We are fortunate enough to live in a society that hasn’t had to endure the heavy toll our ancestors did in terms of diseases. We have yet to experience something so catastrophic it cripples society in a way that we have to scavenge for food and supplies just to make it through the day to day life. If you’ve wanted to know what this is like, Pathologic 2 offers a unique take on the subject matter, placing you in the shoes of a plague doctor in one of the strangest games I’ve ever played.

The game is essentially a reboot of the original Pathologic, which if you’re like me and are naïve to it, it’s a plague doctor sim that wasn’t particularly well-received but generated a cult following. The narrative begins with you on a train en route to your home town after years away to visit your father at his request. It’s not a pleasant homecoming, as he’s murdered hours before your arrival and you are the primary suspect; unlike you, your father was a hero to the town and needless to say, the townsfolk are not happy about his unexpected demise. From here, you’re given 12 days to solve the mystery of your dead patriarch and save as many of the townspeople as possible. The story is very open-ended and weaves through smaller stories that you can investigate in any order you choose, but you are being timed (with no visible clock) so you’re forced to pick and choose what tasks you dive into and as the loading screens constantly remind you – you can’t save everyone.

The bleak atmosphere that constantly degrades as the days pass immediately grabbed me and pulled me into the world in a way few games do. The low, haunting music and dreary backdrops made the town feel real thanks to being filled to the brim with a varied cast of NPC characters, some human and normal looking, others donning strange costumes and masks, and alien-looking beings that look like they would be more at home in a Star Wars venture who are ready and willing to trade or converse with you. How you interact with them is up to you – simply ignore them until you need something, have unsettling conversations that feel like you’re exchanging random lines from different pieces of Gothic literature that don’t match up, or even go as far as punching them in the face. The mild horror tones left me feeling confused and uneasy throughout my time with the game, almost like piecing together bits and pieces of a blackout after a night of heavy drinking; never knowing exactly what was going on, but wanting to dive deeper into the mystery nonetheless.

With the recent update for the Xbox version, the game offers up three difficulty settings which will give you entirely different ways of playing. There’s a story mode, essentially removing almost all of the survival aspects (which is the bulk of gameplay outside of the story), a dumbed-down middle of the road option, and then the original, which is what this review is based on. Knowing full well that I hate most survival games, I should’ve probably opted for one of the less taxing options, but I wanted to get the full experience, and it’s a harrowing one.

The token hunger and exhaustion meters are in place, with the addition of an infection gauge that forces you to seek out food, medicine, and shelter. I found myself running out of time thanks to the need to almost constantly be foraging for supplies to either use or trade with other characters to proceed or face certain death. The game pulls no punches in making it obvious that you and most of the people in the town are not going to see next month due to the unbelievable rates these meters fall, because little known fact, you’re actually playing as Dwayne “The Rock” Johnson and need to eat 15 times a day to survive. The one thing this succeeds in is putting a real need on taking care of yourself over the other people since you’re the doctor and there is one of you and plenty of them to try and save, which is a task in itself since many of them will kick the bucket right before you manage to bring them whatever they need to survive.

Outside of the survival systems, the gameplay is limited to looting, talking, fighting off hostile townsfolk, and the occasional mini-game that allows you to perform surgery on the sick, more often than not simply requiring you to figure out what medicine they need for whatever is ailing them. None of these are standout experiences, as they are either humdrum affairs or kind of broken, specifically the combat and surgery mini games. Combat plays out like any first-person adventure game, but the sluggish controls result in you getting your ass handed to you anytime you’re not at full health or engaging with more than one adversary. This would be forgivable if it was the single technical issue with the game since combat is such a small part, but it’s not the biggest issue or the most impacting.

Throughout my time spent I noticed the highly detailed visuals would be plagued with clipping, missing or delayed textures, a horrid frame rate that spits and stutters anytime more than a few characters are on-screen, and various bugs that you’d expect from the likes of a Bethesda game. These broke the immersion for me from time to time and only added to the frustration I experienced due to the never-ending stream of loading screens which often come with no warning and are quite jarring. And let’s not forget to mention the longer than average wait times despite entering a small linear area.

Pathologic 2 is a hard game to recommend and an even harder one to get out of your head. It will leave a lasting impression on you if you let it, but it clearly won’t be for everyone. I am glad I played it, and enjoyed the mystery and atmosphere, but I can’t say the gameplay is solid enough to make me want to push forward past my failures to see the true ending, at least on the suggested difficulty setting. If you are a fan of horror, survival games, or have the Xbox Game Pass, this is a game you should at least check out to see what the hype is about, but keep your expectations in check.

5 out of 10

Pros

• Extremely Atmospheric
• Haunting Music
• Interesting Cast of NPCs
• Multiple Difficulty Options
• Vast Number of Narrative Threads

Cons

• Buggy As Hell
• Terrible Combat
• Punishing Survival Mechanics

Pathologic 2 was developed by Ice-Pick Lodge and published by tinyBuild. It is available on PC and X1. The X1 copy of the game used for review was provided to us. If you’d like to see more of Pathologic 2, check out the official site.

 

Here at GBG we use a rating method that you are more than likely familiar with – a scale of 1 to 10. For clarification, we intend on using the entire scale: 1-4 is something you should probably avoid paying for; 5-7 is something that is worth playing, but probably not at full price; 8-10 is a great title that you can feel confident about buying. If you have any questions or comments about how we rate a game, please let us know.

Check out OpenCritic for a better idea of how our review stacks against others.