A Body, Divided | Pathologic

At last, I realized that the building was such combination of planes, lines, rhythms and temperatures which can be an ideal repository for a certain soul. No, not human soul- another one! Such soul with which a man cannot enter into a dialogue…”
-Petr Stamatin, Pathologic

In late 1770, the citizens of Moscow were starting to exhibit symptoms of the bubonic plague. Though subdued throughout the winter, the plague was not taken seriously by the people, who did not burn the possessions of the infected and still engaged in business in public despite their symptoms. As a result, a breeding ground was created for the disease, which by next summer ran rampant.

By September of that same year the citizens, who had now been compliant with the recommended medical practices for several months with little result, revolted in backlash. Believing they were being punished by God for not disposing of the diseased dead properly, they started exhuming the infected corpses to perform Christian burial rituals. After several churches and the homes of physicians were attacked by mobs the Russian military had to intervene. It wouldn’t be until the end of the year that the Plague was eradicated from the streets of the city, after having claimed the lives of somewhere in the region of 100,000 citizens.

In 2005, more than 200 years later, in the same city of Moscow, Pathologic was created. Set in a fictional town in the middle of the Russian Steppe, Pathologic takes place over the course of twelve days, just as an outbreak of a plague is beginning. Every day, different sections of the town enter quarantine, which the player must move through or around in order to complete quests, putting themselves at risk of infection. Time passes in the game as well, meaning the player needs to meet characters at certain times and accomplish their quests before the day’s end, in order to prevent important citizens of the town from dying. Further complicating things are the player’s health, energy, hunger and infection meters, making Pathologic a sort of ur-survival game. Looking for items to trade, travelling to a shop for food and medicine, and even sleeping are all necessary for self-care, but this takes away valuable time the player could be using to complete objectives.

The player is directed to look for “the house with the scabs”

Pitching Pathologic as a survival game under time pressure, though, ignores one of the most compelling aspects of the game—the environment itself. Conventional wisdom
says that settings, particularly in the horror genre, can be characters in their own right, with Silent Hill and its titular town being the most-cited example. Developer Ice-Pick Lodge, when creating Pathologic, fleshed out their town’s identity by pulling influence from Moscow’s architecture, both new and old, and projecting anatomical traits on the town, through naming houses after body parts and having them display symptoms. Through this, they created an externalization of the player character’s own body, trying to maintain its health while slowly being besieged with more complications.

Reading “An account of the plague which raged at Moscow, in 1771” by Dr. Charles de Mertens gives a useful tool in pinpointing these influences, both by giving an insight into medical knowledge at the time of the city’s great plague, and describing the then-layout of Moscow. Mertens writes that in 1770s the city consisted of four concentric circles, with the inner two being more affluent districts with houses and walls made of stone. The outer two typically had single-story wooden houses, with the periphery of the fourth ring being surrounded by giant dirt mounds in lieu of stone walls. Canals were a prominent feature at the time in Moscow, and still are today.

The houses in this town are implied to have skin

When the first cases of the plague started appearing at the military hospital, Mertens noted that the suburb where it was located was “separated by a small stream, called the Yaufa”. As such, the stream served as part of the border when the area was subsequently quarantined. The town in Pathologic is separated by canals into three districts, which also often serve as boundaries for the plague zones that appear in the game, mirroring the historical layout of Moscow. This is reinforced by the names assigned to these districts: the western one, which contains the church, stone walls, and several large estates, is referred to as Stone Yard. The easternmost, which next to the factories, cramped with small houses and separated by wooden fences, is referred to as the Land. Both suggest the material patterns of old Moscow, and its architectural rings of stone and wood.

Rather that describe the city in any great detail, however, Dr. Mertens’s writing focuses mostly on details of the plague itself. Using the medical terminology of the time, he describes a number of visible symptoms that affect the skin, including buboes and carbuncles. The most common of them, though, were petechiae, capillary ruptures that resulted in pools of blood under the flesh that were connected by long, spindly lines following the capillaries themselves. Further elaboration is given to other symptoms, including fever and severe pains in the armpits and groin, estimated windows for the development of these symptoms, as well as estimations of survivability.

An externalization of the player character’s own body

The anatomical references, found in both Merten’s account and sown throughout Pathologic, are what really mark out the game’s world. The houses of principal characters, typically wealthy families, are assigned names: the Kains reside in the Horns estate, Vlad Olgimsky lives in a place called the Clot, and the Saburovs’ abode is referred to as the Stem. This extends to some minor characters as well: the house the player stays in during the first campaign is known as the Slough, a term referring to dead skin. The town, extrapolated from these names, is implied to be a whole organism and, because of the use of “horns” to describe the Kains’ Crucible, alluded to be non-human. The most striking example of this personification is the most blatant one: each day different sections of the town are struck with the plague, a purplish filter being applied to the player’s vision. The houses in these parts start to develop dark spots on them; when trying to find one of the first cases of the plague, the player is directed to look for “the house with the scabs”. Over the next couple of days, the sickness moves on and the spots disappear, but windows remain boarded up, as if scarred from its encounter with disease. It’s worth noting these spots resemble the subcutaneous petechiae described as a plague symptom. As such, the houses in this town are implied to have skin.

When looking back to the horrific events in Moscow for inspiration, Ice-Pick Lodge had to figure out how to simulate being in the middle of them. While most studios would be content referencing and recreating historical architecture, from the classes of citizens found in each corresponding district to having canals form the borders of neighborhoods, the developers here went further. By showing the effect of plague on the town, meaning both the collection of individuals as well as the space they occupy, the game creates a symbolic representation that is more immediately felt than 200-year-old writings. Pathologic‘s diseased town is revealed as both a historical and anatomical body, and through this, succeeds in making the player feel as if they’re rotting alongside the world around them.

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Jared Mitchell

Jared Mitchell is a level designer at Ape Law, currently working on Albino Lullaby Episode 2. He also creates videos analyzing level design on his YouTube channel The Playing Field.