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Pathologic 2

Pathologic 2 is a 2019 survival horror role-playing video game developed by the Russian studio Ice-Pick Lodge and published by tinyBuild.^[1]^[2] It serves as a reimagining of the Haruspex storyline from the original 2005 game Pathologic, focusing on the protagonist Artemy Burakh, a local bachelor of medicine who returns to his hometown amid a devastating plague outbreak.^[3]^[4] Set in a remote, isolated town over the course of 12 in-game days, the game emphasizes resource management, moral dilemmas, and exploration as players scavenge for food, medicine, and supplies while interacting with the town's inhabitants and combating the epidemic.^[4]^[1] The gameplay blends open-world survival mechanics with narrative-driven role-playing elements, where time is a critical resource; players must balance personal health needs like hunger, thirst, and exhaustion against quests to heal the sick, perform autopsies, and uncover the plague's origins tied to the protagonist's family secrets.^[4] Combat is intentionally clunky and non-lethal, encouraging avoidance or diplomacy over violence, while economic systems involve bartering, trading, and sometimes stealing in a society on the brink of collapse.^[1] Ice-Pick Lodge, known for titles like The Void and Knock-Knock, drew from the original game's experimental design but rebuilt Pathologic 2 from the ground up using the Unity engine to create a standalone experience that prioritizes atmosphere and player agency.^[2]^[3] Released initially for Microsoft Windows on May 23, 2019, via Steam, the game later launched on Xbox One on December 12, 2019, and PlayStation 4 on March 5, 2020.^[1] It received praise for its unique storytelling, oppressive atmosphere, and innovative survival systems, though some critics noted its steep difficulty curve and dated visuals as challenges for newcomers.^[5] The title has garnered a cult following, with ongoing support including a free DLC, The Marble Nest, released in 2019, which expands the lore through a side story.^[6]

Narrative

Setting

Pathologic 2 is set in the remote, fictional Town-on-the-Gorkhon, a secluded settlement situated on the vast Eurasian Steppe in an early 20th-century Russian-inspired landscape. This isolated community developed around a central meat-processing enterprise known as the Bull Enterprise, reflecting influences from both Russian provincial life and nomadic steppe traditions. The town's geography evokes the endless, unforgiving plains, with the Gorkhon River providing a natural boundary and the surrounding steppe serving as a harsh, open frontier that underscores the community's vulnerability to external threats.^[7] The town's architecture and social structure are rigidly divided into functional districts that mirror class divisions and occupational roles, fostering a sense of compartmentalized isolation. Key areas include the Abattoir, a grim industrial zone dominated by butchers and meat workers; the Playground, a surreal district associated with theater folk and organized groups of children who exert unexpected influence; and the Warehouses, a trading hub for merchants and laborers handling goods and logistics. These districts, often separated by fences or natural barriers, highlight the town's stratified society, where butchers, performers, and traders maintain distinct cultural enclaves amid underlying tensions between traditional steppe dwellers and more settled inhabitants.^[8] At the heart of the setting is the Sand Plague, a mysterious and seemingly supernatural disease that ravages the town, causing victims' bodies to deteriorate into sand-like particles, symbolizing profound decay and existential isolation. This affliction spreads rapidly through districts, turning vibrant areas into quarantined wastelands and amplifying the community's paranoia and desperation. Unlike conventional epidemics, the Sand Plague carries an otherworldly aura, blending biological horror with metaphysical dread, as if the earth itself is reclaiming its due.^[9] The town's culture draws from polytheistic steppe beliefs centered on earth-bound forces and ancestral spirits, where inhabitants revere ancient rituals and shamanic figures known as Menkhu, who mediate between the human world and the land's primal energies. This contrasts with encroaching modern influences, such as utilitarian medicine and economic pragmatism, creating friction between ritualistic traditions—like offerings to the steppe's spirits—and attempts at rational intervention. Nomadic heritage manifests in the Kin, indigenous steppe people who embody a deep connection to the land through oral histories, herbal lore, and communal rites, setting them apart from the town's more urbanized factions.^[10] The atmosphere is one of perpetual twilight and encroaching doom, with foggy, muddied streets under a muted sky, harsh winds from the steppe, and a constant pall of decay that mirrors the town's reliance on cattle trade for survival. This economy, built on livestock processing and barter exchanges of hides, meat, and steppe goods, teeters on collapse as the plague disrupts supply lines and isolates districts, heightening the sense of a community adrift in an indifferent wilderness.^[8]^[7]

