Stardew Valley and Pathologic: Two Sides Of The Same Coin

The cute farming sim and plague survival horror have more in common than you might think

Stardew Valley and Pathologic: Two Sides Of The Same Coin
Source: Author.

On the surface, Stardew Valley and Pathologic seem diametrically opposed. One is a charming farming simulator, while the other is survival horror-influenced (in the words of the YouTuber HBomberguy) ‘Pain Simulator’. I love Pathologic. Since playing it, I’ve compared every game I’ve played with Pathologic 2. Sometimes the similarities are obvious on the surface, but aren’t actually all that deep, like the plague outbreak in Dishonored. Sometimes what they have in common isn’t immediately apparent but seems obvious once you see it, like the dialogue-heavy nature of Disco Elysium.

And sometimes, comparing Pathologic with a game seems like a joke, almost a forced attempt at humor, but once you see it, you can’t unsee it. I think this is one of those instances. In this piece, I want to go over the many parallels between Stardew Valley and Pathologic, commonalities in their setting, premise and even in their mechanics, and make a convincing argument that these two games which couldn’t be more different at first glance, actually have a lot in common.

1. The Beginning

Pathologic 2 and Stardew Valley both open with the player character arriving at the town that the game takes place in because they received a letter from a dying family member. Artemy Burakh of Pathologic is summoned to town with an urgent letter from his father, who died just before he arrived. In Stardew Valley, the player character receives a letter from their grandfather just before he passes away informing them of the farm they own in Pelican Town. This extends to two of the playable characters in Pathologic Classic. Artemy’s story is the same, and Daniil Dankovsky is summoned to town at the behest of Simon Kain who also dies just before he arrives.

2. The Setting

On the surface, the charming, idyllic Pelican Town couldn’t be more different from the oppressive, bleak Town-On-Gorkhon. But stripping away the events that take place in these towns and the atmosphere of each to consider some of the fundamental similarities they share. They are both isolated, small towns far from any major cities. They both have only one point of travel to the outside world — the bus in Stardew Valley and trains in Pathologic, which are closed after the protagonist arrives, (although the player can get the bus up and running in Stardew Valley) rendering them unable to leave the town. These towns are also home to a large cast of characters, each with their own goals, agendas, likes and dislikes, and the player character gets to know them better during the course of the game.

3. Time Is An Important Element

Pathologic and Stardew Valley are examples of “Clockwork Games,” games which program events and NPC actions to occur on a set schedule which happen regardless of whether the player is present or not. This serves to immerse the player in the world by making them feel like they are only one part of it and not the center of the universe. Pathologic and Stardew Valley both have day/night cycles with NPCs found in different areas depending on the time of day. In Pathologic, missions must be completed within a certain amount of time or the player will fail it, causing the player some stress. Stardew Valley is much more forgiving about not completing tasks on time, although personally I always feel a sense of inadequacy when it comes to developing my farm like I haven’t done all I could have. A similar feeling to playing Pathologic, basically.

Both games have bovine animals that you can own. They’re literally the same! Source: Author.

4. The NPCs

The towns of both games feature a cast of quirky characters that you come to know better through the course of the game. In both games, you learn more about these characters by talking to them and doing side quests for them. Pathologic 2 occasionally uses Tragedians who tell the player things about NPCs that they would never tell you directly, such as their deepest fears, regrets and dreams. In Stardew Valley, giving characters gifts raises the player character’s relationship with them, giving you special cutscenes that reveal more about that character. Characters in Stardew Valley have specific likes and dislikes, and remembering which character likes which item is key to winning their affection. The bartering system in Pathologic is similar to this. Keeping in mind which items each NPC type barters with and for is essential to staying alive.

5. Crafting Versus Purchasing

In Pathologic, Artemy has the ability to harvest herbs from the Steppe and create tinctures and antibiotics. These are generally more effective than the pills that you can buy from shops, but the downside is that finding the herbs takes time that the player might not have. Players generally fall into a routine of harvesting herbs at least once a day and then making tinctures out of the herbs. This pattern of harvesting and then crafting is a core feature of Stardew Valley. Additionally, Stardew Valley is rife with choices of crafting versus purchasing. For example, mining is a good way to obtain materials like stone, coal, and ores, but the mines are full of slime monsters that must be killed. If the player doesn’t want to obtain these items in the mines, they will have to buy them from various merchants, who sell these items at relatively high prices.

6. Chore Simulator

What do you do in both these games, when it comes down to it? What’s the basic gameplay loop? An average day in Pathologic probably includes going to the Theatre (don’t ask) to do the hospital mission for the day, doing the mission of the day which generally means walking across town to talk to someone, gathering herbs, scavenging bins, and bartering for items. The average day in Stardew Valley means looking after your crops, looking after your animals, taking care of your farm, doing a side quest, or giving someone a birthday gift and some fishing to supplement your income. Functionally, this means the player walks around town, never as fast as they’d like, watching with varying amounts of dread as time ticks on by with you only marginally closer to accomplishing your daily goal. If there are any distinctions here, it’s that in Pathologic you run more errands for other people and in Stardew Valley, you do them for yourself, but at the end of the day, they’re both chore simulators.

