You are in a theatre, looking down from the stalls at three people on stage. These are the three playable characters of Pathologic - the Bachelor, the Haruspex, and the Changeling. Their dialogue is stilted and unnatural as they discuss who among the three of them is best suited to take the helm of this game, each with their own approaches to a problem you have yet to discover. Leaving the theatre, you are taken to a character selection page, where you can play as either the Bachelor or the Haruspex. The Changeling is locked until you have completed the game as either the Bachelor or the Haruspex, and for a first time player, the Bachelor would be the best choice, as his gameplay functions as a tutorial of sorts.
So, you select the Bachelor. Your name is Daniil Dankovsky: a bachelor of medicine and the head of a research lab dedicated to defeating death. This project is not going particularly well. The ‘powers that be’ threaten to halt the research if it doesn’t yield results within the next year. This is what brought Dankovsky to this small town - a man here - Simon Kain - has lived a remarkably long life, and Dankovsky believes he may hold the secret to immortality.
When you (Dankovsky) arrive in the town, you are sent to stay in the house of Eva Yan, a rich young woman with a fear of dirt and disease. She asks you to ‘take care’ of two ‘strange men’ in her back garden. Should you go to her back garden and engage these two men in combat, you are quickly overpowered and the game is over. This introduces the main themes of the entire game - futility and disempowerment.
The fighting mechanics of the game are deliberately terrible. Left-clicking plays a random attack animation, with a random range and random effectiveness. There is no way to position yourself so that all attacks will hit your opponent, and no way to prevent their attacks from hitting you. Right-clicking does pull up a blocking animation, but this does nothing to prevent your health bar going down. It will take hours of practice to learn how to fight effectively; moving forward to hit and walking backwards out of the opponent’s attack range. One-on-one fights are difficult enough, especially without a weapon - this initial two-on-one fight is present to teach you that engaging in combat is useless and will get you killed.
If you survive this fight and sustain a few injuries, good luck healing them. In a typical game, you could eat some food, have a nap, and be greeted by a full health bar in the morning. But not in Pathologic. Should your health drop too low, the only way you can improve it is by buying medicine like meradorm or novacane, which are incredibly expensive and take hours to come into effect. This all goes to show you that death is cheap, and your health is expensive. You are not a fighter, you are a doctor, and you would do well to behave accordingly. Any loot you get from killing these ‘strange men’ is cheap, damaged, and barely worth the health you lost to get them. Fighting these men was a mistake.
So, you restart the game and leave the men to their own devices. You instead depart to speak to the ‘immortal’ Simon Kain in his home. However, upon your arrival you are informed by Simon’s younger brother that he died just before you arrived. So much for immortality, I guess. Simon’s brothers Victor and Georgiy each ask you to investigate Simon’s death, and so you leave to search for clues, going to speak to the town doctor and close friend of Simon’s - Isidor Burakh. Upon reaching his home, you discover that he’s dead too. The townspeople theorise that a killer is on the loose, but it becomes evident that a plague has broken out, has killed both of these men, and is about to kill everyone else too.
This, of course, is the survival aspect of the game. As the Bachelor, your main opponent is the plague, and it is the only thing that threatens your life, provided you don’t attack the townspeople. If you do continue to attack them, your ‘reputation’ bar will quickly diminish. This may not seem like a problem until you enter a shop, and the shopkeeper refuses to serve you. Or maybe until you leave the shop, and random townspeople begin chasing you with weapons, because you've been killing people, and that's definitely not a good way to get people to like you. This all goes to show that even though you technically can do what you want in the game, the consequences are dire, and it's much more advantageous for you to keep your head down and mind your own business.
Now, if you’ve been a good citizen thus far in the game, you won't have experienced too many issues. This remains to be the case until you discover the plague, and it also discovers you. After hearing of the deaths of Simon Kain and Isidor Burakh, you will start to see clouds of ominous grey smoke and skulls floating around the streets. Should you approach these clouds, you will become infected with the plague, and you will die. This isn't immediate, but instead you experience a slow increase in symptoms that affect the gameplay, such as slightly slowed movements, distorted visuals, and NPCs that try to kill you with fire. You can slow the process by taking some medication, but this is expensive, painful, and ultimately does not cure you of the plague. The only way to avoid the plague as the Bachelor is by… avoiding it. Walk away from infected people, walk away from rats, walk away from plague clouds. Thug it out, basically.