Plot

Pathologic 2 follows Artemy Burakh, known as the Haruspex, a native of the steppe and an apprentice doctor who returns to his isolated hometown after years away, only to be accused of murdering his father, the town's chief physician.^[1] Upon arrival, Burakh must navigate the unfolding crisis as a mysterious plague begins to ravage the community, turning the town into a nightmarish landscape of fear and decay.^[11] The narrative unfolds over the course of 12 in-game days, each progressing toward a climactic confrontation, with the protagonist's actions shaping the story's direction through moral choices that influence relationships, resource allocation, and the town's fate.^[12] As the days advance, Burakh investigates a series of murders linked to his father's death while combating the escalating plague outbreak, which spreads unpredictably and forces difficult decisions about whom to aid or quarantine.^[13] Key events include tense interactions with enigmatic town elements, such as the looming Polyhedron—a utopian theater-like structure symbolizing the town's ambitions—and confrontations with influential leaders, including figures like the Mistress and the General, who represent competing visions for the community's survival.^[14] These encounters highlight branching paths where Burakh balances personal loyalties against collective needs, often at great personal cost, as the plague serves as a metaphor for societal collapse, personal guilt, and the inexorable march of fate.^[13] The story culminates in multiple endings determined by the player's choices, ranging from saving the town through sacrifice—such as preserving certain districts at the expense of others—to outcomes where progress demands irreversible losses, underscoring themes of fate versus free will and the human cost of utopian ideals.^[1] Throughout, the narrative emphasizes inevitability, with no path guaranteeing total victory, as Burakh grapples with the limits of his agency in a world teetering on ruin.^[11]

Gameplay

Core mechanics

Pathologic 2 employs a strict time system structured around a 12-day cycle, during which the player must manage escalating crises in the plague-ridden town, with each in-game day lasting approximately two real-time hours at the start, accelerating toward one hour by the later days to heighten urgency.^[8]^[15] This real-time progression pauses only during menus, dialogues, or specific interactions like trading and autopsies, forcing players to prioritize tasks amid competing demands, as the day-night phases influence NPC availability and environmental hazards.^[12] The system's design emphasizes tension, with each day's end revealing the toll of the plague through death tallies, underscoring the inexorable decay of the town.^[12] Exploration in Pathologic 2 occurs in third-person perspective across an open-world town layout divided into districts like the Flank and Hindquarters, navigated on foot at a deliberately slow walking speed to evoke unease and simulate the protagonist's fatigue.^[8] There is no fast travel mechanic, requiring strategic route planning around fog-shrouded streets and barricades, while a basic map highlights key locations and figures such as the factory owner or judge.^[12] This approach encourages deliberate movement, as districts progressively become inaccessible or hostile due to infection spread, integrating exploration with the broader survival framework.^[8] The inventory system utilizes a grid-based interface with limited slots, necessitating efficient packing akin to Tetris, as items cannot be rotated and must accommodate essentials like food, tools, and potentially contaminated goods.^[12] Trading operates through bartering with townsfolk, where currency often proves unreliable amid the economic collapse, prompting exchanges of goods such as rusty scissors or extracted organs for necessities like bread or bullets, with prices fluctuating based on the plague's progression.^[8]^[12] This dynamic economy ties resource gathering to social navigation, as vendors may refuse deals if relations sour. Reputation mechanics govern interactions with town factions, including locals and groups like the boosters, where player choices—such as aiding victims or engaging in violence—affect district perceptions, displayed on the map as statuses like "hated" or "indifferent."^[12] Positive actions, including quest completion or donations, can unlock dialogues, areas, and alliances, while negative ones lead to hostility, barring access to shops or triggering confrontations.^[12] These relations evolve over the 12 days, influencing the availability of aid and altering the narrative's branching paths without direct numerical tracking beyond qualitative feedback.^[8] The user interface adopts a minimalist design, featuring a journal for tracking quests and leads via a web of interconnected notes, alongside a map for orientation and a thoughts screen for reflecting on events.^[8] Controls support keyboard/mouse and controllers, with a deliberate "clunky" feel in movement and interactions to mirror the protagonist's stress and physical strain, though saves are restricted to specific clocks in safe buildings.^[12] This setup prioritizes immersion over accessibility, reinforcing the game's themes of limitation and consequence.^[8]

