Pathologic: All the World’s a Stage

Pathologic is a survival horror that is often referred to as a plague simulator. It is a first-person game that relies very heavily on text quests.

Is Pathologic by Ice-Pick Lodge worth your time? Is it worth trying to get through the clunky graphics and bugs? Is it worth trying to learn the not very simple to master mechanics? Well, it is pretty common to view the game’s writing, plot, and characters as the best part of Pathologic. Let’s try to review them without spoiling too much.

Pathologic and Its Plot

The original Pathologic is a survival horror that is often referred to as a plague simulator. It is a first-person game that relies very heavily on text quests while throwing in a brawl or two just to keep you on your toes. You will be playing as one of the three doctors who arrive to the Town at the same time. And as you play, the other two doctors will be completing their quests too, sometimes making it harder for you to live through another day. The main characters are Daniil Dankovsky, who is a Bachelor of Medicine, Artemy Burakh, who is a surgeon and master of the traditional medicine of the original people of the Steppe, and Clara, who seems to be a holy healer. Or, perhaps, a steppe demon, it is not clear.

The main characters of Pathologic
The main characters of Pathologic: Bachelor, Haruspex, Changeling, the Town, and the Theatre

I will not spoil the entirety of the plot here, but I will tell you that the town is a very curious place. On the one side, there are the Abattoir and Termitary, which house most of the Steppe people who had lived there before the town was built. On the other side, the rich quarter of the new settlers is situated along with a miracle of architecture, the Polyhedron. You, as the player, have to answer this question: can these two worlds coexist?

The Mysterious Polyhedron
The mysterious Polyhedron, a miracle of architecture

The plot is very curious and takes some time and determination to fully unlock. Pathologic has layers, in which the game’s plot has a metacommentary, and that metacommentary has some more metacommentary. The game considers the concepts of life and death, futility and self-determination; it toys the ideas of both child play and theatre play while talking to you as the player. Pathologic brings these ideas forth both subtly through the gameplay or plot and directly through your conversations with the main NPCs.

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The main NPCs are a lot of fun to interact with. They often have things to say outside of your usual interactions with them, and while it might be difficult to find the time to visit them when your daily quests do not require you to, it is worth a try.

Executor and Tragedian
Then, there are Executors and Tragedians. Wonder what they are all about

Mechanics-wise, though, the plot and characters are there to make your life miserable. The town is not ready for a plague, and Bachelor will have to run around, trying to fix that and reduce the death toll by developing a serum that prevents the infection. Haruspex will be looking for the cure while trying to figure out who killed his father and taking on his responsibilities as the leader of the steppe people. And Clara needs to figure out herself (and her twin sister) because she does not remember who she is. She will also be struggling with the often-lowering reputation as people try to decide if she is a steppe demon or a god-sent healer. All the while, the NPCs will be lying to you, using you to their own ends, and generally being unhelpful to the point of sometimes failing your quests. The characters in this game do not exist for your sake; they have their own minds, and you might be the main actor in this play, but even your intervention is not that meaningful.


Pathologic has a deep and rich lore and plot, and its characters are well-written and fleshed-out. We do not want to spoil too much; you can check out more information in the game’s wiki; just be aware of spoilers! What we want to say is that Pathologic offers a unique narrative experience, and it may well be worth trying, provided that you want to deal with its bugs and are ready for the challenging mechanics.

Our Rating

9 / 10



5 / 10



5 / 10