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The problem is that it does all of this rather awkwardly, and first-time players will likely throw it aside due to its odd presentation. Players can assume among a cast of three characters the role of Daniel Dankovskiy, a scientist on a desperate mission to save his financially unstable laboratory. He hears rumors of a man named Simon Kain, who has lived for countless centuries in a quaint little northern hamlet removed from ordinary society, and immediately sets out to research the man and regain his reputation.
Upon arriving, Daniel finds that Kain has been murdered, presumably by a demon, and a mysterious plague is slowly starting to consume the town. In many ways, Pathologic is the equivalent of an interactive David Lynch film. As you leave your lodgings for the first time in the game, a bird-man you know, like one of those hooded Black Death guys approaches you with his creepy masked buddy. Your alter ego has six very important status bars. First is the reputation bar.
According to what you do in the game, your reputation will go up or down. Do evil things and your reputation will go down. For example, the town will steadily become engulfed in the aforementioned plague, and this gets portrayed in very grisly ways — the air turns foul, bodies start piling up, people start to panic, bandits start to feed off the chaos. The game is divided into several days, and each day has a limited amount of time for you to perform the main quests as well as the many secondary ones.
This actually makes Pathologic quite difficult to deal with initially, since you have to learn where everything is and how to get to it fastest.
Rough edges and all, the game plays similar to other first-person role-playing games. Like Oblivion with terminal cancer, you go around locations trying to solve quests and find loot.