Pathologic 2 occupied my mental state. I had a tetris-like experience with it, when at some point my dreams became Pathologic as I kept seeing the imagery of the town and contant time opression. It's such an engaging game and the most surprising thing about it is how enjoyable it was to play. If you try to break it down to basics then you can describe Patholofic 2 a routing/resource management game. Each in-game day you have several objectives to fulfill which will be sparsely spread around the town and the aim is to create the route optimized, ideally, for the best time and most conservative resource expendeture. As you come to grips with mechanics and learn the structure of the city you also learn how to circumvent cutthroat resource drain through exploration, barter, crafting and timely task fulfilment. But Pathologic wouldn't be Pathologic if it didn't try to bring you back to your knees when you start to get a handle of the whole process. The game constantly throws curveballs in your plans by changing the state of the world and even its own rules each new day of the play. This an ever-regressing world and as one of the most important people in the town you gain opportunities to slow down the degradation, but since mistakes are unavoidable you will find yourselves in situations when you have to give up something important. While struggling for your own life you'll probably have to stop pursuing a goal, or give up a chance to gain information, or maybe you'll have to bet on the life of a story character. Dialogue and character interactions themselves become the reward in such an opressive gameplay flow. The journey to unfold the nature of the cosm is full of pain, dread and sorrow, but it's also one of the most rewarding gaming experiences you can have. Masterpiece

A beautiful miasma. Lies and death. There's no joy to be found here, only a deeply uncomfortable test of character. And I wouldn't have it any other way.
One thing I find so fascinating about Pathologic is how it manages to be a true "Role-Playing" game despite lacking the stats, perks and numbers commonly associated with such. It's not just that the writing is staggeringly good, it's that Pathologic understands that playing a video game is like acting out a script - that you're an actor on a theatre play. You're given a prefabricated role to play on the stage, but what differs is your portrayal of the character.
Does Artemy believe in the steppe tales? Does he want to take his place among the Kin, or is he more reluctant and skeptical? Does he still care about his old friends, even seeing what they've become? There are a great deal of dialogue options in the game that shape your understanding of your character's worldview and desires, through the ethically fraught choices and even the mundane ones.

Amazing atmosphere, great writing, interesting story. Only reason I abandoned it is a basically mandatory (it isn't technically mandatory but not doing it would make the story feel incomplete) section near the end of the game that suddenly forces you to fight after being able to just run from all your enemies throughout the entire game, and it's frustratingly difficult without being any fun or me understanding what I was doing wrong.
Still worth a try, maybe you're better at combat than me, or even just to enjoy the game up to that section. I hope Bachelor and Changeling will be even better.

One of best games ever made, expertly crafted systems to convey the opposite of a power fantasy, a hard game but not to necessarily create a sense of satisfaction after beating it but to make you empathize with the harsh conditions of the world that the characters are living in, you are as likely to die as any character of this game, the only advantage you have is you're a doctor an you can treat yourself and another people, however combat is not your area of expertise and even an 1v1fist fight can be pretty dangerous, not that necessarily you're gonna die but you can lose a big amount of health; in the case where there is a 1v2 or 3 fight or someone of them has a knife, you can die pretty easily even if you have a knife of your own. There are guns in this game but then again you are a doctor and therefore it's not something easy to use and maintain, reload times are larger than one might expect, the gun can jam at any moment when you use it enough and ammunition is rare and expensive, doesn't mean that having a gun is bad, it can get you out of situations fast but you can't abuse it, this game is not about shooting your way out, this is a game about making decisions to survive and find a cure.
One can talk about a lot of things this game does right, how genius some design decisions are, how well written the story is, how every system and detail the games has comes together to create this unique experience, where other games force you to make moral, scripted and sometimes binary decisions, the systems from pathologic 2 create those harsh scenarios naturally; where other games try to make feel sad for killing some random NPC they forced you to kill, pathologic 2 systems CAN even make you consider to kill CHILDREN in your most desperate moments without forcing you with scripts, it recognizes that even if killing can be cruel... bad times can make you do cruel decisions, and if you want to survive in these times you have to take some extreme decisions.
You can't save everybody in this game... and that is what makes it exceptional.
I'm eager to play the other two characters Ice-Pick Lodge are developing and I hope the best for them.

This is probably the best art game I've ever played.

Though it doesn't have a style like a painting, or cinematic motion-capture drama, or a call-to-action moral, it stuck with me more than any game. P2 is an art game because it uses interactive elements to force a subjective emotional experience on the player. Pathologic 2 is a stressful, punishing, obtuse experience -- but always for a reason. Fumbling through the campaign mechanically encourages the player to consider the game's written themes and reflect on themselves as well as their own beliefs.

