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Pathologic 2 Review

Official Score

Overall - 50%


Pathologic 2 is a game that will appeal to a very particular type of player, and be despised by everyone else. Those on the fence should scope out the game on either YouTube or Twitch to know what you are getting into.

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Pathologic 2 is a remake of the original Pathologic, bringing with it some modern updates. Does it hold up against other games in the same genre, or should it have stayed in the past? Check out our review and find out.

Pathologic 2 Review

Pathologic 2 starts the player at the end of the line. Your hometown has been lost to the Sand Plague, and you can do nothing to prevent it from being bombed by the military. A man appears to tell you that you are already in the second act of this play, and asks if you’d like to try the first scene again. Now that you have seen the end, it is your job to do everything you can do to prevent it. After a very bizarre dream sequence tutorial, you end up in town and find out it has already begun to go to the wolves. You hop off a train, take out some thugs, and the race against time begins.

You play as Artemy Burakh, a surgeon who left his hometown to go to medical school. Your father asks you to return home and help him out, as he is one of the only doctors still in town. Unfortunately, you arrive too late and learn that your father was killed last night. So now you want to find his killer, and you know that a Plague will come. To top it off, you have 12 days to sort this whole mess out. What could go wrong?

Pathologic 2 isn’t really about winning in the modern sense of the word. Rather, it’s more about making tough choices in a game where everything is falling apart around you. As one of the only doctors in the town, you have to try to keep as many people alive as possible. Failing to act on certain quests or events can get people killed, or even infect an entire city block with the Sand Plague. For every victory you achieve by helping out a friend, there are two or three things that are going wrong. There isn’t enough time in the day to help everyone, meaning you have to pick a choose who you aid. There might be a 100% run where you help everyone, but you would need a very detailed guide to pull it off.

Pathologic 2 honest review

On top of all of this, you have to worry about your hunger, fatigue, thirst, and stamina. Survival elements are usually an afterthought in games, but it proves to be front and center here. Your hunger meter drops extremely quickly, and food is not cheap. If you don’t get enough sleep, you start to lose HP. However, if you sleep too long, and you miss out on events. When the Sand Plague finally hits the city, water becomes scarce, so you need to stock up. My daily run would have me complete events for people I liked, scavenge for supplies to either sell or eat, and then get a couple of hours of sleep. Even having a decent routine still has me stretched too thin multiple times.

Here is my biggest issue with the game. The entire first playthrough feels like a tutorial. There are things you cannot know until later in the game that you really want to prepare for. The Sand Plague, for instance, is something you know is going to happen, but have no idea on what day until you get there. If the game was quick, that would be okay. My first run lasted around 19 hours, and I didn’t even make it to the end. You are expected to commit an absurd amount of time to this game to actually win. However, that seems to be the point of the game: not to win, but to make it to the end in one piece.

Another thing is that you are a doctor, and I don’t always feel like I am doing enough doctoring. You can remove organs and blood from dead people, but that will lower your reputation. When the Sand Plague finally hits, the doctoring amps up, and you need to create tunics for resistances and to help cure diseases. Even then, you can only do so much to prevent death. You can do everything right, and the dice can land on six instead of one through five, and you lose someone. I often felt like I was more of an errand boy than a doctor

Pathologic 2 honest game review

Inventory management is another significant factor in this game, since you have a limited amount of space, but everything has a use. Even if you don’t use the marbles yourself, you can barter with someone and trade them for whatever items they have on them. Everyone in town will trade with you as long as your reputation isn’t bad. So on top of survival, events, and looting, you need to worry about trading daily as well. The trouble here is that it doesn’t always fit. As the Sand Plague hits, people are still actively trading away immunity pills for literally peanuts and a button. The prices go up as supplies get more scarce, though, making it at least realistic.

The atmosphere of the game is spot on though, giving you a never-ending barrage of despair with each new day. Fog and rain are common, thugs will try to kill you during the night, the orderlies look like some sort of bird demon, and white-faced mannequins are lurking all around. Even the infected are wrapped up like Lepers and treated like monsters. Hopelessness runs rampant in the city, and there is very little you can do to fix it.

Pathologic 2 is a game that will appeal to a very particular type of player, and be despised by everyone else. Those on the fence should scope out the game on either YouTube or Twitch to know what you are getting into.

This review of Pathologic 2 was done on the PC. A code was provided by the publisher.
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Johnny Hurricane

Johnny Hurricane is the resident hardcore gamer here at Gamers Heroes. You'll usually find him diving deep into the latest releases as he attempts to conquer each and every game that crosses his path. Mostly known for his ability to create detailed and comprehensive guides on even the most complex of game mechanics, you'll sometimes see the odd review and editorial topic but his true abilities lie in competitive gaming. Johnny Hurricane's Gamer Biography
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