I have a confession to make: I haven’t played the first Pathologic. Actually, I have another confession: I have played it, but gave up after a few hours at most; and since this was about a decade ago, I can barely recall any of it, so I don't feel it counts. To play and quit on a game somehow feels worse than not having played it at all, especially when the game in question is a beloved cult classic.
I feel I should come clean with my lack of experience of the original, given the fervor with which its fans cling onto it. They have the smug air of those who've experienced an esoteric masterpiece only the gaming literati know about. I wish I had the fortitude to stick with it; judging by everything I’ve read and seen of Pathologic, I reckon I'd have that same air if I did.
Thankfully, as I understand it, Pathologic 3 is a quasi-remake of the original, and I have played that. It’s an experience quite unlike anything else, to invoke a platitude wheeled out by the evangelists. More importantly, though, it’s a decidedly messy, human-made affair that could be exactly the kind of game the industry needs right now, given the specter of AI slop looms large on the horizon.
First steppes
You play as Doctor Daniil Dankovsky, mainly known as Bachelor throughout, on the hunt for a supposedly immortal man in an eastern steppe town, in the hopes of learning his secret. But before he gets a chance to meet him, a plague breaks out, and Bachelor is trapped in a lockdown. The only way out is to find a cure and save the town — all within 12 days.
But our hero is seemingly thwarted at every turn from the very beginning, with his vital medical equipment stolen as soon as he arrives. Things only get worse from here, as the situation escalates quickly and he’s met with cryptic answers at best and hostile reactions at worst from the townsfolk he questions.
The outright mechanics of the game are nothing spectacular: you’ll trudge along in first-person, talk to non-player characters (NPCs), and fight monsters and deadly miasmas with a prototype weapon and some matches to light warding bonfires. So far, so AI-replicable. But beneath the surface, there’s so much more to Pathologic 3.
Back to the future… and back again
For one thing, there’s the apathy/mania bar to contend with. This acts as a kind of survival mechanic, requiring you to balance these dangerous mental states to stay sane and alive. However, striking the perfect balance between the two isn’t always desirable, given that mania can increase movement speed considerably; always useful to avoid threads, but at the cost of depleting health.
The time-jumping narrative of Pathologic 3 is perhaps the starkest illustration of its craft, though. You start out lost in the chaos, unable to understand much of anything, and there’s seemingly very little you can affect. This is when my Bachelor felt his most apathetic — a truly frustrating state to be in, given how much it slows you down.
Inevitably, you fail, but then you’re given a chance to relive previous days to fix your mistakes, with new insights gleaned from your past exploits. Suddenly, the pace of the narrative ramps up. You no longer wander the town in utter bafflement with no real leads to follow. With this reinvigoration comes shifts in gameplay, and you find yourself playing a melange of genres.
One moment, you're a full-on medical detective, examining bodies and making formal diagnoses; the next, you’re in a management sim, as you work to tight schedules and issue various decrees to combat the pandemic. How the game swings masterfully between these modes is a real feat.
You get a better handle on the situation, even as the town is overcome with panic and rioting, as you race to contain the outbreak. However, at the back of your mind you know things could easily spiral out of control at any moment. With the town’s capricious nature and the unexpected time-jumps, Pathologic 3 constantly keeps you on your toes, and there’s no way to predict what might happen next.
Real and unreal
Then there’s the writing of Pathologic 3. In a story that deals with the heavyweight aspects of the human condition, it’s no surprise that character dialogue can easily spill over from the profound to the pretentious. But the great thing is that when it does, there’s nearly always a chance for Bachelor to burst the bubble. I particularly enjoyed Bachelor labeling a point in his internal mindmap (which acts as the game’s progress tracker) as a ‘bunch of nonsense’, in reference to a particularly esoteric and unhelpful interlocutor.
For the most part, though, the writing helps to paint a convincing portrait of a town that isn’t governed by the same logic and conventions we're used to. It's understanding of time, death, and the nature of reality is fundamentally different. As a man of science, most of Bachelor's dialogue options express frustration at the less-than-concrete answers to his questions. But as he begins to realize this approach fails to elicit helpful information from many characters, they become more tolerant and accepting of otherworldly possibilities.
Simultaneously, the writing in Pathologic 3 also helps to make the town's plight believable. It does a tremendous job depicting the full spectrum of human behavior in the face of a deadly outbreak, from cowering in fear to foolhardy acts and outbursts of violence. I’m sure we all recognize these reactions from a recent pandemic of our own.
Conversations also reveal the complex inter-family dynamics and politics at the heart this society. Various power struggles are at play, with competing philosophies and pseudo-religious beliefs coming head-to-head, as the elite attempt to control town's fate. Naturally, as you’re caught in the middle of such feuds, the game gives you some degree of freedom in dealing with them, letting you play the diplomat or pour fuel on the fire.
The art direction of Pathologic 3 is also a marvel. Like the best horror games, Pathologic 3 produces plenty of stark images and moments that’ll live long in the memory, from the moving to the absurd: masked theatrical performers hugging clocks, women in pagan garb dancing around cows, a stage appearing out of nowhere depicting an apparent flashback in real time, a cathedral housing a giant clock with raindrops cascading through the middle.
The AI antidote?
For all its greatness, though, Pathologic 3 isn’t perfect. As much as I admire its willful obscurity for the most part, I’d prefer some clarity in certain areas. For instance, there’s no option to revisit tutorial hints, so if you haven’t taken in some key information about the game’s mechanics, you’re on your own. Time-jumping isn’t sufficiently explained, either.
It’s also punishing at times. The mania/apathy meter can oscillate wildly and catch you off-guard, and having to deal with its extreme ends without restorative items — which are few and far between — almost made me walk away for good... again. I have enough trouble maintaining this balance in real life, let alone virtually.
But at its heart, Pathologic 3 is a singular experience that simply couldn’t have been made by a developer other than Ice-Pick Lodge, let alone a non-human entity. I struggle to imagine any AI model, regardless of the size of its data set or generative capabilities, being able to conjure up anything other than a diluted backwash of a game like this.
With companies such as Level-5, Remedy, and Take-Two Interactive open to using Generative AI to develop their games, Pathologic 3 reminds us that only a bunch of humans with their creativity dialed up to 11 can make a truly unique and unforgettable gem that'll stay with players long after they’ve finished it.
Pathologic 3 is an antidote to the plague of AI slop that might soon hit the games industry. Playing it makes you feel like the real-world Bachelor: fighting the good fight to stop the spread of some infectious disease. If we get more games like this, perhaps we can stop the contagion in its tracks. Until then, I’ll just have to keep an eye on my mood swings.
➡️ Read our full guide to the best horror games
1. Best overall:
Alien: Isolation
2. Great for multiplayer:
Dead By Daylight
3. Best remake:
Dead Space
4. Best story:
Alan Wake 2
5. Best Resident Evil:
Resident Evil 7: Biohazard
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