Review for Pathologic 3: Quarantine

Pathologic 3: Quarantine is a narrative-driven, free-to-play Prologue featuring a mysterious plague ravaging a small town. Players step into the shoes of young but accomplished scientist and doctor, Bachelor Daniil Dankovsky, whose search for immortality has made him a target. Through investigation, interrogation, and patient examination, Bachelor fights to decipher the “Sand Plague” before it is too late.

With its eerie urban setting, Pathologic 3 immediately establishes a compelling atmosphere – the looming, ominous undertones appropriate for a disaster-riddled city are captured in muted tones and the somber soundtrack. With Bachelor serving as the point-of-view protagonist, players step into the shoes of a physician in an unsettling landscape of discarded bodies, dancing fire-creatures, and occult symbology.

Dialogs will often change point-of-view perspectives in the middle of a conversation, which is jarring at first. The player begins by choosing dialog responses for Bachelor then, suddenly, they’re choosing responses for the interviewee. Once the initial surprise wears off it’s a refreshing take, giving depth to the interactions and a better perspective of who Bachelor is in the eyes of others. This creative choice does an excellent job of preparing the player for later aspects of the game, specifically the medical examinations and inherent puzzle-solving requirement of diagnosing illnesses. Characters in the world will lie to you, either intentionally or via omission, and an opportunity to be in their shoes is a treat.

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Thoughts appear as floating text when Bachelor looks at other people and objects, giving insight into the good doctor’s mental process, fears, and observations. This title does an excellent job of enhancing the narrative experience with this mechanic without adding too much to already extensive information. When Bachelor interacts with others in the world, the dialog options are compelling and choosing one response from several is often a difficult task. Characters will make statements, verbally, that do not correspond with the dialog choices, but otherwise the conversations are not narrated. The disjointed conflict in words leads to the impression that Bachelor is coping with some sort of mental instability.

The mechanic to examine an area for interesting objects is an excellent way to avoid floundering on the part of the player, and Pathologic 3 encourages exploration and deep investigation of the scenes with this mechanic in areas without imminent danger. Similarly, examinations of patients are cleverly done. Characters come to life behind the curtain and players conduct a physical examination while collecting symptoms, complete with animated “reversal” options for regions of the body. Zooming in to look more closely, or rotating the camera for a new angle, deepens the immersion.

At first, the Casebook is an overwhelming amount of information, but navigation is easy to learn and quickly a wellspring of details. During a patient examination, the player can consult the Casebook for suspected symptoms and potential diagnoses, read details from the medical chart, and note subtle details like date of admission. By process of elimination, which is genuinely challenging given that players don’t receive 100% matches, conditions and ailments can be crossed out in the Casebook to narrow down the possibilities. The combination drops the player into a Historical Physician Simulator.

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As the third installment in a series, Pathologic 3 begs the question: Do players need to have played the previous two titles to understand the story? While there are plenty of callbacks to prior chapters in the saga, Pathologic 3 works well as a stand-alone experience. Confusion around the plot appears intentional; an unstable, unreliable narrator, a world suffering from a mysteries disease, city patrons who are not what they seem, are all elements that create a deliberate lack of understanding. That’s part of the charm with Pathologic 3 – the player is primed to experience unfolding events with the same lack of certainty as the protagonist. 

However, with a confusing user interface and the frustrating lack of a tutorial, Pathologic 3 pushes the envelope as to what aligns with an undependable narrator delving into questionable storytelling. Given that Bachelor is a physician, certain mechanics should be explained and not left to haphazard experimentation. By leaving the player to struggle to decipher inventory items, remember illness symptoms to correspond with the journal, and even humanely euthanizing the sick on the streets, the connection to Bachelor and his wealth of expertise is diluted into frantic trial and error.

This lack of instruction is where Pathologic 3 struggles. Some mechanics are punishing, but at least well-understood. For example, the agony of a highly limited stamina pool that creates a sense of desperation by denying the player an urgent escape. Or when traversing the world with a vague map as a guide means entering highly dangerous areas, where Bachelor’s only defense is an attempt at intimidation by raising a revolver at would-be attackers. Unfortunately, the duration of the enemy hesitation is brief, and it is easy to get overwhelmed and defeated by multiple assailants, especially towards the end of the game. Enjoyment of the ominous world is diminished when the player must frantically run through a section of the environment to survive, leaving little time to appreciate the unnerving scenery.

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These design choices compound the greater issues, which are the confusing inventory system and the mania/apathy dynamic. The latter is a ticking clock on the player’s screen, but the only way to manage these two aspects of Bachelor’s health state is once again experimentation and trial and error. Selecting the wrong medicine makes apathy skyrocket, and Bachelor will choose to eat a bullet rather than continue his story. More clarification around how to manage time – but especially treating apathy mania – is a reasonable expectation when the point of view is that of a doctor. Leaving the player adrift without guidance on even basic mechanics goes beyond the perplexities of an unreliable narrator.

Ultimately, the Pathologic 3: Quarantine Prologue accomplishes what it sets out to do, whetting the appetite for more details about the story, this plague, and the reason for the outbreak. Bachelor is established as a determined, moderately arrogant scientist who isn't concerned about retaliation by his superiors, and he isn’t afraid to get his hands dirty. Players encounter enough story threads to mandate further exploration in a subsequent release, and the cast of characters are as compelling and complicated as the world itself. Running around 3-4 hours in length, this opening chapter in the third installment of the Pathologic franchise paints a bleak picture of suffering, dark medicine, and the struggle to keep your humanity when faced with horrible odds.

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The game would benefit from some user interface tweaks, especially inventory management and item usage, though the greatest need is in basic explanations of game mechanics. The duality of mania versus apathy is a fun twist on the psychology of Bachelor, but players need to be empowered to manage these dynamics – especially while occupying an erratic protagonist. The story, cast, and world provide enough grounds to question Bachelor’s experiences and the truth of every situation, and explicated mechanics won’t diminish those foundations.

Pathologic 3: Quarantine does an admirable job of putting the player into a bleak world by using screen effects, an excellent soundtrack, and witty dialog, while promising to further expand upon these themes in later releases. This freeware Prologue is a fun – if frustrating – trek into the latest Pathologic story, and minimal clarifications or a stronger tutorial would go a long way to improve the gameplay experience.