But this is the thing - all this withholding of information, fracturing of narrative, narrative structure, mechanics and form and incredibly deliberately mundane and even deliberately boring opening few hours and its gruellingly slow pace are all part of one coherent goal, which is that EVERYTHING in
Pathologic is designed to slowly grind the player down and get under the player's skin and EVERYTHING is about the slow turning of the game against both the player and the playable character so that, what at first seems mysterious and intriguing, gradually but relentlessly, and entirely unstoppably, becomes utterly overwhelming and suffocating - this is why I found it so emotionally engaging and why I've never played another game which was so compelling while at the same time being so emotionally exhausting.
...
Pathologic has by far and away the best survival system of any survival game I've played in terms of how it uses its system to create emotional engagement. It features 6 main survival mechanics - reputation, health, immunity, hunger, exhaustion and infection (as well as having to chose differing clothes which help protect from melee attacks, gunfire, fire and infection respectively) and these survival mechanics are all balanced heavily against each other. By this I mean, if you are feeling hungry you might find a lemon or raw meat, these quench your hunger but may weaken your immune system. You may feel exhausted and need sleep but while sleeping you cannot eat or take medication so your hunger will rise and your immunity levels will drop. You may be out of food and need to attack innocent people to get some simply to stop yourself starving to death, thus causing your reputation to diminish etc. etc. Trying to increase one of your survival mechanics may cause another one to decrease and so on, so there is this constant balancing act going on and make no mistake, balancing these survival mechanics is hard, especially for the inexperienced player and you will die A LOT - But that is exactly what makes the survival system so great - it's always nagging away at you, never giving you a moment's rest as the time ticks on and it creates this incredibly stressful and emotionally dejected feeling which really allows you to experience the situation and unrest the plague has caused and allows you to understand the rationale behind the characters - and this is sense of tension is only increased even further once you catch the Sand Plague (and you
will likely catch the Sand Plague at some point - there's nothing to fear from having it, in fact the game becomes even more engaging once you actually do catch it) - while you have to balance various pills and medicines, particularly before going to sleep - some antibiotics such as Neomycinum, Monomycium etc. which can reduce the level of infection but at the cost of your health, these need to be covered by Analgesics such as Meradorm, Novacaine etc. which build your health in your sleep to stop the plague from killing you in your sleep. It's a beautiful and tense balancing act that goes on, but getting your hands on these drugs in the first place can be just as stressful.
It's not just in that it creates emotional engagement in the sense of constantly being on the verge of death and needing to survive, but because, when coupled with the time-management needed in a perpetual, changing gameworld it also opens so many options with regards to organic player choice and getting the player to forge their own story, rather than simply selecting choice through binary or tertiary decision trees, as well as the changing nature of the town's economy. The economy was based on the World War I economy of Eastern Europe to represent the panic of a disease ridden town and it is merciless. Money is scarce so trading is the general way you are going to get things, the only problem is that shopkeepers have all the power and the town is quarantined off so basic amenities such as bread, milk and medicine all become ridiculously overpriced. At times you will have to hand over weapons, bullets and protective clothing all for a loaf of bread just to stop yourself dying of hunger. The economy only gets worse as the days go on and shortages of different things (food, medicine, clothing etc.) means they fluctuate day to day making it unpredictable as to what you need to hoard adding to the tension even more. There are other ways to find resources though - scavenging bins around town to find trinkets and bottles will allow you to help trade with the townsfolk. Sharp things can be traded with children for ammo and sometimes food and bottles can be filled up with water at various water tanks round town and traded with drunks for bandages and tourniquets. Thieves and murderers who come out at night and start you can also be killed and then robbed of money, lockpicks and resources (and, while playing as Haruspex, their organs) and finally, you can break into people's houses and steal their final resources from their own home.
Houses in diseased districts can be looted, however there is high risk of catching the plague in them. Houses in "cleansed" districts can be broken into but are full of looters who will attack you on sight. The most lucrative place to find items is in houses in non-diseased districts and although these are not open as they are in diseased or cleansed districts, lockpicks can be found on robbers or be bought at Grief's warehouse on the black market. However, it's incredibly disconcerting when you start robbing people's homes and the men of the house start trying to attack you to defend their home and it's amazing how much this got to me. That was perhaps the greatest and most creative aspect of the economy - the way it made me feel guilty. At the beginning of the game, I wanted to be as nice as I could, but survival is so difficult I was forced to break into people's homes and steal their things, even kill a couple of innocent men simply trying to defend their homes and it surprised me how genuinely bad this made me feel, but it's testament to just how beautifully designed
Pathologic truly is - and this is what sets it apart from much more mechanical emotional engagement in games like
Shadow of the Colossus or
Planescape: Torment where the sense of guilt is deliberately laid out to the player through the narrative by telling the player they'd done things they unavoidably had to do to progress and had no choice over if they wanted to reach the end of the game, which don't get me wrong, is fine and those games are effective at making the player feel a sense of guilt. However,
Pathologic for me was so much more effective at creating a sense of guilt because it happened entirely organically, it happened through the way I was actually choosing to play the game myself, not because I'd made some choices out of a variety of selections from dialogue choices, or because the actual written narrative made me feel guilty for doing things I had to do to progress the game (after all, the only thing you have to do to progress the game in
Pathologic (after the first day), is to simply stay alive), but because
Pathologic drops you in a desperate situation and tells you to survive how you like, but its ultimately its presentation of organic choice and getting the player to tell their own story of how they are willing to survive in this desperate situation which make it shine so well.
