or to reroll bad loot from a corpse. It’s not one of those meticulously-interconnected reactivity-heavy RPGs where everyone remembers what you did to them the last time you met (like Alpha Protocol). If you don’t finish a quest, it’s assumed someone else did it in your absence; if you refuse to help someone dump a body, the body is gone the next day anyway, and the person you asked doesn’t seem to care that you never helped. You can’t kill named characters or do whatever you want, and you’re occasionally railroaded into doing something stupid. You won’t find robust systems for emergent gameplay. Crimes lower your “reputation” meter regardless of the presence of witnesses, and good deeds — like ruthless vigilantism — cancel out bad deeds — like knockout-gaming some innocent lady on the street. In other words, it’s got the kind of crude one-axis system of moral judgment we all got tired of and begged The Witcher to save us from in the years since.
But in absence of these grand and ambitious designs few can deliver upon, Pathologic takes a seat at the table on the strength of its writing and meta-intent, or whatever you want to call it. That’s not to call it a small and simple game. In fact it’s so complicated that it’s difficult to pick an angle to approach discussion from.
On its most immediately apparent layer, it’s a game that often subverts expectations and doesn’t hold the player’s hand. Characters who are at cross purposes with the player will give you pointless quests which don’t pay off just to waste your time, or they may ask for your charity and simply have nothing of comparable value to give you in return. It’s quite clever with little details, like the skyrocketing of food prices during a pandemic, encouraging the player to profiteer in a time of need. There are endless mysteries and layers of lies and character motives, many of which never get explained from one playable character’s perspective, or perhaps at all. Even by the end of my first playthrough I didn’t know what if anything was supernatural in origin and what could be explained away rationally, if certain characters really could commune with the dead or prognosticate, if monsters from local folklore really existed. Even in the case of a totally bizarre work of architecture which defies gravity and warps space, one rationalist in town still dares to suggest that it’s all just smoke and mirrors, suggesting that what you see with your own eyes may not necessarily be true.
There’s widespread consensus that the Bachelor is the ideal protagonist for the first playthrough. As a visiting doctor from the capital, he’s the best player surrogate, as he’s as uninitiated in local customs as you are, and can ask all those questions. When people say insane and cryptic nonsense, the Bachelor is the one most likely to have a “What the fuck are you talking about?” dialogue option, and when people claim they can see the future, he can openly doubt them. His questlines also clearly got the most development time, and make the most robust use of characters and locations.
The three protagonists aren’t taking on the same jobs. When you’re playing as the Haruspex or the Changeling, the Bachelor is still there, doing the quests you already did when you were playing as him. (Well, sort of. You don’t actually see him shuffling around town cramming meat in his mouth, but he’ll often have dialogue about his own tasks.) Sometimes their quests intersect, and on Day 1 as the Changeling, you might approach a sidequest you remember from Day 1 as the Bachelor, only from another angle. One might provide aid to an NPC injured by another. And they don’t always do what you remember them doing when the roles were reversed.
The further you go past that first playthrough as the Bachelor, the more off-the-rails things get. The ambiguity of the supernatural becomes overt. The other protagonists are progressively stranger themselves, more initiated in the customs of this weird place, more exposed to its secrets, and less rooted in the objective facts of the civilized world. Soon, you’re the one saying insane shit that doesn’t make sense. The story becomes less concerned with what’s literally going on. By the time you’re on the third protagonist’s route, you’re more of a symbol than you are a human being, and the fourth wall is constantly broken. All the while you come to a better understanding of what the Bachelor’s route was really supposed to be analogous to, what its themes were. Well, maybe.
It also starts to feel a lot rushed and sloppier, with fewer interesting sidequests or characters involved in each day’s events, and the devs readily admit to being pretty rushed in the back half. It was already a pretty jank game in the best of times.
