Second Opinion Spotlight: You Should Play “Pathologic”

“Doctor” I Coleman prescribes his audience two tablets of deadly Sand Plague

Second Opinion is not a show about games you haven’t heard of. Except when it is. These are the games whose first opinion declared them “Dead on Arrival.” These are the games in need of a Second Opinion Spotlight.

Hey, everybody! Second Opinion Shorts is called Second Opinion Spotlights now. Make sense? Good, because I’m going to be running these for a couple (meaning literally two) weeks while I deal with some non-HPP work and make some improvements to the flagship show. That’s right, folks – that ancient Windows Movie Maker intro is finally gonna get its much-needed overhaul.)

But! With that out of the way, let’s get on to the meat of this episode. Second Opinion Spotlights is a show where we shed a…well, a spotlight on a good game that most of our readers have probably never heard of. And to be quite frank, it’s pretty impressive that this series-within-a-series has been going on this long without mentioning one of my favorite games of all time, Pathologic. While the game was an award-winning success in Ice Pick Studios’ Mother Russia, it’s almost completely unheard of here in the West, thanks in large part to a garbage translation that did everything it could to destroy the subtle nuance of a game that’s all about storytelling. The fact that the North American port had more bugs than a hornet’s nest certainly didn’t help, either.

But now that we have a remastered version of the original game in the form of Pathologic Classic HD and a new game coming out this year that’s…also titled Pathologic (god dammit, games industry), there’s never been a better time to revisit this forgotten classic. And you should, because if you have any interest at all in the idea of interactive storytelling, you owe it to yourself to play this game.

It’s difficult to describe Pathologic – another factor that certainly led to its dying in obscurity. The game takes place over twelve days in an unnamed Eastern European town during an unclear time period somewhere around the first few decades of the 20th century. You play as one of three characters, all of whom are healers of a sort, and all of whom arrive (coincidentally?) on the same day that the town is overtaken by a nightmarish disease. The Plague – or Sand Plague, or Filth, or any of a half-dozen other names given to the disorder – is no ordinary illness. It’s incurable, it takes hundreds of lives every day, and it seems to be specifically targeting anyone who would help you try to fight it. Worse, it doesn’t just make the townsfolk sick – it takes away their humanity. The workers in the Termitary have turned to eating their dead, while the children of the town seal themselves off and form a Lord of the Flies­-esque civilization of their own, attempting to cure the disease with deadly “Shmowders” made of rat poison, wine, and any other materials they happen to find. So no, I wouldn’t exactly describe Pathologic as a “laugh-a-minute” romp.

The game is usually described as an RPG, but that feels a little disingenuous. There are quests, sure, and sidequests, but very rarely do they have any sort of “solution.” You might spend a whole day looking for a plague carrier only to find that no such person exists. Or you might choose to report an innocent girl, which will make you look better than coming up empty-handed but which makes you no better than the butchers outside. Also: you might go whole days without even finding a quest, or pursue what you don’t realize is a sidequest only to learn that it has no bearing on the story.

Your only real mission – the only thing you have to do to make sure the game progresses – is to survive. But even that will prove a challenge – if you ever play the game, I highly recommend you save at the start of each day, because you will get the game into an unwinnable state on your first few runs. Time ticks down far faster than you feel like it should, and the supplies you desperately need will become more and more rare as the game progresses. Even if you get into a groove and feel like you’re doing well, you might find that the money you collected to buy food tomorrow is worthless, because all the stores have tripled their prices, and that the only way to eat today is going to be to barter with the local children. And the only thing they’ll trade for are the shiny baubles you probably threw away because inventory space is limited and those items seemed useless.

