The more you play Pathologic 3, the better it gets

I would describe my time with Pathologic 3 as a roller coaster; It's a cliché, but fits surprisingly well here. I began my journey intrigued and intrigued, fascinated by the oppressive environments and sheer boldness of the game design choices, and then the friction set in.

The mechanics frustrated me as I found myself resenting not only the stubborn characters that got in my way, but the game itself. It wasn't fundamentally fun to play and, as I went along, I drafted horrible versions of this review in my head. Then, around day 7 in-game, something clicked; a breakthrough It stopped feeling like a punishment and started to fill me with wonder and excitement. I haven't felt this way about a game in a very long time.

A distant view of the Polyhedron, a giant physics-defying building in Pathologic 3.

For those unfamiliar with the series, a brief primer: the games take place in a remote Russian steppe town built around the meat trade and ruled by three powerful families. A deadly plague called the Sand Pest has struck first, and now threatens to consume everything within twelve days. Pathologic 3 offers a graduated route through the story of this city, starring the capital's Danil Dankovsky, a doctor willing to defeat death, as the protagonist.

What bothers me is how well my experience with the game reflects Dankowski's own story. The Bachelor arrives in a town full of scientific certainty, but is quickly torn apart and subjugated by the events he witnesses. He has missed the basics and must rebuild his understanding from the ground up, and his reward is less futile than it originally appeared.

What the city does to Daniel, Ice-Peak Lodge did to me.

That's where Pathologic 3 shines

I covered a lot of the mechanical complexities in my preview – the Apathy/Mania system, the time-travel mechanics, the incredible patient diagnosis gameplay – and there my thoughts stand. What I wanted to save until I saw the whole thing was the way Pathologic told its story.

Danil is a scientist seeking immortality who comes to Town-on-Gorkhan to find a man who thinks he is immortal. As a hero, he's interesting, and I say 'hero' because he's definitely no hero, initially plotting to leave the town in its misery. You get a sense of his personality through his dialogue choices; He's a stuffy, highly educated blowhard who talks down to almost everyone he meets (sometimes in Latin!), dismisses local customs as superstition, and carries himself with the certainty that he's the smartest guy around.

He's not likable, but that's what draws me to him as a lead; At games like this, I always try to be a goody-two-shoes when meeting new people, but Danil won't let me. It feels free to inhabit his grateful persona and fulfill his role to the fullest.

What highlights Daniel's role are the moments where you really lose control of the dialogue options. The focus flips to whoever you're talking to, forcing you to read Daniel's dialogue and react as the previously non-playable characters he's talking to. Sometimes, it's used to subtly tutorialize a mechanic, but on other occasions, it's a brilliant way to give the player character center stage in a way I haven't seen before in a first-person game.

A near-death conversation with Daniel in Pathologic 3.

This is the meta-awareness of the compounding game. Daniel know He can manipulate time. He is aware of Amalgam's ability to break mirrors, revisit previous days, and change his decisions. It's not hidden from the story—the characters acknowledge it, the framing device of the inquiry after the fall builds on it, and the writing leans into this awareness with a kind of dramatic flair.

Mark Immortel, the town's mysterious theater director, talks to you like he knows you've been here before—because maybe, in a sense, you have. And when I say 'you', I mean you, the player. At some moments, especially towards the end, it feels excessive and heavy-handed, but the glimpses of meta-awareness are enjoyable.

Equally refreshing is the game's insistence that failure isn't just possible—it's necessary. You can't save everyone. The town's population will be thin, no matter how well you play, and the choices you make will determine who survives and who will be harmed. There is no true happy ending waiting at the finish line, no perfect race where every thread resolves into victory. Pathologic 3 asks you to accept that some people will die because of your decisions, and others will die in spite of them, and I respect that. Needing to go back in time to 'un-save' someone I previously kept alive because I'd be banned from day 12 otherwise felt like a knife to the heart, and I loved it.

Where Pathologic 3 collides

A corpse hanging from a lamppost in the infected district of Pathologic 3.

No Pathologic game would be complete without friction, and plenty of it serves the experience beautifully. Some systems, however, overstep the challenge into pure tedium. The Amalgam system is my main problem, as it sits uneasily between punishment and resource management. The concept that death and time manipulation require limited resources – is bold, but the reality is that you spend free days exploring dangerous streets because you forgot to talk to a person on day 4 or misdiagnosed someone on day 6. This is the type of system that allows you to plan forward. guesswork; You never know what the future holds for you.

What this turns into is the exasperation of the once engaging survival mechanics that now hinder the progression of the story which only leads to frustration. While most of the game traveled from point A to point B, it became a slog. Add to that a small number of bugged (but important) quests and tons of typos, and you'll end up feeling bitter about the time you spend playing.

For all its narrative strengths, the story falters in its final act. The game has you spend hours in the flesh – diagnosing patients, navigating political tensions, managing resources – while carefully planting hints of the unknown lurking beneath the surface. That foreshadowing works beautifully. The problem is the salary.

When the story finally turns to lucid visions and fantasy, it does so with a suddenness that feels less like light and more like whiplash. I understood what the game was getting at thematically, but the execution left me cold – disappointed rather than moved. After investing so many hours into the city's existence, the ending felt like it didn't belong.

But maybe that's the point. Pathologic 3 is about disease and friction and hard choices. It's not a game for everyone, and it doesn't try to be. It is demanding and deliberately ambiguous, and asks you to embrace failure as part of its teaching method; That will turn people away. But for those willing to meet it on its terms, it offers one of the most thematically rich and emotionally resonant experiences in recent memory. I wouldn't go back in time to escape this roller coaster, but I don't want to live through it all again.