Pathologic is dense with thematic experiments and open questions about the nature and utility of games, which surprisingly feel more fresh and funny than trite in their execution, even after over a decade of continued academic pontificating on this subject. It’s not just about choice and agency, but, as one NPC describes it, “constructing a sarcophagus for a miracle”… trying to seize something that was meant to be fleeting, overcoming “inevitability”. This could mean overcoming death but also the permanence of dreams, or capturing a moment in time, and probably explicitly the presence of the player in the game itself, until one has exhausted it of all possible options and moved on. In a more abstruse and philosophical way, I think it touches upon some of the same ideas Undertale had. I don’t dare to say I have a perfect deconstruction of all of it in my mind, but despite all its riddling and refusals to speak plainly, I think the game ultimately wants to be understood. In a sort of epilogue to an absolute victory condition, the creators explain many of their intentions to the player outright.
I did sometimes find myself not sold on these intentions. The three protagonists are not empty vessels for the player, but each have their own agendas, whether you are currently inhabiting them or not. But I couldn’t shake my bias that if a game intends for something to be convincing to its protagonist, it should convince the person controlling them. Although the game is very frank about the limits of your control in this medium, I don’t wish to give it undue credit, and I think I should be on the same page with my character, for the purposes of, well, basic storytelling things like empathy and engagement. The game runs the risk of biting off too much allegory at the cost of these things, affecting my interpretations of the endings in literal terms and generally muddling things up for me.
It seems somewhat ironic to me that the Bachelor’s “Utopian” ending only took on some value for me with later, less literal interpretations of events, while it seemed to appeal to the character himself immediately. There’s a lot of subjectivity in these hang-ups of mine, of course — whether the ideas that are less than entirely grounded in what is actually happening were rolled out at the right pace, whether some symbolism should have been traded for frank answers — but these are the sorts of rabbit holes you’re likely to go down in discussing Pathologic. I’ll admit that any of these offer a richer discussion than whether it’s still any fun to climb a building in Assassin’s Creed games, and also that I’m less qualified to have them. I’m trying for brevity here anyway — if I start talking about humanism or Leibnizian optimism or whatever, I’ve failed — but you can easily waste four hours watching video essays about the game on Youtube if you want.
It dissolves into chaos. Unspoken agreement between game and player is broken. NPCs who represent the game’s creators mock you for being unable to say things other than your proscribed dialogue options, or because you’re not allowed to go back to an earlier part of their dialogue tree and ask a different question instead of the one you asked. In turn, you might antagonize those NPCs for not really being the creators, but echoes, a series of programmed responses left behind by some writer who “left this place a long time ago”, while you as the player have the gift of being the only real person present. It’s all very silly but occasionally some character would realize something they weren’t supposed to, or would be frightened out of their wits by you spoiling the nature of the game a little, and I couldn’t help but bark out a laugh in these moments.
So I’m fond of this game, even the inaccessibility of it, given all the insanity. But, good god, one can’t review this game and brush aside just how agonizing it is just spending whole days slowly walking around the map, getting obstructed by fences you can’t climb over. So many quests are simply about delivering messages to people who live on opposite sides of town — “these people need to get a fucking phone” quests, as I like to think of them. I almost gave up on Pathologic a few days in. At many times I wanted to skip the tedium and use console commands to jump straight to my objectives, but fought off this urge for my Bachelor run, feeling that the game would only become more boring if I no longer had to be calculating. I think I was right not to, to fully commit to what the game was asking of me at least once. Properly learning the ins and outs of the mechanics, discovering things that weren’t even written in tip guides I read online, when and how to sleep, finding the arbitrage in trades with NPCs, ultimately allowing myself to get infected and managing it with drugs instead of save-scumming every time I ran into a plague cloud, embracing misery — these were things I found most rewarding, outside of the story and writing.
But for the record, I cheated constantly in my second and third playthroughs. I was already many dozens of hours deep on a game with awful gameplay, and felt removing all of the fucking walking was the only way I could bring myself to uncover the rest of the story. I’m happy I did, because it would have been a shame to quit there. Do what you gotta do, I guess.
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