On Storytelling: Pathologic 2

Words: 3772 Approximate Reading Time: 25-30 minutes

Spoiler warning: Pathologic 2 is a game that is radically different to experience for yourself than it is to watch or read about. And so I strongly urge anyone not familiar to at least try the game for themselves and get through it if they can (but if you can’t, then feel free to watch someone else play). What follows is going to presume a decent familiarity with the game, its mechanics, and its storyline.

For the past several months, I have been absolutely obsessed with Pathologic 2. I’ve mentioned it in a couple other contexts already, but it has skyrocketed to being among my favorite games of all time. I’ve played through it twice and both playthroughs felt like significantly different experiences despite being the same core game.

And one of the things that hooked me fairly early on was the game’s narrative and theming. I’ve already written several essays talking about the integration of various facets of certain games into its themes – how not just the core narrative, but even components of the gameplay or music or world design all fit into this larger theme the game is exploring.

And one thing I have loved about Pathologic 2 is how thoroughly it integrates so much of the theme into its gameplay. How it messes with you as a player and compels you to think about what you’re doing. How it ultimately leads you to think about the game as a game and what that means for how you interact with it. There’s this fundamental beauty to its theme that has stuck with me, and I find myself thinking about the game again and again.

And so I wanted to write this essay as a way of sharing my love for this game in a more concentrated fashion. Not by alluding to it in various ways or talking about isolated components, but trying to share all of these components of the game and their central focus around a particular theme.


Fate is a curious concept within media. When you read a book or watch a movie or hear a story in any other way, the narrative you experience is fated. The story you see or hear does not warp or change. The characters perform their actions whether you are there to witness them or not. If you walk out of a movie, the movie will still play. If you close a book, the story still continues, though of course your knowledge of what happens has ended. Stories as we commonly experience them are bound by their fates.

But games in general, from video games to tabletop role-playing games to choose-your-own-adventure books, all have a more tense relationship with the concept of fate.

It would be easy to say that games eliminate fate entirely. After all, no two playthroughs of a game will be precisely the same, and so the player is never perfectly fated to do the same thing. This argument, of course, might not apply to games which are thoroughly linear such that there is no real player input, but let us set aside those examples.

But even taking this argument at face value, it doesn’t quite work. Because even if the individual journey differs in these small ways, the broad strokes are still there. Sure, if you play Mass Effect, you might have a different Commander Shepard, but you still have the same basic goals. You still need to visit these planets, learn these things, defeat these bad guys, and so on. Every Shepard is fated to defeat the Reapers, the question is simply how.

Hence why we can’t say that games truly overcome fate. Which is ultimately fine: they don’t need to in order to be games or to be interesting. Rather, the reason I bring this up is that games are still bound by fate to a degree. Even if you personally put down your copy of Mass Effect and never play it again, the story still technically continues. You don’t accompany Shepard, but Shepard will still go on to defeat the Reapers without you.

This is why I am so fascinated by games that incorporate the very concept of quitting into their narrative. Because they reach – or at least get close to – the idea of escaping fate as a boundary.

But if fate is going to haunt us as people who consume stories in all these different ways, what do we do about that?

Which brings me to Pathologic 2. Which is a game about fate. It is a game about fate in almost every ounce of its existence. And it is a game that asks you what fate means, whether you can fight fate, whether fighting fate is worth it, and what fighting fate looks like. In doing so, it asks you what your relationship is to the game itself – what it means to play a game, and to participate in that game both as a player and as a character.


So let’s start with the core story of the game.

You are a doctor named Artemy Burakh. You grew up in a small town located out in the steppe of an unknown country (but, let’s be honest, it’s Russia). Your father was the town’s healer and a respected man, and when you came of age he sent you to a university to study medicine. After some years away, you were summoned back to the town by your father. Only you find out quickly that he died soon before you arrived.

But that’s not actually how the game starts. Instead, you begin in a theater. As you exit, you chat with several other characters who tell you about how a plague has ravaged the town. You make your way through the streets to head to a cathedral, where two other characters are debating what to do. Neither cares what you have to say. And then a strange character named Mark Immortell offers you an opportunity. He says you messed up, but if you’d like he can send you back and allow you to try again. But he suggests it won’t matter: you’ll screw up again and find yourself right back here.

As both a player and a character this is confusing. For Burakh, this man is suggesting that he can literally turn back time. For you as the player, you are being told that previous actions you had no part in resulted in what you see.

This opening sets up a core theme: fighting fate. Because by going back in time, you are acknowledging that you can prevent this scenario from happening. You can change the world through your actions. It is a claim made explicitly by your character, and implicitly by your engagement with the game. And of course, Immortell suggests that you are fated to wind back up here. And so the question becomes: are you?