Here is a nice illustration of just a few small examples of the way Pathologic presents organic choice which is pretty cool
...
The town's ever changing nature and aforementioned slow transformation as it becomes more and more chaotic as each day goes on is also another factor which make
Pathologic so emotionally exhausting. It's a cliché of
Pathologic reviews to use this sentence but I'm going to use it anyway because it makes such sense, but: much is talked about in open world games in trying to create a
"living world", whereas
Pathologic does the opposite: it creates a
"dying world" and by doing so creates this incredibly lively and riveting environment. Day by day, different areas become infected - different characters are introduced and react through different events. Riots begin to happen, military men with flamethrowers come in to stop the infection spreading. The sand plague becomes more and more potent as the days tick by and the town, its economy and its people begin to become more infected and more panicked as a result. Again, the tension in the game just builds and builds in such a slow, scrupulous yet incredible way. There's often an obsession with post-apocalyptic worldbuilding in gaming, but
Pathologic creates something much more beautiful because it doesn't deal in post-apocalyptic themes, or post-apocolyptic worldbuilding; it deals in
apocalyptic themes and
apocalyptic worldbuilding which so, so few games do, despite the fact gaming is the perfect medium for doing so, as its much more affecting to actually be part of the event and deal with its devastation first hand and actually play a part in the chaos it causes, rather than simply walking through the aftermath of an event and seeing the devastation it caused.
...
This is heightened further by the game's ugly, but beautiful artstyle and "uncanny valley" character design. The town us ugly, diseased districts look like their houses are growing bulging red tumours and a turgid orange glow resonates around "cleansed" districts, but the game makes incredible use out of its dated graphics engine! The limited draw distance and strange rain physics fit the atmosphere of the game perfectly, as do the bizarre character models, who's eyes all seem to be several inches too big and all seem to walk with a strange-limped slouch, but each character design and model certainly has character and are incredibly memorable (the executors and tragedians have probably become the most iconic images of the game and there are certain areas which I won't spoil and one in particular which are absolutely breathtaking and clearly an influence on
Ice-Pick Lodge's follow up game
The Void[Тургор]) and really suit the unique attempts at bizarre worldbuilding within the game.
But even though the world can be ugly and lonely, there is something incredibly beautiful about it. Something incredibly beautiful about the derelict ugly houses, the identi-kit character models all the same in the eyes of the plague, as it chooses its prey both directly and indirectly, its representation of working-class Russia. And this is definitely something Eastern European and especially Soviet games seem to do so well - it's the same with
The Void[Тургор],
Knock-Knock, the
S.T.A.L.K.E.R. trilogy, the
Metro[Метро] games,
This War of Mine etc. etc. - this decrepit beautiful worldbuilding in which sometimes it's just the smallest ambience (both of a visual and/or aural nature) will set me off - a bark of a dog somewhere in the distance or the sound of rain as you're wading through the empty steppe at the southern part of town, or the autumn leaves wafting in the strange orange glow of the sky which were enough to give me shivers all over. There's just something in the relentless and consistent worldbuilding that means often the most chilling moments are entirely organic of the world and nothing to do with actual set-pieces or individual moments or characters. The soundtrack is another thing which I found really helped the game get slowly under my skin. At first I didn't think it fitted in with the atmosphere of the game at all with its eclectic mix of ambient and world music, but again, there's just something about its incessant droning and chanting that just burrowed itself so deep under my skin and grew and grew on me until now I absolutely adore it and in fact it's one of my most listened to albums! In fact, I often listen to it while walking along the street, especially after dark and it will never fail to give me chills all over.
And it's all the combined together, which make
Pathologic such a gruelling and emotionally engaging game which manages to elicit feelings of awe, beauty, frustration, guilt, exhaustion etc. through both deliberate and organic means in a way no other game I have ever played has managed.
Pathologic isn't just about building atmosphere therefore by reaching a certain point in the narrative and then a cut scene happens.
Pathologic isn't an interactive film, or an interactive tv show, it's a video game, it knows it's a video game and it wants to make use of the advantages of being a video game - it's about watching a slowly decaying town in front of your eyes and trying to survive
yourself within that, possibly helping or possibly not helping people, if you can drag yourself away from going to get some clean water to survive. And that's where the enjoyment lies - it's a game about experiencing a shut off plague-ridden town and interacting with people within that town.