Survival elements

In Pathologic 2, survival revolves around managing multiple depleting meters that simulate the protagonist Artemy Burakh's physical and mental state in a plague-ravaged town. The core health system includes three primary survival meters—hunger, thirst, and exhaustion—that decrease over time based on activity, sleep, and environmental factors. Hunger builds gradually and, if it reaches maximum, begins draining the overall health bar, potentially leading to death if unaddressed; it can be mitigated by consuming food items like bread or fish, though these are scarce and often require bartering or scavenging. Thirst escalates with physical exertion, such as running or combat, reducing stamina regeneration, and is quenched primarily through water from town wells or other liquids like milk. Exhaustion accumulates during wakefulness and sprinting, impairing movement and increasing vulnerability, with relief obtained via sleep, which in turn accelerates hunger and thirst depletion.^[12]^[16]^[8] Complementing these is an immunity bar that protects against the game's central plague infection, starting at half capacity and diminishing in contaminated areas or through exposure to infected individuals, rotten food, or plague clouds. Low immunity risks full infection, which rapidly erodes health unless treated with rest, prophylactic tinctures, or immunity boosters; infection can spread to the player during interactions like healing others. Healing occurs through a crafting-based system where remedies are prepared in Artemy's lair using herbs (such as bloodtwyre or zürkh), water, and extracted bodily components like organs or blood. Basic tinctures address hunger (Yas), thirst (Zürkh), or exhaustion (Medrel), while advanced ones like painkillers or antibiotics require combining healthy or infected organs with herbs at a makeshift brewery, emphasizing resource scarcity and trade-offs.^[16]^[12] Autopsies provide access to rare components by dissecting corpses outside the hospital, yielding organs (liver, kidney, heart, brain) or blood, but this carries significant risks: performing the procedure on infected bodies can contaminate the player, lowering immunity and potentially causing infection, while it also damages scalpel durability and incurs reputation penalties from witnesses. Combat reinforces the game's emphasis on avoidance over aggression, featuring stamina-draining melee attacks like jabs or charged strikes against nocturnal threats such as bandits, looters, or plague victims; blocking consumes stamina, and firearms like revolvers or shotguns are available but prone to jamming if poorly maintained, with headshots offering efficiency at the cost of limited ammunition. Direct confrontation is discouraged due to the protagonist's fragility, as even minor injuries compound with depleting meters, making evasion through sneaking or surrendering preferable in most encounters.^[16]^[8] Death imposes lasting consequences rather than full permadeath, with each instance reducing maximum health (up to half after multiple occurrences) and applying debuffs like accelerated hunger or exhaustion depletion, while allowing respawn at save points like clocks or the theater. The "pinned days" system enables partial rewinds by replaying specific days from a fixed point, preserving the town's evolving state—such as plague spread or NPC deaths—across attempts, which heightens the permanence of survival failures. Environmental hazards amplify these risks, with plague zones dynamically expanding to infect districts, draining immunity upon entry and spawning aggressive entities like roamers or sentries that enforce quarantine-like isolation; decisions to enter or avoid these areas directly impact resource access and infection rates. Weather effects, including fog and rain, further erode stamina and obscure navigation, compounding the challenge of traversing the labyrinthine town at night.^[12]^[16]^[8]

Quests and interactions

In Pathologic 2, quests form a non-linear web integrated into the game's narrative structure, rather than being divided into main and side categories, allowing players to pursue tasks such as curing infected districts or mediating local conflicts within flexible time windows that span multiple in-game days. These objectives often involve traversing the town's districts to gather resources, resolve disputes among residents, or assist vulnerable groups like orphans, with completion influencing the progression of the outbreak and community dynamics. The absence of rigid checklists emphasizes exploration and player initiative, as quests emerge organically from environmental events and conversations, creating a sense of urgency tied to the 12-day timeline.^[17]^[12] The dialogue system features branching conversations with over 30 key non-player characters (NPCs), presented in text-only interfaces that prioritize immersion through cryptic, philosophical exchanges revealing fragments of the town's lore and cultural tensions. Players select responses that can build alliances, unlock new quest paths, or alter NPC attitudes, with outcomes tracked via a mindmap interface that visualizes thoughts and connections as nodes rather than traditional journal entries. This design encourages replayability, as choices in dialogues may lead to reputation shifts across districts, opening or closing interaction options in subsequent encounters.^[17]^[12] Character archetypes in the game exhibit distinct personalities that shape interactions, such as the enigmatic Twins who offer riddles tied to ancient traditions, pragmatic traders who negotiate based on economic needs, or authoritative figures like the town judge who demand adherence to local laws. These NPCs belong to broader groups, including child gangs in the outskirts or factory workers in industrial zones, each with unique behavioral patterns that respond to the player's reputation tiers—ranging from trusted ally to outright hostility—unlocking deeper lore or aid as relationships evolve. Interactions often incorporate role-playing elements, where the protagonist's background as the Haruspex allows leveraging medical expertise or kinship ties to sway outcomes, such as diagnosing ailments during talks or invoking cultural rituals.^[12]^[17] Moral choices permeate quests and dialogues, presenting dilemmas like euthanizing terminally infected individuals to prevent spread or prioritizing one district's needs over another's, which branch the narrative without predefined "good" or "evil" resolutions and instead highlight the town's inescapable trade-offs. These decisions manifest in the mindmap as yellow nodes representing missed opportunities, reinforcing themes of consequence and ambiguity, while affecting long-term alliances and the plague's trajectory. For instance, sparing an aggressor in a confrontation might preserve a potential informant but risk broader reputation loss, underscoring the game's emphasis on ethical ambiguity in survival scenarios.^[17]^[12] The role-playing depth arises from how the Haruspex's identity influences interactions, enabling specialized approaches like using anatomical knowledge to negotiate treatments or drawing on steppe heritage to resolve feuds among locals, with some scenes staged in a theatrical manner to heighten dramatic tension. Reputation mechanics further enhance agency, as positive standing in one area might facilitate trades during dialogues—briefly referencing inventory management—while negative perceptions heighten risks like ambushes. This system fosters a personalized experience, where player-driven choices weave into the town's evolving social fabric, prioritizing relational consequences over combat or resource hoarding.^[17]^[12]

