After beating Pathologic 1, I wasn't sure if I would like the second game, but it really is a perfected version of the first game. The story is way more in-depth and is semi-randomized, so every play will be slightly different. A major theme is inevitable loss, and the game is balanced toward that.

What characters get infected or die is partially random, so even if you try to save them, they can die anyway. This can lock you out of certain quests or even what items you can buy. The game is designed to be this way, as there isn't enough in-game time to complete every quest. The story is also much more integrated into the gameplay. Every time you die, you get debuffs that lower your stats. Every time you find a way to break the economy, the game takes that away from you. This is the only survival game I've played where I had to sell my clothes to stop myself from starving to death. I almost quit at the beginning because of how frustrating it feels constantly "losing" the game. I would mainly recommend this to people who like hardcore survival. There are easier modes, but I don't know how much they change the game.