The story unfolds through the eyes of The Powers That Be, who look at Daniil’s actions. Like Pathologic 2, players must investigate and diagnose patients. Depending on your research, decrees may be issued, though you can’t save everyone. Maybe you’ll unravel the greater truth or fail and time travel to try again.

Pathologic 3: Quarantine promises “fragments” of the full game’s mechanics, overlapping with the latter’s intro and showcasing the Capital for the first time in the series. This is a standalone experience, though, so it’s not required to play.

As for Pathologic 3, it’s out later this year for Xbox Series X/S, PS5, and PC. Like its predecessor, players must take steps to save a plague-ridden town. Check out our interview for more details.

"With Pathologic 3, we knew from the start that we wanted to make a different experience"

Pathologic 2 started development as a remake of the original before turning into what it became, but with Pathologic 3, it looks like you’re starting off with surer footing in terms of your vision for the game. How has that change impacted the game’s development in your view so far?

When we set out to make Pathologic 2, it took us a while to become bolder. We first began with a faithful step-by-step remake of the original game, but then slowly realized we were unhappy with certain choices. So we changed them, added new mechanics — and found a completely new game on our hands.

With Pathologic 3, we knew from the start that we wanted to make a different experience — i.e. tell the Bachelor’s story through mechanics that are different from the Haruspex’s. Subjective storytelling via not only quests but also mechanics is the core focus of Pathologic, so it was crucial for us to choose precisely the elements that would shape Bachelor’s worldview. For example, being respected by the town’s elites (unlike the Haruspex), he doesn’t need to bother about finding food or money. Instead, he may struggle with his own mind — and also needs to make decisions that shape the whole face of the town.

Pathologic 3 is adding a significant new mechanic with players now having the ability to go back in time. Can you talk about how the decision to introduce this mechanic came about?

It is first and foremost a tool of confused and unreliable storytelling — it seems that The Powers That Be are convinced that some events did not unfold the way Bachelor remembers them. …Or is it?

"This approach allows us to explore unhappy stories and let the player make mistakes"

Given Pathologic‘s emphasis on time management in general, how much of a challenge has it been to properly balance the new time travel mechanic? How many limits will it place on players in terms of what they can do with it?

It’s an absolute pain in the ass that makes both the story and the in-game economy very complicated. The things we do for love.

As for players’ freedom, they won’t be able to do just anything, of course, because permutations are endless for a sufficiently creative mind. But you will be able to move to different points of the story (in both future and past) and change how events unfold — given that the Town even exists at that point. Which is not guaranteed, so you’ll first have to find ways to stop all these people from destroying themselves.

This approach allows us to explore unhappy stories and let the player make mistakes — because they can then go back and “fix” things (or maybe break them differently).

Where the actual medical investigative mechanics are concerned, how is Pathologic 3 expanding on its predecessor’s gameplay? What kind of a toolset will players have at their disposal?

All protagonists of Pathologic are healers. But it’s a game about many things, so in the first installment their medical work was, surprisingly enough, implied — they dealt more with the Town’s social element, survival, and their personal quests. In Pathologic 2, hospital was added, but it was a series of unique mini-games.

In Pathologic 3, medical work is finally systematic. You get to interview and examine patients, diagnose them. But since Bachelor is more scientist and thinker than bleeding heart, he is often dissatisfied with just measuring someone’s temperature or examining their skin condition — he dives into their life stories to make sure ALL factors are accounted for. Because sometimes people lie, and bodies too, and a symptom can be a red herring.

Basically it’s like House MD gamified, except your patients are unusually fond of talking philosophy and weird.

"Gameplay-wise, time flows normally in Pathologic 3."

What can you tell us about Pathologic‘s choice and consequence mechanics? That’s obviously an area the series has always been known for, but particularly with time travel now thrown in, how much more complex will that side of the experience be?

You start in medias res, on Day 5 instead of Day 1, as a Daniil Dankovky who has failed all of his opportunities. The town is on the brink of death. But maybe that’s not how it went? Maybe someone’s trying to frame him? So he explains how things could have gone differently.

Gameplay-wise, time flows normally in Pathologic 3. But at any point in the game you can jump to another day — as long as you have the resources for it — and make different decisions, which of course have repercussions (often delayed and unexpected). When a certain part of the story is completed, it is locked and you don’t have to repeat it even as you jump back, but you can unlock it if you want to make different choices (again, if you have the resources to travel back).

We always enjoyed writing characters with hidden agendas, characters that lie to you, go on with their lives offscreen, and refuse to cooperate. With these mechanics we can explore this side of the human condition in even more detail because if Daniil is tricked, he can fix it now.

(Or rather break it differently.)

Roughly how long will an average playthrough of the game be?

It strongly depends on how fast you can read and how you choose to interact with certain elements (for example, you may try to avoid infected districts — or dive into the heart of the storm), but generally the scope is the same as Pathologic 2, so around 20-25 hours.

Though standalone like The Marble Nest for Pathologic 2, it provides “fragments” of the core gameplay for Pathologic 3. Furthermore, it’s meant to showcase the world and “set the stage for the story”, somewhat overlapping with the game’s intro. Pathologic 3: Quarantine will arrive sometime this year, with more details coming later.

As for the game, it stars Daniil Dankovsky, who visits a remote plague-ridden town like the previous game. He has 12 days to save it, but events can play out according to the player’s desires. Depending on your choices, people’s behavior will change unexpectedly.

While you can go back in time to change certain outcomes, it’s also possible to see how badly things turn out in the future. Pathologic 3 launches this year for PC, Xbox Series X/S, and PS5. Stay tuned for more updates in the meantime.