Development

Production history

Pathologic 2 was developed by Ice-Pick Lodge, a Moscow-based studio founded in 2002 by Nikolay Dybowski. The studio gained recognition for its debut title, the original Pathologic, released in 2005, which achieved cult status despite initial commercial underperformance due to its unconventional narrative and survival mechanics.^[18]^[19] The remake project stemmed from a desire to revisit and expand this foundation, drawing inspirations from Russian literature, including works by Fyodor Dostoevsky, and surrealist elements to deepen the game's philosophical and atmospheric layers.^[20] Development began in earnest with the launch of a Kickstarter campaign on September 4, 2014, which successfully raised $333,127 from 7,139 backers against a $250,000 goal, enabling the studio to fund a full remake of the original's three interlocking storylines.^[21] However, due to escalating time and budget constraints, the scope was scaled back to focus primarily on the Haruspex route, with plans for the other routes deferred as separate releases. A key milestone was the 2017 release of the Marble Nest demo, a prototype that tested core mechanics and garnered publicity for its innovative approach to survival horror. Alpha builds were shared with backers in August 2018, followed by major overhauls leading to the full release on May 23, 2019, for PC via Steam, GOG.com, and Humble Bundle.^[20]^[22] The small team of around 16-20 developers, including director Nikolay Dybowski and lead designer Ivan Slovtsov, faced significant challenges throughout production. Financial difficulties intensified after the loss of a $2 million investment deal in 2015 amid Russia's economic crisis, forcing the studio to rely on personal savings and repurpose demo assets to sustain operations. Nearing insolvency by 2019, Ice-Pick Lodge was rescued through a publishing partnership with tinyBuild, announced in 2017, which provided crucial funding and distribution support. The game features voice acting in both English and Russian for key dialogues, with notable performances enhancing its immersive, theatrical tone.^[20]^[2]^[23]

Design and differences

Pathologic 2 functions as a reboot and expansion of the Haruspex storyline from the original 2005 game Pathologic, which offered three separate playable routes for different protagonists; the sequel deepens this single path with additional quests, branching narratives, and new endings to provide a more focused yet enriched experience.^[20] Developers at Ice-Pick Lodge shifted away from a direct remake early in production, recognizing the need to evolve the concept beyond faithful replication.^[20] Mechanically, Pathologic 2 accelerates the pacing relative to the original's often grindy survival loops, streamlining resource management and daily cycles to heighten tension without excessive repetition.^[24] Combat has been refined for better responsiveness and less frustration—incorporating improved hitboxes, blocking mechanics, and AI behaviors—while deliberately preserving elements of "jank," such as deliberately slow walking speeds and unpolished animations, to maintain an immersive sense of unease and physical limitation.^[24] The user interface sees enhancements like a dedicated "People" screen for tracking infections and reputations, alongside a grid-based inventory system that encourages strategic item placement, contrasting the original's more opaque and cumbersome controls.^[20] Artistically, the game utilizes the Unity engine to craft surreal, hand-built environments in the Town-on-Gorkhon, featuring dreamlike animations and static character poses that convey emotional expressiveness through subtle, theatrical staging.^[25] This design emphasizes ostranenie—a literary device of defamiliarization rooted in Russian formalism—to alienate and unsettle players, rendering familiar actions like walking or interacting as deliberately awkward and otherworldly, thereby amplifying the game's themes of isolation and perceptual distortion.^[26] Narratively, Pathologic 2 intensifies the personal exploration of protagonist Artemy Burakh's psyche, delving into his internal conflicts and cultural heritage in ways underdeveloped in the original's broader, multi-perspective structure.^[20] It introduces metaphysical layers, such as recurring theater motifs where the plague outbreak unfolds as a staged performance directed by enigmatic figures, symbolizing the artificiality of reality and human roles within crisis—elements absent from the 2005 game's more grounded, plague-focused realism.^[27] The sound design diverges notably, with an original score by in-house composer Vasiliy "Mushroomer" Kashnikov and the Russian neofolk band Theodor Bastard, blending ethereal vocals, tribal rhythms, and folk instrumentation to evoke atmospheric dread and cultural otherness.^[28] This neofolk-infused approach creates a more dynamic tension through lyrical, haunting tracks that underscore surreal sequences, contrasting the original Pathologic's predominantly ambient and industrial soundscape, which relied on droning synths and minimalistic tribal elements for a subtler, more oppressive unease.^[29]