When you teleport back, you are treated to a cutscene where three men ambush Burakh as he’s stepping off the train. Burakh kills all three of them, but that leaves him with very little health. Hungry, tired, and bleeding out, you eventually direct Burakh to an old friend’s house, where you’ll be able to get a bit of sleep. There you have a dream: you see the corpses of the three men that Burakh killed, and you are given an opportunity to go back again and relive that experience. But, the question is, what will you do? Once again, the character offering this choice suggests that you can’t fight fate. That you’ll just do the same thing over again. And when you’re plopped into a 3-on-1 fight, you can win (which is admittedly quite tough, even if you’re seriously trying). Or you can just let yourself get taken down (which won’t kill you, since it’s a dream after all).[1] If you try to resist fate, you’ll find yourself almost completely depleted of health. But then, this teaches you a lesson: you can fight fate. But it may cost you.

Anyone who has played the game already knows I’ve skipped over several important things. Other places where fate is already mentioned and presented to you as something to consider. And yet, there is so much here that to cover every last bit would take more words than I care to write or that you care to read. Hence why it is ultimately so important to experience the game itself.

After you spend a few days in the town, there is an outbreak of an unknown plague. It is deadly, killing everyone that it infects, and it has no known cure. Medicine can stave off infection, or can postpone death, but cannot stop it.

Again, we have the theme of fate. The plague itself marks people with death: those who catch the disease will die. It is possible to save them, but doing so requires either very careful play and planning – plus some degree of luck – or else one of two very important items. These two items are the only possible cures for the disease in the game, and are themselves constantly referred to as miracles. The only way to fully fend off fate is through some kind of intervention that exists outside of reason and rationality.

So the story of the game is ultimately about you as Artemy Burakh trying to accomplish a few tasks. One, you need to figure out who killed your father. Two, you need to figure out what this plague is and try to develop a cure for it. Three, you have a list of characters that you need to protect from the disease.

So much of the game is working against you, essentially pushing you to failure. And this is to reinforce the central theme of the game. You were told that you were going to fail. And so will you reject that prediction and fight against fate?

The game can end in one of two major ways. You can succeed in your battle against fate, or not. Technically there are more possible endings, but I want to highlight those two ideas.

Firstly, you can reach the end of the game. There are a lot of ways that you can do this, but basically as long as you survive to the final day and complete one major task, you will have found some way to save the town. What “saving” means depends on a choice you make and the perspective you wish to take on the matter. Whatever the case, you will have successfully fought fate. And, in fact, you will be congratulated for doing so.

Secondly, you can take a very important deal. I won’t directly reveal what that deal is, but if you take it then you seal your own fate. When you try to complete the game, you will find yourself blocked off. You will have doomed the town, and you are effectively ejected from the game’s world.

Practically everything about this story, from its core narrative to the meta-narration presented to you as a player, focuses on this question of fate. Does fate exist, and is it something that is escapable? What does it mean to fight fate? If you succeed in fighting fate, what have you really accomplished? Is it even worth it? These are the kinds of questions that, with a little twisting of the terms, have haunted philosophers and other thinkers for thousands of years. To have these questions presented to us again and again over the course of about 20 hours is enough to make your head spin.


But as I said, the theme of fate is not just something that is communicated through the game’s story. Every single mechanic is in some way supposed to evoke the idea of fate, and your struggle against it.

Firstly, the game relies heavily on survival mechanics. You have health that can be depleted, you can get hungry, you can get sleepy, and you can get infected. Managing these meters is an important aspect of the game, because if you don’t, you will wind up dead…a lot. But these meters themselves are an aspect of fate. The need for food and sleep is inescapable. You can manage these things, but they cannot be avoided. And the trials that come with those meters are necessary as well. You will have to find the time to get food. You will need to take the time to get some sleep. The meters cannot be ignored. Or, again, you’ll wind up dead.

Speaking of death, death is practically unavoidable, at least your first time through. Hell, it’s easy to imagine expert players still winding up dead at least once or twice. Which introduces its own special mechanic.

Dying in the game warps you to the town’s theater. There, you are confronted by Mark Immortell, who tells you that you’ll be facing a punishment each time you die. You start by losing a bit of your maximum health, and then the punishments grow each time. By the end you can lose about half of your total health bar, lose a bit of your maximum hunger and exhaustion meters, and occasionally find useless items when you perform autopsies on bodies rather than organs.

The mechanic of these penalties is that they are permanent. They apply across all saves for that game file. So if you try to load up an earlier save because you lost a bit of health, then that bit will still be gone no matter how far back you go. The only way to remove the penalty is to literally start from scratch with a new character. And of course, you are warned of this fact. You can even tell Immortell that you’ll just be more careful about saving and be told that you can’t escape these penalties that way.

It’s also important to talk about infection. Not your infection, but the infection of NPCs. Specifically of special characters in the game. Each day the plague will hit different parts of the town, and certain characters on the list will be at risk. You can then make the decision to pay them a visit and give them medicine to hopefully stave off the infection, or leave them be. Whatever decision you make, at a certain time each day the game will roll the dice for that character, and then at midnight you will be shown the result. You can never get a character’s immunity to 100%, so there is always some chance no matter what that they can get infected even if you help them. And there is always a chance that they can avoid infection even if you ignore them. But this mechanic in turn means that whether characters live or die is more about fate than about your actions. Whether you helped or not isn’t really up to you, but is up to the game.

