Six years after deciding to split Pathologic 2 into multiple separate chapters so it could actually get the game finished and released, Ice-Pick Lodge has chucked that plan into the creepy medical incinerator and decided to go full steam ahead with Pathologic 3 instead.

In Pathlogic 3, players will become the Bachelor, a doctor from the city who travels to a small, remote town to unravel the mystery behind a devastating plague and, in the words of publisher HypeTrain Digital, “conquer death itself.” As in the previous games, there's a tight time limit to getting the just done—just 12 days—but this time around you can zap back in time, to some extent, “to revisit key events and alter them” so things don't work out quite as awful as they did the first time around.

As a doctor, you'll examine patients, research pathogens to develop treatments, implement quarantines, and establish patrols to ensure they're followed. In your downtime, you'll explore “a decaying town on the brink of collapse, where every choice carries weight and trust is a luxury you can't afford.”

Superficially it sounds fairly straightforward, at least in videogame terms—save the people, be the hero!—but Pathologic doesn't roll that way. It's intensely strange and janky, and that makes it challenging: PC Gamer's Phil Savage said in 2014 that it “wasn't good in any of the ways you would traditionally associate the word,” but that it was “weird and interesting” and “completely unforgettable.” In his 2019 review of Pathologic 2, former PC Gamer writer Tom Senior said, “It's a slog, and that's the point of it,” which may be the most spot-on summation of the whole Pathologic thing I've ever come across. It is what it is, and you either like it or you don't.

Despite that niche appeal, the Pathologic series has proven remarkably durable. The original came out in 2005 and was remade in 2015, while the sequel, Pathologic 2, followed in 2019. Developer Ice-Pick Lodge first began talking about Pathologic 3 in 2020, although at the time it was expected to be a new “chapter” of Pathologic 2. Instead, over the course of the past four years it's evolved into a full-fledged standalone game.

It's worth noting, especially given our somewhat unusual “really enthusiastic, equally reluctant” takes on Pathologic, that both games in the series have “very positive” user ratings on Steam. Niche and difficult though they may be, it's clear a lot of people dig what they do. I wouldn't mind terribly if Pathologic 3 eased up on some of its most impenetrable jank just a little bit, although not too much—otherwise it wouldn't be Pathologic.

Pathologic 3 is available for wishlisting now on Steam.