Release

Launch details

Pathologic 2 was initially released as a digital title for Microsoft Windows via Steam on May 23, 2019.^[1] Console ports followed, with the Xbox One version launching on December 12, 2019, and the PlayStation 4 version on March 6, 2020.^[30]^[31] The game remained digital-only at launch, with no physical editions produced for the PC version due to production costs.^[32] tinyBuild acquired publishing rights for Pathologic 2 in 2017 and managed its global distribution, emphasizing the game's horror-survival elements through promotional trailers and live streams to target niche audiences.^[2] The standard edition launched at $34.99, available digitally with optional DLC such as an artbook for $8.99; no special editions were offered at release.^[33] In the months following launch, tinyBuild and developer Ice-Pick Lodge issued free patches addressing technical issues, including fixes for crashes, stuttering, and item loss bugs.^[34] The game featured full voice acting in English and Russian, a significant upgrade from the original Pathologic's notoriously awkward localization, which had suffered from poor translations.^[8] Subtitles supported multiple languages, including French, German, Spanish, Japanese, Simplified Chinese, and Brazilian Portuguese, marking the first Pathologic title to launch with such extensive textual localization beyond English and Russian.^[1] Feedback from a pre-launch demo and alpha builds, originally tied to the game's 2015 Kickstarter campaign, informed the final polish, helping refine gameplay balance and performance before the full release.^[35] Console versions also launched digitally without physical copies initially.^[30]

Expansions and updates

Following its initial release, Pathologic 2 received The Marble Nest as its primary post-launch expansion, a free DLC released on October 28, 2019, for owners of the base game prior to that date.^[36] This content serves as a one-day prequel set before the main events, with players controlling the Bachelor in an attempt to avert the plague's outbreak; it expands on the 2015 demo by incorporating new endings, refined mechanics, and overall polish to integrate seamlessly with the core narrative.^[37] The game underwent several major patches between 2019 and 2020 to address gameplay and technical issues, including fixes for combat responsiveness, AI behavior, performance optimization, and bug resolutions such as improved despawning of plague clouds and faster NPC reactions.^[38] A notable update in June 2019 introduced customizable difficulty sliders, allowing players to adjust parameters like hunger depletion, health loss, and resource scarcity, which served as quality-of-life enhancements carried over to subsequent platforms.^[39] Console ports followed, with Xbox One receiving the game on December 12, 2019, and PlayStation 4 on March 6, 2020; these versions included port-specific optimizations for controller support and stability, alongside the adjustable difficulty options to broaden accessibility.^[40]^[41] Additional content extended beyond gameplay with the full original soundtrack becoming available on major streaming platforms on March 22, 2024, featuring 52 tracks composed by Mushroomer and Theodor Bastard to capture the game's atmospheric tension.^[42] No further major expansions have been released since The Marble Nest, though community modding support has grown through tools like the P2ModLoader on Nexus Mods, enabling custom scenarios, music replacements, and inventory tweaks without official Steam Workshop integration.^[43] As of 2025, no new DLC has been announced for Pathologic 2, but ongoing compatibility tweaks for modern hardware—such as performance adjustments discussed in community forums—continue to maintain playability, while the October 2025 announcement of Pathologic 3, scheduled for release on January 9, 2026, has renewed interest in the series.^[44]^[45]

