Pathologic 3, the review: a psychological horror of difficult choices

Pathologic 3 is just the latest installment in a saga, albeit a very niche one, that has garnered mostly positive attention over the years. And perhaps fans of the survival horror genre have already encountered this franchise, and probably already plunged into one of those remote cities in the Russian steppes, namely Gorkhon.

The concept put forth in this franchise is very interesting: doctors must investigate a contagious disease called "the Sand Plague" that is decimating the population exponentially. And Pathologic 3 continues this trend, revisiting this mysterious plague and rewriting it in a somewhat original way: we will have only 12 days to save the lives of the citizens.

In this narrative, we will be Daniil Dankovsky, a true medical prodigy working for an organization searching for a method to "defeat death." Apparently, in a certain city, a man who seems immortal has been sighted: some might think it's a tall tale, perhaps a myth, yet the opportunity seems truly ripe to investigate this mystery.

What exactly is Pathologic 3?

We are talking about a Story Driven adventure, developed by the Russian team Ice-Pick Lodge, which focuses (as you may have guessed) with greater emphasis on a thrilling story, probably much more cryptic than the previous chapter. And this seems quite normal given that, in the mysterious and oppressive city of Gorkhon, all sorts of things will happen to us. What you will find yourself facing is an "episode" lasting a good 25 hours (or perhaps even a little more), which confirms an uncommon longevity if you add to this the presence of several endings.

As mentioned, we will be an amazing Russian researcher who will have to solve certain problems with a decidedly unusual ace up our sleeve: the ability to predict the future and discover what will happen in the coming days. And think about it, with such a capacity we will only have to solve the problem in the present... provided everything goes smoothly, of course.

We know, it all seems very convoluted, but trust us when we say that Pathologic 3 is not the simple experience you might imagine. Perhaps the authors were a little too brave to insert such a delicate mechanic into a formula that is already quite complex.

For most of the time, we will do nothing but talk to the various NPCs, citizens of Gorkhon who will not be at all brief: they will fill the screen with veritable "walls of text," speeches that sometimes might even bore you (especially if you don't have a good grasp of English). Fortunately, there's the Mind Map which will give us some hints about the main events and the various conversations we've had with all the enigmatic characters.

What is certain is that there will be moments of disorientation, where you won't be able to understand what to do to solve even the simplest problems. Also consider that, as the formula was conceived, Pathologic 3 does not record dialogues already had, and when time restarts, we will have to endure them all again. This aspect makes the experience more frustrating and not exactly digestible. And as if that weren't enough, if we don't remember the old answers, we could repeat the same mistakes again.

What is certain is that the story is decidedly multifaceted and difficult in some respects, but at least the characters have been monumentally characterized.

Pathologic 3 and its gameplay so... enigmatic

What we will face is not a raw survival game, where you have to take up arms and shoot down hordes of bad guys on every street corner. The experience as a whole can be seen as a Walking Simulator (also talking, let's face it) in which most of the time we will manage the psychic side of Daniil, the doctor who fights the madness looming over Gorkhon with rationality.

The gameplay itself is driven by choices and dialogues, and every decision we make (almost all of them) will influence the mind of our beloved doctor, pushing the indicator towards two conditions: an apathetic one where we will feel very slow, decidedly frustrated and which will push us towards the inevitable (and we'll let you imagine it) and another definable as mania. In the latter, we will feel more reactive, time will go faster but our heart could play tricks on us at any moment. The best solution is to keep the indicator in the center, and here some drugs to take during our investigations will also help us.

Another characteristic to consider is the amalgam, a substance that Daniil uses to travel through time and which, let's face it, is not found at the corner store. And here there is a big limit to the general formula: time travel is limited, and we will have to perfectly understand the moment to use it correctly. The bitter taste in the mouth remains, because in a video game like Pathologic 3, time jumps represent freshness, moments in which we could try something new and discover unexpected developments: limiting them was not one of the wisest moves.

One of the game's objectives is to eradicate the so-called "Sand Pest," that is, to prevent this plague from spreading by creating an effective vaccine. As you may have understood, we will have to visit various patients and diagnose a disease, so pay attention to everything the sick communicate to us. And don't think it's that simple because the information they give us could turn out to be falsehoods (perhaps even unknowingly) and lead us completely astray.

In a world crushed by the pandemic, difficult decisions must also be made to limit contagion: local authorities (after all) will give us control of the situation, allowing us to issue some decrees to contain this "mass contagion." This is where the somewhat strategic side of Pathologic 3 comes into play, which is overall interesting even if quite simple in its execution.

The neighborhoods that Daniil will visit are generally very quiet, where you can explore without any worries. The problem arises when we move to those governed by rebels, where bandits could be a real obstacle. Don't expect them to be so combative, however: just pull out a simple pistol and point it at them to make them stand still with their hands up.

The gameplay of Pathologic 3 itself is, strangely enough, mostly driven by its narrative. In fact, the difficulty is determined by the dramatic decisions to be made, the emotional impact experienced on every occasion, and the struggle against one's own self. All problems will fall upon us, and every incorrect diagnosis could prove more than fatal for our patients.

From a graphical point of view, there hasn't been a big improvement compared to the second episode: the NPCs have few facial animations and sometimes the movements seemed unconvincing. Technically speaking, we can never consider it a video game suitable for the current generation of consoles and PCs, not to mention some glitches or bugs we encountered during various explorations (fortunately the team is working to refine the overall usability).