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Pathologic's ambition and atmosphere made it easy to praise, but hard to enjoy

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In this classic feature, Quintin Smith re-reads the grubby entrails of cult classic survival mystery Pathologic.
We’re digging into the PC Gamer magazine archives to publish pieces from years gone by. This article was originally published in PC Gamer issue 214, June 2010.
In the past, I’ve described Pathologic as:
(1) “An errant hypodermic needle thrown into a children’s ball pit.” 
(2) “A Nick Cave ballad brought to unlife in hideous 3D.”
(3) “The single best game you’ve never played.”
Following this weapons-grade hyperbole, imagine my surprise on returning to find it’s even better than I remembered.
In case you don’t remember Pathologic at all, it’s an epic arthouse open-world game made by Moscow-based developers Ice-Pick Lodge. Before you even reach the character selection screen, you get a theatre performance of your three options bickering about which of them is best suited to defeat the coming crisis. Anyone unfazed by this will at least raise an eyebrow at the choices themselves: Bachelor, Haruspicus, or Devotress. Which roughly translate as doctor, shaman, or shackled messiah.
Your enemy in Pathologic isn’t a villain, but a disease. You arrive at a hick Russian town the day plague breaks out. It’s your job to fight it and keep the terrified community from imploding into violence as time runs out and the death toll spirals into the thousands. There’s lots of first-person combat too, but it’s a sad essential rather than anything exciting.
Instead, heroism in Pathologic is found in conversations, or jogging across town with a bucket of blood samples in one hand and a revolver in the other while stifling the groan that’s been swelling inside you for days like a slow-motion explosion. Actually, heroism is playing Pathologic at all—the game is a tinny, shivering nightmare, unpleasant in almost every respect. Its ambition and atmosphere make it the easiest game to praise, but the hardest to enjoy.

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