Many characters in Pathologic 2 hide their faces behind masks. There are the bird-like creatures who loom ominously in black cloaks and speak through the beaks of bony plague doctor’s headwear; there are the personified psychic reflections of characters, figures in skin-tight leathery leotards and surprised-looking white masks; there are town residents infected by the “sand pest” plague decimating Pathologic 2’s setting, who stand motionless or shamble through clouds of animate black pestilence in mouldering grey burial shrouds that reduce their physical individuality into a kind of pre-corpse.

All of these masks serve a specific aesthetic and thematic purpose—every bit of Pathologic 2 swells with meaning, sometimes just out of touch in dreamlike fashion and sometimes brutally clear—but they also work more broadly as an immediate visual cue that connotes obscurity and secrecy, illusion and hiddenness. When players begin the game, they’re thrown into the role of Artemy Burakh, called “The Haruspex” after the ancient Roman entrail diviners, as he arrives in the remote Town-on-Gorkhon. Everything about the situation is mysterious. The town’s culture, politics, and even Artemy’s immediate history are initially inscrutable, reality and fantasy merging in strange dreams and nightmares featuring the game’s cast—hazy omens that augur the days to come. What's actually happening in the Town seems impossible to tell. Everything, at least initially, is hidden behind layers and layers that are eventually, like a mask, removed to reveal the game's true face.  

What's immediately clear, though, is that Artemy and the town’s residents are facing an increasingly dire situation. People have been getting sick and the closest thing they have to a government—three families who control the Town's beef industry, architectural planning, and legal system with varying degrees of authoritarian power—don’t seem to have much help to offer beyond hoping that Artemy, a surgeon newly returned from a distant city, will cure everyone. Unfortunately, Artemy is one person. And he’s one person whose allegiance is split between sometimes opposing factions ranging from the town’s wayward gangs of children and his scattered group of old friends to the animistic steppe culture of the Kin urging him to pay more attention to the rhythms of the natural world than his knowledge of university-approved medicine. The player and Artemy have no time to acquaint themselves with all of this, though: the plague begins choking the town even before it’s possible to figure out where Artemy should sleep or the best way for him to enter into a web of above and below ground food, drug, and clothing markets.  

Coming to grips with Pathologic 2’s world is a tense, desperate, and enthralling process of violent anthropology. Death comes easily and frequently. Artemy will starve. He’ll be beaten. He’ll contract the plague. But each time he’s reborn, bearing new afflictions from his setback, he will continue on in an attempt to tend to the town’s population. Artemy may fall to the ground, a nauseating black fog or pulsing layer of bloody muck clouding his vision, only to wake up to be taunted by a clownish director in the temporary limbo of an abandoned theatre. Each time he (or, as the director calls him, the next actor) returns to the physical world, the town is coloured with an even greater sense of desperation. Artemy will be even weaker, still in the same horrible position he was in before dying before. The map’s icons are still in place. The town is still diseased, dying, and in need of a surgeon like Artemy to do what he can to help. There's a sense to all of this that he's alone against a problem too huge for any one person, no matter how determined, to solve. It's frustrating. 

The question of why Artemy (and, of course, the player) would want to struggle through this is, on one hand, answered by the drive to understand the Town's mysteries on an intellectual level—to hear an unfamiliar dialect spoken and come to understand it conversationally—and, on the other, to persevere through the pain and misery it so capably presents in order to reach, hopefully, some kind of enlightenment, big or small.

“An open wound is a window into the world,” the plague says in the hoarse voice it sometimes uses to address Artemy, and the player knows this is true. Inside the game, death is a teacher in the way that so many games instruct through mortal failure; outside of it, we feel a nearly instinctual urge to persevere through Pathologic 2’s miseries to see what life looks like on the other side. From following Dante into his “dark forest” to willingly sitting through a horror movie’s two hours of dread, certain art has always counted on its audience’s desire to know the structure underlying what would otherwise be the formless terrors that haunt our lives.

And Pathologic 2 is very much interested in illustrating the structures that create such a sense of futility. It's a game about a rural town struck by a seemingly unstoppable plague—a town whose hardscrabble workers already lived in an economically and culturally stratified system of the steppe’s Kin and “urban” dwellers, the wealthy and desperately poor, the industrial barons and the bent-backed labourers with no choice but to support (or violently revolt against) them. Playing this game now, in the summer of 2020, is deeply compelling in the way that engaging with any good art that speaks so fully to the particulars of a moment is compelling. (That is, in this situation, it’s a bit like staring at a lovingly painted image of your home burning down.)

