First released in 2005, Pathologic carved out a niche by containing elements of the survival and RPG genres with a layer of distinctly surreal horror on top. Its eerie world, strange characters, dense philosophical musings, and often unforgiving gameplay created an experience unlike many others. Pathologic's experimental nature and twists on traditional design subsequently made it a cult classic, with an HD remastered version dropping in 2015.

Pathologic 2 then launched in 2019 after being successfully Kickstarted, though it was more of a modern reimagining rather than a full sequel, and focused on a single character's tale out of the three contained in the original.

Pathologic 2 was well-received, earning a very positive rating on Steam, and developer Ice-Pick Lodge planned to continue the remaining two storylines that were absent from the 2019 version.

However, despite audience reception, sales numbers put its next leg in question for a period. Recently though, Ice-Pick Lodge announced Pathologic 3 and confirmed it is set for release next year, being published by HypeTrain Digital. To delve into the details of the upcoming entry, Ice-Pick founder and creative director Nikolay Dybowski chatted with Game Rant about how Pathologic 3 aims to keep what makes the franchise unique intact while expanding its scope in new and intriguing ways.

The following interview has been edited for brevity and clarity.

How Pathologic 3 Builds Upon Series Foundations

Q: Pathologic 2 is known for being a challenging game, and difficulty sliders were added later. Will Pathologic 3 have these or something similar included at the outset?

A: We’ve done a lot to preserve the vibe, mood, and atmosphere of this world and the unique identity of the game.

This is what our studio usually succeeds at best, but with The Bachelor as a protagonist, gameplay will be different. It’s the same Pathologic and the same Town beloved by thousands, but now there’s a different hero. Unlike the Haruspex, The Bachelor is a man of intellect and high status.

He doesn't need to fight for survival every moment, so we assume he’ll die far less often. But that doesn’t mean the game will be easier.

Q: It looks like the Bachelor’s Plague Finder is returning. Can you speak more about this and other gameplay elements in Pathologic 3?

A: From the start, we wanted this to be a game about a scientist, not a scavenger.

He observes and draws conclusions. He examines and collects data. He shouldn’t rush or act hastily. He needs to scrutinize and think, so the Bachelor’s main tools are:

• Plague Visor: to observe plague particles in the air
• Examining patients: to identify symptoms of diseases on bodies and in their blood
• Environmental analysis: to focus on details that provoke hypotheses and thoughts crucial to the investigation

Pathologic 3's Approach to Time Travel and Nonlinear Design

Q: The time travel mechanic looks to be the biggest new change for the series.

How did this idea for Pathologic 3 come about?

A: The Bachelor tries to conquer death using an outdated, Newtonian worldview—a task that seems impossible. He’s chasing after Simon Kain, who holds the secret of immortality, but doesn’t realize he’s not yet ready to comprehend it. He must break apart his worldview and reassemble it.

This applies to fundamental concepts of time, space, and humanity. We wanted the player to experience a world shattered into fragments—a familiar world made strange, that must be pieced together anew.

Q: The non-linearity of time and how it will be related to the nature of the Town are also core story components.

How did this affect design and direction?

A: Connecting non-linear time with a long, narrative-heavy story that involves many characters and cause-and-effect chains would be extremely difficult. We focused on what the player feels in the moment rather than on gathering information in the right order. The latter approach works well in shorter formats like Her Story or 12 Minutes, but in Pathologic, it would be overwhelming.

We wanted players to feel like “everything, everywhere, all at once”—similar to Billy Pilgrim in Slaughterhouse-Five.

Different versions of reality coexist simultaneously, creating a “quantum” feeling for the player. Look at the time travel mechanic as an opportunity to correct mistakes, or even to make deliberate mistakes in order to unlock new paths and ideas. It is like a "sanctioned save scum."

Q: Were there any other concepts or more radical departures that were looked at during development?

A: Yes.

Initially, I wanted to make a game with a single time-based resource—a lifespan running in real-time, which could be shortened or extended depending on the circumstances encountered.

In this prototype, the Bachelor was like a car with a punctured fuel tank, constantly leaking fuel even when standing still.

If you press on the gas (move a lot), more fuel would be consumed; if the car hit a rock (contact with infection), the tank would get another puncture, causing fuel to leak faster. Occasionally, he’d make it to a “fuel station” (talk to the right character on the right day) and, if lucky, add a few dozen liters back to the tank.

It was a tense and beautiful way to represent time, but it turned out this kind of resource was difficult to work with in short gameplay sessions.

The changes were too small to notice and feel in real-time, while large contrasts made the game nearly unplayable. We had to abandon the idea, sadly!

Pathologic 3's Connections to the Franchise's Past, Present, and Future

Q: How will Pathologic 3 accommodate newcomers who may be less familiar with the franchise and story so far?

A: The original Pathologic was designed so that players could begin with any character, but when playing as the Bachelor, it’s easier to get acquainted with the Town on the Gorkhon because the Bachelor is an outsider, much like many new players.

He doesn’t understand much, is unfamiliar with local ways, and initially dismisses many of their customs as superstitious. This makes it easier for players to absorb new things from that perspective—gradually shifting their views on familiar aspects that initially seem entirely straightforward.

Q: Conversely, how will it connect to and consider the events and characters in Pathologic 2?

A: Consider it as two subjective retellings of the same events.

This is the same Town, the same twelve days, the same participants and events that occurred in the Haruspex’s story. But this is a different perspective. Like two witnesses recounting the same event in Rashomon, the stories vary greatly, each focusing on different details. Finally, we always give our heroes the right to make honest mistakes, forget, and even lie.

Every narrator is an unreliable narrator.

Q: How did Pathologic’s previous philosophical explorations help inform or play into the narrative and themes here?

A: Everything we now see as true and valuable, we’ve kept. Everything we’ve outgrown, like childhood clothes, we either reimagined and reinterpreted to give these ideas new meaning, or let go of them.

After all, we’ve grown a lot (hopefully, along with the industry). When I first conceived Pathologic, I was 21 and completely alone. Now I’m 47, surrounded by incredibly talented people who enrich this universe as much as I do, and that makes a difference.

We’ve kept the idea of the tragedy of utopian projects.

We kept the idea that the plague is a voice of the natural order—one that the thinking human mind cannot accept—and that it has its own truth. We retained the belief that evil cannot be defeated with its own tools or outplayed on its field; yet it can be defeated realistically in a different, orthogonal way.

In another dimension.

Q: It’s mentioned that the Bachelor is searching for an immortal man in Pathologic 3. Can you say if this is in reference to Mark Immortell?

A: No, there’s no connection between Simon Kain (one of the town’s rulers) and Mark Immortell (the director of the town theater).

Mark is a clown. He awkwardly mimics Simon, parodying him, which is why he takes on this pseudonym. He's fully aware that he’s a jester, and the gesture itself is ironic.

Q: Can you give any hints about any more major changes or surprises in store?

A: As usual, keep an eye on your rivals, the Haruspex and the Changeling.

We didn’t want to repeat ourselves, so we aimed to keep only the most crucial aspects unchanged.

Q: What do you hope players will take away most from Pathologic 3?

A: The hope that humanity remains a promising and capable species.

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