Aside from the plague, the main obstacle you must contend against is time. Time in the game does not slow for you, and you must complete your main daily quest within the time allotted, or else a friend of yours will have to do it for you. And they’re not you, so obviously, they get infected. This incapacitates that character for the rest of the game, and you are down one aide in your search for a cure to the plague. Aside from this main quest, the game gives you many other side quests to complete, each with its own location, equipment, and time slot allocated to it. This hammers in an impending sense of dread, as you are constantly being made to check the time, to check your inventory, to check your health, to check your quests, and so on and so forth. It is through this sense of dread that you really begin to notice just how slowly you walk in the game. You might have noticed that in this article, I haven't once mentioned you running in the game. That is because you can't. You can only walk, and hope you get to wherever you need to be on time.
This is one of the most divisive parts of Pathologic. You are not a character in a fun adventure game, you are a real human person, and you will behave like it, walking to complete quests, and walking to buy food. It’s not fun, it’s not interesting, it’s downright boring. This is one of the main reasons people decide to put Pathologic down - it’s so agonisingly slow, with lots of time invested into minimal rewards. The clock is always ticking, you always have somewhere to be, and you are always walking. This induces a level of stress that feels completely disproportionate to what's going on. Even standing still is stressful. You're wasting time.
At this point in Pathologic, you’re either in or you’re out. Some people just cannot tolerate the slow, agonising pace of the gameplay, and others are completely immersed by it. For the latter group, the stress they experience will only grow as the game continues. Time is not the only stressor, but food availability, the trustworthiness of the townspeople, and what might occur the next day.
Speaking of the next day, I haven’t properly touched on it yet. Nearly everything mentioned above is only experienced in day one of gameplay, and it only gets worse from there on out. At this point in the game, you’ve discovered the plague, you’ve met some other characters, and you've got used to the basic game mechanics. So, you go to bed with your hunger bar full, your reputation high, and enough money to last you quite a while, should you need it.
You wake the next morning to discover that prices in the town have skyrocketed, and the money you had yesterday is now barely enough to buy one measly egg. It seems that word has spread about the plague, and people are beginning to stockpile food and medicine. Your best bet right now is to find the head of the town, and try to convince him to do something, anything, about the plague.
However, when you meet with the head of the town - Alexander Saburov - he is unwilling to exercise his power, due to conflicts between him and the other rulers of the town. Therefore, you must spend the majority of the day collecting evidence to prove that the plague is a serious problem, and you must lay it out in plain English (or Russian, I suppose), in order for all the town leaders to agree to take action. While doing this, you encounter a friend of yours - Andrey Stamatin. You both agree that you both ought to get out of the town quickly. Once you convince Andrey’s brother Peter that the plague is a serious issue, you all agree to meet at the train station and escape the town once you've helped Saburov get the power he needs to start taking control of the situation.
So, 10pm rolls around and you head to the station to meet the Stamatin brothers. However, when you arrive you are greeted by armed guards who tell you that the town is on lockdown, and no one is allowed to leave. This is one of the rules Saburov put into place. By completing your quest for the day and collecting the evidence needed to give Saburov his power, you locked yourself into this town, and you cannot escape. If you attempt to argue with the guards, they all attack you, and if you fight back then you lose reputation, since they're all just doing their job, and you’re the one trying to escape the quarantined town. You dug your own grave today, and the game is forcing you down by the shoulders to make you lie in it.
This all comes together to teach you one of the most important facts of gameplay: the game is not here to help you. It will not bend to your will, it will not give you tips and tricks, and there are no second chances. Enemies don't drop food, they drop their own organs, and maybe some nuts. Helping the town leaders doesn't get you any money, just a word of thanks. Exploring a cave doesn’t let you find a loaf of bread or a loaded pistol, it lets you find dirt and stones and puddles. Because it’s a cave.
Once you get to grips with this feeling of total disempowerment, you will essentially begin to bend yourself to the game’s will. It feels less like you’re playing the game, and much more like the game is playing you. Technically, you are free to do whatever you want, but should you? The game teaches you that you shouldn’t trust your own preconceived notion of what games should be like, or else you will die. But contradictingly, it also teaches you that you cannot trust the game, because it will make you do things that make everything harder for you. So, what can you trust?
Nothing. That's the point.
You have to adjust your own worldview when playing Pathologic, otherwise you will die, or fall victim in someone else’s power struggle. The game is full of twists and lies and misinformation, all of which work together to make you feel wholly isolated in the gameplay.
This all sounds awful, doesn’t it?
Well, Pathologic is a game about disease. It is not fun, it is not pretty, and it is a wholly miserable experience. Despite all of this, it tells an incredible story, touching on some of the most interesting ideas I’ve ever heard. It really makes you think about the world, both in the game and in real life. Pathologic is not a fun game, but it is an incredible experience.