I know that doesn’t sound like very much fun. And the truth is, it isn’t. It’s not supposed to be fun. This is Russian literature in the classic style, where hopelessness isn’t just an emotion, it’s a way of life. Last week we talked about how Dark Souls presents a hopeless world on the brink of extinction, but that it’s hard to feel that hopelessness when the actual gameplay’s about killing giant monsters with a bigass sword. And this is a problem with most quote-unquote “hopeless” games – The Last Of Us still had Naughty Dog’s signature action setpieces, and even Telltale’s The Walking Dead couldn’t totally let the player act unguided and had to throw up that stupid “CHARACTER X WILL REMEMBER THAT” pop-up every time you had an over-telegraphed Big Decision Moment.

But Pathologic truly couldn’t give a shit about whether you live or die. You are not the hero of this story – depending on your actions, you may not even be the main character. That’s why the game continues even if you fail to cure the disease, or mess up the quests with horrific consequences. If you’re to be a hero, your heroism must be earned. If you want to survive, you have to work at it. This is one of the few games where NPCs will lie to you – and I don’t mean some kind of story betrayal like the worst scene in Dishonored. They will straight-up give you quests that will hurt you, or give you false information that only furthers their own goals, or otherwise work against you. And it’s not like it’s only certain “bad” characters that do this – characters whose help you must rely on to complete the game will give you half-truths and riddles. It feels weird to say this about a game where two of the three playable characters are basically witches, but in terms of how you interact with the world and the people in it, Pathologic might be one of the most realistic games ever made.

Much of the game’s philosophy is best expressed through one of its most iconic elements – the Masks (pictured above.) The thing in the bird mask is an Executor (I mean, it’s gotta be a mask, right? Surely…), while his white-faced friend here is one of the Tragedians. In a game centered around Threes (three protagonists, three ruling families, three major areas of town), they are the only Two. I know this because they told me so, and while the Executors very rarely tell me anything I want to hear, I’ve never known them to lie.

You see, Pathologic isn’t a game. It’s a play. It opens with the three heroes standing on a stage and melodramatically explaining their motivations and personalities through soliloquy. And every night, you can go to the theater to watch the Masks act out the events of the day before, customized to the decisions you chose to make. The Executors represent the tragedies you’ve failed to prevent, while the Tragedians – described as faceless “placemarker heros” represent you and your utter uselessness. Watching them unflinchingly act out the events of the play you wrote is something of an indescribable feeling.

But the Executors aren’t actors, not really. Outside of those performances, they act more as the game’s tech crew. You never see them moving, but they appear when you need them most – usually, as the first sign of a named NPC’s impending demise. These named NPCs are always among your closest allies. “These people must die because of you,” the Executor preventing your entry into their house explains, “because these are the only people who would die for you.”

And they’re not speaking to the Changeling, the Bachelor, or the Haruspex – the three playable characters who seem to have no idea what in the world these bird-men are talking about. In their own words, they’re speaking to the actor who’s playing these characters. The person who’s pretending to be a hero. You. Yes, you. You right now, reading this article. How dare you. Every day you while away your sad little life playing games that let you feel like you’re a good person, but when was the last time you actually did anything for anyone else, huh? The most important experiences of your life were the ones you had sitting on a couch, holding your thumb to the analogue stick. And now you need me to tell you how you should feel about a game you’ve never even played. Are you the best humanity has to offer? You sicken me, you really do.

Sorry about that. But while it’s one thing to talk about what Pathologic is, in terms of its core mechanics, the hard part is trying to get across how exactly the game makes you feel. “Deep” is a word that’s lost all meaning in modern criticism, but there really is no better way to describe the game. Pathologic is deep in the same way the sea is: you can drown in it. Something about the way you spend the whole game walking through the same town, talking to the same people – despite the dated graphics, Pathologic’s environment still feels more like a real place than a million brightly-polished “open worlds.”

But it’s also deep in the sense that this is a game that has layers on layers. Most of the time, you’re only seeing the surface of the town’s problems – an unrelenting nightmare plague would be enough of a story on its own, but then you encounter the Masks. And then there’s the Odongh, the not-quite-human worms who are used as slave labor but seem like they’re working for something other than their masters. And what about the two huge and mysterious buildings on either end of town – the physics-defying Polyhedron and the enormous, blood-soaked Termitary that produces most of the town’s meat? What’s their role in this? And how does the town get so much meat, anyway? And would you believe that these questions, too, are surface-level queries introduced in the first hours of the game?