Without getting into spoilers, this game made me reconsider how I live my life and how I work on personal relationships in my real life. Very, very few games can say they have had that kind of impact on me. Maybe none?

Pathologic 2 definitely is NOT for everyone, but if you like what I've described, or enjoy any of the following games, please consider buying it:
-LISA: The Painful RPG
-STALKER
-Morrowind
-EYE Divine Cybermancy
-Rain World

"Reality and fiction walk an incredibly thin line throughout Pathologic 2. There is a constant sense of self-awareness which cuts through the provocative writing. Some may call it “meta,” but the game doesn’t temper its audience with discussions regarding our relationship with artificiality, which modern day indie titles so often seem hung up on. Pathologic 2 is obsessed with fiction, with perusing our collective confusion within an ever-increasingly unstable period of worldwide disorder."

You can read my review over at Project Icarus Gaming:
https://pig.gg/an-ode-to-pathologic-2-the-best-game-of-2019/

Note: This review contains no direct spoilers, but it does pull the curtain on how the game works in a general sense. If you're interested in the game, I recommend against reading it and just starting your playthrough.

Reacting to all of a player’s decisions is a common goal for games, but it simply isn’t possible. Doing so would require not only creating reactions for each choice, but for each set of combinations, leading to infinite complexity. The real question is how games that use decision making as a focal point are able to fake the reactivity in a way that still gives choices impact. Telltale games typically let choices affect the player’s relationship with other characters, but not the flow of the plot itself. Bioshock Infinite’s choices don’t end up mattering at all, with director Ken Levine’s philosophy being that the real impact of decisions happens in the player’s head, not in the game itself. These could be interpreted as lazy or misleading ways to sell a game, but as mentioned before, developers have limited resources and need to ensure their effort is used economically. It’s this principle that allows a game like Pathologic 2 to exist at all, promising a town full of radiant choice and consequence from an indie team on a relatively small budget. The player’s goal is to stay alive as a doctor in a steppe town overrun by plague, and save as many people as you can. There are about thirty named characters to keep track of, and generic townspeople you can trade with or heal to manage your supplies and increase your reputation. You have to survive for about ten days, making deals and compromises along the way to make it out as best you can.

So, with the aforementioned need to compromise, where does Pathologic 2 stand on the reactivity spectrum? Oddly enough, it falls closest to Bioshock Infinite, with the vast majority of choices having no discernible impact. The game emphasizes how the plague is random and how you can’t save everyone, so the cast mostly consists of disposable characters who could die and leave the story unaffected. Ironically, this also forces the few plot-critical characters to be totally immune until the plot says so. The endings suffer a similar irony, where a theme of nuanced decisions is filtered into a binary choice so the narrative can have structure. This recurring mismatch between a focus on player choice and the limitations of a set-narrative structure might be Pathologic’s fatal flaw, especially when the plot exists more as a framework for decisions than a narrative in its own right. If a game is about tough judgement calls, but as a result can’t present any real consequences, isn’t the design an inherent failure?

It might be tempting for me to answer that with a “yes”, and use it as an example of why most games with choices keep a tight leash on their narrative structure, there’s still the mental half of the decision making process to factor in. Players recognizing the pointlessness of their decisions at the end doesn’t matter when they felt real in the moment, and with media being inherently artificial, the real pointlessness would be in trying to convince people that their actions did have consequences. For most games, I would say this interpretation is giving way too much credit, but Pathologic has a recurring theatrical motif that fully acknowledges the artificiality of the drama. The truth is that the intention was never for players to have narrative agency, but to be like an actor in a play. The script may be unchanging, but the emotions and energy brought to a role can add a different life to the same material. The changing circumstances of the player’s survival helps shift this context in this way, creating a narrative arc that is tied to the process of decision making in itself.

I’ve fluctuated between these pessimistic and optimistic viewpoints of the game, and it’s been difficult to draw the line between flaws and intelligently acknowledged limitations. Analyzing the game’s structure in a vacuum makes it easy to be on the positive side, but the dryness and repetitiveness of the actual moment-to-moment interaction puts me on the negative side. Fans will counter that the game’s not exactly supposed to be fun, I might counter that it should at least be engaging, there’s never an easy answer. In everything from the minor details to the overall structure, the line will be drawn based on how much you’re willing to entertain the game’s artistic ideals, rather than them entertaining you. While I wasn't a fan, I still respect the game immensely for committing to an artistic vision that a lot of people would never have the patience to try. It’s a game I can’t exactly recommend, and can’t even really say I like, but trying something new and broadening your horizons will always be an excellent choice.