Reception

Critical response

Pathologic 2 received "mixed or average" reviews from critics, according to review aggregator Metacritic, earning a score of 70/100 based on 28 reviews.^[5] On OpenCritic, the game holds an average score of 70 from 43 critics, placing it in the "Fair" category.^[46] User scores were more favorable, with Metacritic reporting 8.6/10 from 376 ratings.^[5] Critics frequently praised the game's unique blend of survival horror and narrative-driven role-playing, highlighting its oppressive atmosphere and emotional depth. Reviewers lauded the storytelling's exploration of themes like sacrifice, mortality, and human resilience amid crisis, often describing it as a haunting, immersive experience that blends surreal elements with philosophical undertones. The atmospheric sound design, featuring original music by the Russian neofolk band Theodor Bastard, was noted for enhancing the eerie, folkloric tone of the plague-ridden town.^[12]^[47]^[48] However, common criticisms centered on the game's clunky controls and combat system, which many found unresponsive and frustrating, detracting from the overall experience. The steep difficulty curve, driven by time-limited survival mechanics and resource scarcity, was said to overwhelm newcomers and lead to repetitive tasks, such as scavenging and managing health, hunger, and stamina under constant pressure. Some outlets argued that these elements, while intentional, bordered on punitive and hindered accessibility.^[8]^[13]^[12] Notable reviews included PC Gamer's 66/100, which commended the moral complexity of player choices and the game's ambitious world-building but critiqued its obtuse mechanics as nearly unplayable for some.^[8] GameSpot awarded a 5/10, praising the bleak narrative while faulting the punishing structure for obstructing story engagement.^[13] Rock Paper Shotgun described it as a "frustrating" yet fascinating surrealist drama, emphasizing its innovative take on immersive sim elements despite technical shortcomings.^[12] Despite these flaws, the game received praise for its bold innovation in blending horror with existential themes.^[47] In thematic analysis, reviewers often drew parallels to literary techniques like defamiliarization, noting how the game's alienating mechanics force players to confront familiar concepts—such as disease and societal collapse—through a distorted lens. The plague narrative was interpreted as a metaphor for real-world pandemics, gaining added resonance after the game's 2019 release amid global events, with critics appreciating its prescient commentary on isolation and ethical dilemmas.^[47]^[49]

Commercial performance and legacy

Pathologic 2 achieved modest commercial success as an indie title, selling an estimated 20,000 to 50,000 copies in its first month following the May 2019 launch, generating approximately $490,000 to $1.225 million in revenue from Steam alone.^[50] By 2020, Steam sales reached around 280,000 units, with lifetime Steam sales estimated at over 400,000 units as of 2025.^[51] Published by tinyBuild, the game proved profitable for developer Ice-Pick Lodge despite its niche appeal and lack of blockbuster performance, allowing the studio to sustain operations on experimental projects.^[51] Player engagement reflected the game's challenging nature and dedicated audience, with a peak of 1,422 concurrent players on Steam shortly after release.^[52] While daily active players have since stabilized at 100 to 150, it has cultivated a cult following through online communities, fan wikis, and discussions that delve into its lore and mechanics, fostering high completion rates among committed players despite the steep difficulty curve.^[52] The title earned a nomination for Outstanding Story-Rich Game at the 2019 Steam Awards, highlighting its narrative strengths amid broader indie recognition.^[53] A 2020 free update introduced an easier difficulty mode, improving accessibility and boosting player satisfaction, with Steam reviews reaching 92% positive.^[54] The game's legacy lies in elevating Ice-Pick Lodge's status as innovators in experimental, narrative-driven horror RPGs, transforming the original 2005 Pathologic from a commercial disappointment into a renewed cult phenomenon and boosting its sales through renewed interest.^[55] Its themes of plague, isolation, and societal collapse gained poignant relevance during the COVID-19 pandemic, spurring academic and critical analyses that framed it as a prescient allegory for global crises.^[56] This enduring impact paved the way for the series' continuation, with Pathologic 3 announced in October 2024 and set for release on January 9, 2026, completing the trilogy by centering on the Bachelor route and expanding the lore through fan-supported resources like wikis.^[44]