Furthermore, the way I’ve just described it sounds like Pathologic is throwing blood at the wall and seeing what sticks. Far from it. Disease, cannibalism, murder – these are only the symptoms of something much more horrible, much more all-encompassing. On day 8, you see the town for what it really is, a twist so perfectly executed and deeply chilling that I could write a whole second feature just on that singular moment of gameplay. For now, you’ll just have to play the game and experience it for yourself, and believe me when I say this: you will never see it coming.

Honestly, Pathologic is one of those pieces of art that feels like it couldn’t have been made by an actual human being. The attention to even the smallest of details is so astounding that I almost just want to sit here and list some of the more awesome mechanics. Oh, wait. What’s that? It’s my show and I can totally just do that? Well, okay.

The exhaustion and hunger meters use a color palette that gets friendlier as you get closer to death, in contrast to how these things usually go, which is in line with the Executors’ repeated insistence that you should just give up and succumb to death. The design of the map is used brilliantly – like on the first day of the Bachelor’s playthrough, where after finally finishing the long walk to your mentor’s house you turn the corner and immediately see that something has gone horribly wrong. Oh, and the other protagonists actually show up no matter what story you’re playing – the other characters aren’t anything so crass as different classes, they’re three sides of the same story, and the way those stories are woven together is masterfully done. Like how in the Bachelor’s run, the Haruspex seems like an idiotic, primitive killer, while in the latter’s run the Bachelor comes across as a selfish stuffed shirt, even as he makes the same decisions that made perfect moral sense back when you were the one making them. I love the way that the only reliable way to get Bandages – the game’s only useful healing item – is to collect empty bottles from trash cans, fill them with water, and trade them to drunks, which gives even your very survival a healthy mix of random chance and skill-based exploration.

I could go on for days, but we’re starting to run short on time. I’m not sure I’ve done the game justice, but at the same time, I’m not sure you can. Games like Undertale and the aforementioned Telltale products have been rightly praised for offering a wealth of player choice, but it’s a shame that almost no one knows that they already lost the fight back in 2006. Even Undertale had good endings and bad ones, challenges that you had to overcome – it was, at its core, still a game. Pathologic offers no such comforts, and perhaps the most impressive thing about the choices it offers is that they’re all system-driven. There’s almost no scripted events, only scripted changes to the system like the aforementioned price tripling. How the player solves those problems is up to them. How they accomplish their goals – and indeed, what their goals even are – is up to them. This game takes everything you loved about those experiences, expands on them, and stretches them out into a 70-hour RPG. It’s a game that has to be seen to be believed – except that after you see it, you still won’t believe it.

Sure, it will never be a game for everyone. It’s a horror game where the horror is your own mortality and the futility of everything you’ve ever done or will ever do – that’s a hard sell even when you leave out the gameplay’s utterly unforgiving difficulty cliff. But if you’ve the stomach for it, I think you’ll find it’s one of the most horrifying, engaging, and emotionally affecting experiences you’ve ever had with any piece of art. And if nothing else, it’s a game we need to be talking about. This is the second article I’ve written about Pathologic and both times it felt like I spent more time selling the game than analyzing it, mainly because people have to actually play it before we can give it the deep-dive criticism it so richly deserves.

But – ah, I see my time is up. The children are at play. The actors are all in position, the Executors are waiting in the wings. Let the curtain rise.

Because after twelve days, everything ends.

I. Coleman
I Coleman believes that videogames are the most important, most fascinating, and most potentially world-changing entertainment medium today. When not saying dorky, embarrassing crap like that, I is a game designer, science fiction author, and former reviews editor for the now-defunct with years of experience writing for and about games.

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