PAX West 2017: Pathologic 2 is Genuinely Creepy

A town is being ravaged by plague. The military has come out in force, the towns folk have gone mad and there is only one doctor left in the entire place with the wherewithal to handle it. Unfortunately, the deck is stacked against him. The people are either crazy, in pain, violent, or any mixture of the three. As the doctor, it is up to the player to try to cure the disease, solve the myriad mysteries surrounding it, and just plain not die in the open world survival game Pathologic 2. 

Acting as kind of a sequel/remake of the original, the developers realized that, though the original is a cult hit in Russia, it didn’t quite catch on elsewhere. The original had issues with translation that made it more difficult to play than was necessary, and there are all sorts of technical improvements to be made. With this self reflection in mind, they approached the plague ridden town with fresh eyes, and have worked to create the most dour, disturbing hole on Earth to act as the doctor’s playground. Based on the demo I experienced, the end result is incredibly effective.


Exploring the town, the inflicted, wrapped in bandages, would moan and attempt to get my attention in hopes of receiving attention. Approaching the soldiers would find numerous rifles pointed at my face and even the townsfolk had it out for me. Knowing that I had a penchant for autopsies, they seemed to want to see how I would like be cut open. This is an oppressive place, brought to light with a creepy art style and a sound design that caused me to jump even at the basic click of a rifle. I’m not even sure if the folks who would talk to me were even real, what with their adornment of plague doctor masks and cryptic answers to questions chosen through the dialogue tree. It seems possible that the good doctor is also barely holding the threads of his sanity together, though that could just be me. It was a long PAX, after all. I might have been the one who was losing it.

Exploring the town, it is up to the player to speak to those who would listen, in hopes of finding clues as to what to do next. Finding the deceased would grant an opportunity to perform an autopsy, allowing us to collect organs that could be useful later. I even found some type of key in one, which opened up a whole slew of questions for me as a player. How did that get there? Is he the keymaster? How was he going to use it when he needed it? Using the key, I made my way outside again, and walked smack dab into a airborne cloud of plague. Succumbing quickly, I passed out only to awaken in front of a firing squad, who handled their grisly work in short order. So, you know, don’t go walking into clouds of dark spores in a plague town. This lesson should serve well in life as well as the game.


My time with Pathologic 2 could best be described as one of frightened confusion. I didn’t quite know what I should be doing to best handle the situation, but I knew that I had the tools and abilities to handle the situation that I was thrust into. In that, developer Ice-Pick Lodge has already succeeded before the game is even finished. Most “horror” games tend to get by with jump scares and some creepy design, with only a select few understanding how to create a truly terrifying atmosphere. Pathologic 2 creeped the hell out of me. The world felt like it was pressing on my shoulders as I made my way through the town’s streets with a bag of organs rhythmically plopping at my back. As I am one that watches horror movies out of a sense of pitch black humor, and finds most “horror” games to be boring, the fact that this managed to have an effect on me is saying something. One wouldn’t want to live in the world that the developer is creating, but it’s looking like it’s worth a trip.