References

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Pathologic 2 on Steam
Rating 4.5 (4,361) · 14-day returnsDeveloper. Ice-Pick Lodge ; Publisher. tinyBuild ; Released. May 23, 2019.
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Aug 31, 2017 · Utopia aka Pathologic, then there was Pathologic Classic HD (a remake), and now we're working on Pathologic 2. Let's not get back to the ...
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### Summary of Pathologic 2
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Rating 70% (29) PlayStation 4. Initial Release Date: May 23, 2019. Developer: Ice-Pick Lodge. Publisher: tinyBuild. Genres: Survival · Full Credits & Details. Related Games ...
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Pathologic 2 and the Problem of Video Game Difficulty - EGM
Nov 22, 2019 · As you wander the plague-choked Russian steppe town of Pathologic 2, you gather resources. Dig in a trash can for a rusty scalpel or a ...<|control11|><|separator|>
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Rating 66% · Review by Tom SeniorMay 28, 2019 · Pathologic 2 asks challenges you to survive 12 in-game days in a town that's going completely to shit. Disease, paranoia, mob justice, and paranormal ...
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May 6, 2022 · Pathologic 2 offers four ways to cure the Sand Plague. Three of the methods can be conducted at any time, while the fourth is story ...
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Jul 1, 2020 · Ice-Pick Lodge's cult classic Pathologic and its sequel, Pathologic 2. This compilation is curated by Andrew Bailey, a Ph.D. candidate within the Art History ...
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Pathologic 2
Pathologic 2 is an open world survival thriller set in a town that's being consumed by a deadly plague. Face the realities of a collapsing society as you ...
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how long is the game? :: Pathologic 2 (EN) General Discussions
May 24, 2019 · So to explain, this game is composed of 12 in-game days. Each day is exactly 2 real life hours. However, you can sleep to become less ...Question about time limit :: Pathologic 2 (EN) General DiscussionsSlowing down time by editing files :: Pathologic 2 (EN) General ...More results from steamcommunity.com
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Aug 12, 2019 · Pathologic 2 developed by Ice-Pick Lodge is an open-world survival thriller set in a town that's being consumed by a deadly plague.
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Ice-Pick Lodge founder Nikolay Dybowski departs Pathologic dev
Mar 14, 2025 · Pathologic players recently uncovered allegations of abuse and kidnapping against Dybowski, and called on Ice-Pick to act.
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Sep 5, 2014 · Ice-Pick Lodge has launched a Kickstarter seeking $250,000 to remake Pathologic for Linux, Mac, PC, PS4 and Xbox One. A story-driven, first- ...
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Apr 24, 2019 · Pathologic 2 gets deeply dream-like in its new playable demo. Live half a day as the Haruspex, and dig deep into your heart for the truth.
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Jun 29, 2019 · ... Mistress. They control the Bull Project (the slaughterhouse), so ... They believe in the preservation of the town, and they sponsor the Haruspex ( ...<|control11|><|separator|>
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Save 80% on Pathologic 2: Soundtrack on Steam
Rating 8/10 (31) May 23, 2019 · Pathologic 2 Official Soundtrack includes original 14 tracks by Russian neofolk band Theodor Bastard and set of 40+ tracks from the game.
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In stock 6–7 day deliveryRelease date. 12/11/2019. Play with. PC; Xbox One; Xbox Series X|S. Capabilities. Single player; Xbox achievements; Xbox clubs; Xbox cloud saves. Compare ...
[29]
Pathologic 2 - PlayStation Store
4.5 15K · Free deliveryRelease: 3/5/2020; Publisher: tinyBuild GAMES. To play this game on PS5, your system may need to be updated to the latest system software. Although this game ...
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No physical release? :: Pathologic 2 (EN) General Discussions
Apr 14, 2019 · They've said there are no plans right now for a physical edition on PC due to ESRB costs. People have asked them about limited runs on the discord.
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Pathologic 2 Price history - SteamDB
Rating 89% (11,326) · $34.99 · WindowsSteam price history ; U.S. Dollar, $34.99, $34.99 ; South Asia - USD, $11.99, $11.99 ; Russian Ruble, 1200 ₽, $14.83 ; CIS - U.S. Dollar, $16.49, $16.49 ...Patches · Steam charts · Cloud saves · Metadata
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Pathologic 2 Patch 7 - Steam News
Gamepad support, optimization, bugfixes and headshots.
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Pathologic (Мор.Утопия) by Ice-Pick Lodge - Kickstarter
Aug 31, 2017 · 7,139 backers pledged $333,127 to help bring this project to life. Last updated October 14, 2024.Missing: date | Show results with:date<|control11|><|separator|>
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Surreal plague horror Pathologic 2's Marble Nest DLC out next week
Oct 22, 2019 · Pathologic 2, for the uninitiated, is a re-imagining of Ice-Pick's idiosyncratic, rough-around-the-edges 2005 cult-favourite Pathologic, and ...