7. Ambiguous Time Periods

Neither game has any one time period that its setting can be tied to. Pathologic features weapons from the early 1900s, décor from earlier than that, clothes and medicine from after, and impossible floating staircases that will probably never exist. Stardew Valley seems to be a bit more modern, with more comforts of modern life like TVs and refrigerators, but most of the farming technology is miles behind. Your starting tools in the game are virtually from the Iron Age, and even after you make some progress, you will never be able to make use of tech like harvesters, chainsaws, and other modern tools. This persists outside of the player’s farm as well. No one seems to own a car except for Mayor Lewis, and given how narrow the roads are, its appearance raises its own questions.

8. The Player Character Saves The Town

Now, this one seems like a cheap inclusion, right? It’s a trope that has been present in almost every story we’ve told since the beginning of storytelling. But I think I have a legitimate reason for listing this here. Both these games have the main character saving their town despite their settings and/or to make a larger point. Pathologic is a game that repeatedly drives home that your character is not a hero, they are not different from the other characters or special other than their medical skills. Not helped by this is a number of townsfolk actively hindering the progress that you make. This makes coming up with a solution to the plague all the more difficult and meaningful.

In Stardew Valley, you have the option to restore the community center to its former glory, which if accomplished, kicks the parasitic Joja Mart out of town, saving the local economy and environment. It’s noteworthy because open-ended simulator games like this one generally don’t have a hero saving the town from an antagonist. Like the hostile townsfolk in Pathologic, people around the Pelican Town will not help you complete the community center bundles. And like Pathologic 2, even restoring the center is entirely optional. Both games let you save the town, but doing so seems to be in direct opposition to the way it’s set up.

9. Central Themes

Pathologic is rife with themes. Many of these like discussions of free will, individualism vs collectivism, the evils of colonialism, and elements of Brechtian theatre do not have parallels in Stardew Valley. But I argue that every theme present in Stardew Valley has a counterpart in Pathologic. The most obvious theme in Stardew Valley is the evils of big business. Joja Mart is a large employer, no doubt, but it is bad for local businesses and bad for the environment. In Pathologic, Vlad Olgimsky’s Bull Enterprise, the Town’s meat industry serves the same purpose. Although presented in much more nuanced terms, the oppression of the indigenous Steppe people, the damage to the local land and water, and the greed and cruelty of Big Vlad himself make this an obvious parallel to Joja Mart.

Environmentalism is the other big theme of Stardew Valley. The game repeatedly drives home the importance of preserving nature and putting into perspective the damage wrought by pollution. Are these themes found in Pathologic? Well, the refuse of the meatpacking industry into the river has rendered the water unfit for drinking, the Steppe people lament that their more sustainable way of life is slowly being lost to industrialization, and the tinctures that you can brew with herbs that you find are more effective than the drugs you buy in shops, so I’d say that yes, Pathologic features a heavily environmentalist bent too.

10. War

One weirdly specific similarity that both games have is that war is currently being waged in the wider world. Pathologic references a war in dialogue options and item descriptions, while the nation that Stardew Valley is contained in, is at war with the Gotoro Empire. The war impacts both games in extremely tangential ways. In Pathologic 2, Artemy’s disconsolate friends make several remarks about wishing to join the Army to get away from the grim situation in Town. Stardew Valley has Kent, a soldier has returned from the fighting in Year 2. In both games, the references to these wars with no direct impact on the towns themselves serve to underscore both town's isolation from the wider world.

Now I want to see Pathologic characters in Pelican Town. Source: Author.

11. Magic On The Edge Of Town

Supernatural elements exist in Stardew Valley and Pathologic. However, these elements are confined to the fringes, both figuratively and literally. These supernatural elements are generally not found in the hearts of both towns, and generally aren’t core mechanics in both games. In Pathologic, creatures of Steppe like Worms and the albinos are largely present deep in the Steppe at the southern edge of the map. The otherworldly Abbatoir and impossible Polyhedron are on the rightmost and leftmost edges of the map respectively. Similarly, in Stardew Valley, the wizard’s tower is located on the extreme left of the town, the mine which is filled with monsters is located on the northern edge, and isn’t visited by most villagers. Although the anachronistic time period and isolated setting would help to make magic seem more fitting, in both games, it is still only found on the edges of town.

Magical towers on the western edges of Town. How weirdly specific… Source: Author.

12. Other Stuff That Doesn’t Take A Whole Bullet Point To Explain

  • You can own some sort of bovine animal in both games
  • You have a conversation with the dead relative whose letter summoned you to town in Pathologic 2 and Stardew Valley
  • Both games have excellent soundtracks. This one is lazy, I know, but the music is so good!
  • There’s actually a mod that reskins Stardew Valley to make it look more like Pathologic.


Pathologic and Stardew Valley are similar games. They are two sides of the same coin. But there’s also challenge in Stardew Valley and moments of comfort and respite in Pathologic. The differences are stark, but I think that fundamentally they represent the same thing. An escapist wish-fulfillment of being able to get away from the stresses of modern life and thrive, the fantasy of taking on impossible odds and through careful resource management and good decision-making, succeeding in eking out some sort of victory. These games are two sides of the same coin.


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