And last but not least, there’s time. Time is something else you’ll need to manage along with your other meters, and the need for time essentially presents the major hurdle to getting things done. Some tasks only become available on specific days and/or at specific points during the day. Getting to those places takes time. Finding food will take time. Sleeping will take time. And often you’ll find yourself faced with all manner of possible choices, not all of which you can complete. Time becomes oppressive, and constantly reminds you that you cannot escape or fight back. You will have to make choices and live with the consequences.

Now, all of these mechanics suggest that you are basically stuck. Yes, you can fight fate in the broad, story sense: you can “save” the town. But all of these meters, the penalties for death, time itself. These are things that can’t be fought. You can’t do everything. You can’t save everyone. Real fate is inescapable.

Or is it?

This is where the game comes alive as a game. Because the clever player can figure out how to manipulate these systems. And when I say “manipulate,” I don’t mean in the sense of using bugs or glitches. I mean it in the sense of understanding the rules of the systems and then using those rules to your advantage.

The meters themselves become hard to manage, but if you know how to effectively trade for items and get money, you can find yourself with an abundance of food, and can even find items that will reduce your exhaustion so that you don’t need to sleep. You still need to manage your meters, but they do not remain as deadly as they were before.

Dying results in a permanent penalty, and upon receiving the penalty you are kicked back to your last save. Even trying to quit and reload after you die results in the penalty. But…what if you just don’t die? What if you pause the game before you get killed and reload your last save? You didn’t die, so no penalty is warranted. This of course requires you to realize when you’re in over your head, but if you do so, you’ll be able to escape the penalty for death completely.

What about infection? As I said, at a certain time each day the game rolls the dice to decide whether a character gets infected or not. But if you understand how the system works, then you can essentially manipulate things in your favor. Is the game going to roll a high number for a character, such that it won’t matter if you help them? Then just ignore them and save yourself the time and medicine. Is a character going to get a low roll such that they don’t need help? Then again, save yourself the time and medicine. Does a character get a roll where your intervention might help? Then that is the character you want to visit. By using your saves, you can essentially use the game’s own mechanics against itself.

How about time? This is again where the aspect of the game comes crashing through to save the day. Because you have two things on your side.

First, the ability to save. As already mentioned, you can use saves to manipulate time itself. Did you waste multiple hours on a dead-end side quest? Why not just reload your old save and spend the time some other way?

Second, your ability to replay the game. Because, of course, the beginning premise of the narrative is “trying again.” Pathologic 2 practically starts as a second attempt. And in replaying the game, you get to carry with you all sorts of knowledge about the game. Which quests are important and which aren’t? Where can you find certain items? What will you need in the coming days, and how can you prepare for it all? That knowledge you have allows you to manage your time more wisely.

And ultimately, while it takes a lot of work and manipulation and some amount of luck, you can save everyone. You can fight fate in the grandest way the game gives you.

And this is what makes these systems so fascinating. Because I don’t think that these manipulations are “accidental.” By which I mean these are fully intended aspects to the game itself. The rules are set up such that a player can discover these workarounds and use them. You as a player aren’t necessarily “supposed to” discover them, as in you could play the game without ever thinking about the rules of these mechanics and how to abuse them. But I firmly believe that the developers understood that players might figure these things out, and expected these outcomes.

Because to use these systems is to embrace the theme of fighting fate to its fullest extent. Because the rules of any game are an element of fate: they constrain us in what we can and cannot do, determine outcomes that we may otherwise not wish for. It is by understanding these rules and using them to our advantage that we properly reject that fate – we take the tools that fate uses to keep us on track, and we weaponize those tools against fate itself.

Concluding Remarks

In a world where so many games and stories put you on some kind of narrative track and essentially expect you to follow that track to the end in one way or another, I find myself constantly thinking back to fate. How is it that we engage with these stories, and what does it mean for us to be an actual participant in them, rather than a mere observer? I can play a linear narrative in a game, and yet it is merely the equivalent of me interacting with a movie. My actions may get the character to the end, but they don’t matter. How do you make a player feel like a true participant?

And one way is by issuing a challenge to the player. “Can you do this? I’ll bet you can’t.” The opening to Pathologic 2 haunts me in many ways, and the explicit statement that it’s not worth me trying to save the town, because I’ll just fail anyway, is something I found myself reflecting on a lot. Because as I was playing, I had to prove that I could save the town. That the game was wrong. And it is that goal that not only kept me playing despite all of the hurdles the game threw up against me, but which allowed me to realize what I was doing. The game had issued a prophecy, told me I was fated to fail. And I had chosen to fight fate with every fiber of my being.

And yet, it’s all a game. None of it is real. I have saved so many characters, and let so many others die. None of it mattered, because they aren’t real people. And yet, I find myself wanting to go back in and save them. I’ve yet to do a playthrough where I save all of the special characters, but I want to, because I want to prove to the game that I can. That I can fight fate. And that on its own gives my interactions a meaning that is more powerful than saving entire cities or planets in other games.

[1] This on its own throws into question what the “fate” being fought even is. Burakh’s fate as a character is to kill the three men. But your fate as a new player is to lose. So is your fate to win or lose? This question itself rests upon another important question that lurks within the game: who are you?

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