Pathologic isn't scary, it's unsettling. Deeply, deeply unsettling.

The Pathologic remake coming this fall to PC, PS4 and Xbox One bears the name and same basic premise of the PC-only 2005 cult favorite original, but developer Ice-Pick Lodge wants it to feel like something new. In much the same way, Pathologic dresses itself in the tropes of horror, but it doesn't fit within that definition - at least not in terms of what we've come to expect from horror games.

It's not liable to make you jump out of your seat, for one, nor is it likely to make you gag in revulsion. There are no monsters to fight, no demons to send back to Hell, no traditional antagonist to speak of. This is a game about talking to people, uncovering a mystery, and making decisions that impact lives. If Resident Evil and its ilk are "survival horror," Pathologic is "exploration disconcertment."

You play as one of three characters drawn to a small town under siege from a disease known as the "sand plague." The illness is fatal and swift in its destruction of human life. It can't be fought by conventional means, and the threat of it hangs in the air (possibly quite literally, though discovering the disease's means of transmission is part of the mystery).

The town is ramshackle and simple, with cobblestone streets and cramped stalls passing for shops. There are, however, ominous structures that loom in the background at any moment. The cathedral is dark, gothic, and foreboding, and the Polyhedron - a seemingly impossible construct that shouldn't be able to stand upright - serves as the base for a tribal organization of children.

Streets and landmarks are named in biological terms, and the townsfolk give unsettling directions when guiding you. "Follow the Spine to the Heart." "Go up the neck and through the Brain." It all contributes to a constant sense of unease, and I had the feeling in the pit of my stomach that something was wrong here; like a dream where things are off by just enough that you can tell something's wrong, but not how. And if the town wasn't unpleasant enough, the people themselves are just as uncomfortable to interact with.

It was clear from the outset that despite my proclamation and profession to be a healer, these people didn't trust me or want me here. They looked at me with sunken, half-glassed eyes, lied through their teeth, and threatened me. For all the help I was trying to bring, I found myself thinking of these citizens' lives as relatively cheap.

People will get in your way and obstruct your progress - not because they're bad or evil, but because they're sick or ignorant. To fight a disease is to spread knowledge, but Pathologic doesn't make that easy or even, at times, desirable.

Even during my short time with the game at PAX East, I found myself flustered and frustrated by these naive hillfolk. The quarantine my character had ordered was being broken. People were looting. I always try to play the most compassionate version of a character I can, but I admit I wondered if these people needed a good slap to wake them up.

"Don't you get it?" I screamed in my thoughts. "Your town is dying, and I can't help you if you don't listen to me!" I hated them and what I saw as their stubborn stupidity.

Everywhere I turned in Pathologic, I felt an itch at the back of my brain, an instinctive feeling that the world was deeply wrong somehow, and I should get out of there as fast as possible. I wouldn't say I was scared or frightened, but I was on alert - unnerved. This despite not being actively pursued by an entity with teeth or claws, nor being startled by sudden loud noises, nor any of the horror genre's contemporary tropes.

I'm not sure what to call Pathologic. Like the town, people, and plague it portrays, it defies categorization. But if I had to pick a word, I'd say it's special.

Sam Prell

Sam is a former News Editor here at GamesRadar. His expert words have appeared on many of the web's well-known gaming sites, including Joystiq, Penny Arcade, Destructoid, and G4 Media, among others. Sam has a serious soft spot for MOBAs, MMOs, and emo music. Forever a farm boy, forever a '90s kid.