There’s a captivating horror to watching the Town-on-Gorkhon flail in the grasp of a deadly disease. The game's dialogue, which often touches on the need to maintain quarantines or to properly wash hands after being out in public, references subjects now familiar enough to warrant a resigned laugh of recognition. Seeing a fictional society descend into a crisis so severe that piles of corpses crowd public squares and its economy collapses to the point where access to food and water become as scarce as adequate medical supplies is an even more upsetting parallel.

But Pathologic 2, despite drawing heavily from the historical background of late-Tsarist Russia, is a game that abstracts and contorts its real-world details into a hazy, more universal sort of nightmare than these comparisons might suggest. The Town works as a microcosm for how we’ve seen many countries around the world react to the ongoing COVID-19 pandemic, but it also exaggerates the underlying systems of a state by making them fantastic and immediate. Pathologic 2 takes place across 12 days of plague, for one thing, and its town is small enough for its geography and population to feel at least partially knowable. More strikingly, the interconnections of a community are rendered in Pathologic 2 in terms of a living organism. Socially and architecturally, this is shown in the anatomical names of the Town’s various districts (“The Gut,” “The Marrow,” “The Spleen”); it’s even clearer in the networked trade and relationship systems, Artemy’s reputation, and the Kin’s animist beliefs, which are borne out in the eventual knowledge (or reminder) that the environment and the humans who live within form a single, intertwined ecosystem.

Naturally, then, the sand pest plague is basically a neutral force—a representation of death and trial that isn’t inherently “evil,” but only inspires evil actions as a social and political catalyst. As it spreads, the player sees a society crack, fracture, and sometimes come together in response to the extremity of the situation. Across the world, we’ve seen similar reactions to COVID-19, the sturdiness of political structures and social welfare systems either helping the sick and desperate or laying bare their inability to serve the needs of the people. The masks worn in stabler times slip off during this kind of crisis, revealing what was obscured by them before.

Pathologic 2 isn't most distressing because it enlarges phenomena that we’re currently seeing play out in reality, but because of what it says about how tragic the consequences of these systemic failures really are. In the real world, we're still living through an era of sickness and death, of monumental despair, so great that the human cost of a plague seems impossible to fully reckon with. In the game, the enormity of this situation is dramatized into something more understandable. Every characters’ death removes possibilities from the future in a very literal sense. Despite the raw statistics regularly shown to track the number of residents who’ve contracted the sand pest, died from it, or, most disturbingly, killed themselves during the day, the main “players” in Pathologic 2’s story personify these numbers. If the leader of one of the Town’s three leading families dies, there’s no opportunity to talk to them for advice or information going forward; if a friend or enemy dies, their story dies with them, cutting off whatever effect they might have had on the world. Each death severs branches of an in-game dramatis personae menu list resembling a family tree. Artemy and the player are unfairly burdened with the knowledge that if they had just been able to better aid those who have died, things might have worked out differently.

The implication, as Artemy dies again and again and the Town suffers along with him, is that no one person can be responsible for something as communal as a plague. The fact that we even expect that of him is an indictment of popular fiction centered on individual heroism and the elevation of Great Individuals as a social concept. In the game’s Marble Nest side-story, the character of Georgiy Kain explains that the plague is, to him, “essentially an exam.” He says “one must not run away from exams forever. Sooner or later, one must take them.”  The disease, in other words, shows us who we are as societies.

At a different point in the main story, Artemy may travel to the Termitary—the towering bull slaughterhouse that functions as the Towns economic (and cartographical) heart. Once inside, the soundtrack begins to boil with infernal screams. The concrete walls of the factory are covered in bloody handprints and drawings. Mounds of dead bodies are stacked in corners, partially covered by canvas tarps. Artemy has come to this human-made hell to find an ingredient that might allow him to formulate a cure—to try, despite us knowing from the game’s brutal precedent that him being able to cure the plague by his efforts alone is impossible.  

“I am the cure for the self,” the voice of the plague whispers as he walks, the words’ intelligence hard to discern as they're drowned out by tormented wails. Amidst all this misery, a single person seems like nothing. Standing in a sprawling factory where human corpses are shovelled into indistinguishable piles, it seems misguided to think that selfhood could ever matter. Humanity is a great mass in the face of a pandemic, and we suffer and overcome its horrors not as individuals, but together, as a species, raging against an organic tidal wave. If the player is able to focus on the plague's words here though—if she can meditate on what it means to describe it as a “cure for the self” in a time and space as awful as the slaughterhouse—she may find some glimmer of beauty while reflecting on one of Pathologic 2’s most harrowing and essential messages.

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Reid McCarter is a writer and a co-editor of Bullet Points Monthly. His work has appeared at The AV Club, GQ, Kill Screen, Playboy, The Washington Post, Paste, and VICE. He is also co-editor of SHOOTER and Okay, Hero, co-hosts the Bullet Points podcast, and tweets @reidmccarter.