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Pathologic 2 will get free DLC despite studio struggles (updated)
Aug 30, 2019 · The Marble Nest DLC will be a "polished and optimised version of what was once Pathologic 2's demo," according to Ice-Pick Lodge.<|control11|><|separator|>
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Pathologic 2 Patch 3 · Pathologic 2 update for 30 May 2019 - SteamDB
May 30, 2019 · - lowered video memory usage. 2. AI Fixes: - improved corpsmen behavior a bit; - plague clouds are now better at despawning; - NPCs react faster ...
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Pathologic 2 - Difficulty Slider and Patch 4 - Steam News
So, we've been told that Pathologic 2 is kind of on the hard side. And, well, we agree. Which is why today we're finally introducing the promised Difficulty ...
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Pathologic 2 Is Now Available For Digital Pre-order And ... - Xbox Wire
Nov 27, 2019 · NOTE: You may pre-download this game, but it will not be playable until the release date/time: 12/11/2019 - 4:00 PM (check the product page ...
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Punishing plague horror Pathologic 2 is heading to PS4 this week
Mar 3, 2020 · Pathologic 2 is a haunting, unforgettable experience for all sorts of reasons (and certainly not for everyone), but the first important thing to ...
[40]
Pathologic 2 Original Soundtrack - Album by Mushroomer
Mar 22, 2024 · Listen to Pathologic 2 Original Soundtrack by Mushroomer on Apple Music. 2024. 52 Songs. Duration: 2 hours 26 minutes.
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P2ModLoader at Pathologic 2 Nexus - Mods and community
Dec 26, 2024 · A mod loader for Pathologic 2, allowing several mods that touch the same file to be used alongside each other. Includes support for code, XML and asset ...
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Pathologic 3 announced with time travel mechanic, due for release ...
Oct 7, 2024 · Ice Pick Lodge announced a sequel to their oppressive plague sim. Pathologic 3 will feature a new character and a time travel mechanic, ...
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Performance in 2025 :: Pathologic 2 (EN) General Discussions
Mar 1, 2025 · Just wanted to leave this here, as there hasn't been any recent thread about how the game runs with modern hardware: 9800X3D + RTX4090, ...Missing: compatibility | Show results with:compatibility
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Pathologic 2 Reviews - OpenCritic
Pathologic 2 is rated 'Fair' after being reviewed by 43 critics, with an overall average score of 70. It's ranked in the bottom 40% of games...
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Pathologic 2 Review: Bearing Witness to a Town's Suffering
Rating 4.0 · Review by Steven ScaifeJun 1, 2019 · It's one of the most stunning examples of a game as a cohesive whole, as every aspect is tuned for maximum stress and horror—an atmosphere ...
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Pathologic 2 Review - Just Adventure
Jun 13, 2019 · + Beautiful soundtrack including songs by neo-folk band Theodor Bastard and music by Mushroomer + Choices really matter. – Janky combat – ...Missing: differences | Show results with:differences
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Review: Pathologic 2 - Rely on Horror
Aug 19, 2019 · It's far from fun and didn't provide any meaningful feedback. The blows lack enough weight to feel useful, and the weapons seem inefficient.<|control11|><|separator|>
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Pathologic's ambition and atmosphere made it easy to praise, but ...
May 6, 2023 · Actually, heroism is playing Pathologic at all—the game is a tinny, shivering nightmare, unpleasant in almost every respect. Its ambition and ...
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So, how did this game do, sales-wise? :: Pathologic 2 (EN) General ...
Aug 18, 2019 · Just wondering, I really wish this game was/is a financial success for Ice-Pick-Lodge, are there any info on how it actually turned out ...<|control11|><|separator|>
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Pathologic 2 – Steam Stats – Video Game Insights - Sensor Tower
90-day returns147. active players (57 min ago) ; 147. active players (24h peak) ; 91.8%. positive reviews ; $9.4m. gross revenue ; 408k. units sold ...
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Pathologic 2 Steam Charts - SteamDB
Rating 89% (11,326) Steam player count for Pathologic 2 is currently 112 players live. Pathologic 2 had an all-time peak of 1422 concurrent players on 23 May 2019.
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https://steamdb.info/app/505230/charts/
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Pathologic 2 - Dragon Quill
Mar 31, 2025 · It's through the funeral that Artemy learns Isidor was killed by the Sand Plague, as well as how he meets Aspity and receives his inheritance.
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[PDF] Ice Pick Lodge's Pathologic Classic HD - Scholar Commons
The first link between Necropolitics (2019) and the Pathologic series is merely historical proximity, but I will argue in this thesis that Mbembe's theory of ...<|control11|><|separator|>
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Pathologic 3 on Steam
14-day returnsPathologic 3 launches on January 9, 2026. News Roundup: release date, demo, three trailers and the Bachelor's voice!