Gruelling but brilliant plague survival horror Pathologic 2 coming to Xbox One next month

Developer Ice-Pick Lodge’s masterful plague survival horror Pathologic 2 will be making its way to Xbox One and Xbox Game Pass on 12th December.

Pathologic 2 is a bit of a strange beast, part sequel to and part remake of Ice-Pick Lodge’s cult-classic, and notoriously wonky, 2005 original. Following the same trajectory as its predecessor, Pathologic 2 charts the sudden decline of a strange, small town on the edge of the Russian Steppe, as it succumbs to a mysterious plague.

The result is, and I say this as someone with zero familiarity the original Pathologic, easily one of the most audacious, atmospheric, and thoroughly mesmerising games I’ve played in a very long time – but, and I cannot state this enough, it’s also one of the most intentionally dispiriting, emotionally draining, and testing ones too.

The set-up is simple enough: you, surgeon Artemy Burakh, return to your isolated childhood town having received an urgent missive from your father – and, very quickly, things start to go wrong. What follows could, I suppose, be described as a blend of immersive sim and survival. Each day, there are relationships to rebuild, a spiralling web of mysteries to uncover, and rather more mundane chores to be done, and each night, your opportunity to progress certain narrative strands will be jettisoned forever.

Complicating matters is the fact that each step you take, every action you perform, will slowly sap away at your hunger, your thirst, your health, and your exhaustion, meaning a good portion of your time will be spent searching out and bartering for sustenance.

On day one, that’s fine, but as the clock ticks on, and the days shorten, the town’s already short supply of resources grows perilously low. Oh, and should you inadvertently submit to death on your journey, the strange forces at work in Pathologic 2’s rather literal theatre of cruelty will be sure to hobble your abilities permanently and irreversibly.

Soon, frantically blinking meters are a constant on-screen companion, and it doesn’t take long to twig that Pathologic 2 isn’t playing a game of survival whack-a-mole like its genre bedfellows. Instead, its meters serve as an ever-present reminder that you’re on a path of permanent, unavoidable decline, and the only mercy you’ll find is in the smallest of victories as the plague, and worse, rains hell on your world. Not everyone can be saved, not every story can be resolved, and the weight of the decisions you’re frequently forced to make can be unbearable. And that’s before things really start to unravel.

Pathologic 2 is full of clever little systems of misery, determined to remind you that, hey, death, plague, and famine really aren’t all that fun after all. But, weirdly, it’s a game of tremendous warmth too, dropping you into the heart of a community, forcing you to form bonds with its strange inhabitants then, through some breathtakingly economical world-building, making you care enough about its crooks, vagabonds, artists, and street urchins, that it’s genuinely disheartening when the realisation strikes that you’ll have to decide who lives and dies.

Pathologic 2 is a fascinating machine, a weird, wild ride, and an artistic triumph too. Despite some low-budget jank on PC, the sheer haunting force of Ice-Pick Lodge’s world design, its distinctive visual style and smothering soundscapes, have, I think, seared its impossible, fog-shrouded streets permanently into my brain. But, and again I can’t stress this enough, good grief is it a tough experience to get through.

The good news for anyone intrigued but understandably wary after all those words is that, shortly after release, Ice-Pick Lodge added a whole range of difficulty sliders to accomodate those eager to explore Pathologic 2’s intoxicating world, but not quite masochistic enough to endure the full dispiriting force of its gruelling original design. And if that’s still not enough incentive to give Pathologic 2 a whirl, it’ll also be joining Xbox Game Pass when the Xbox One edition goes on sale on 12th December.


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