Pathologic 2 grabbed me in a way that not many games have over the years been able to grab my attention and desire to advance the story. As such I decided to create and publish this guide that walks you through each in game day and what is required of you to ensure that you can unlock all of the achievements.

Ticking Away
Feel the flow of time for the first time

Upon completion of the introduction taking place on day 12 you will earn this achievement.

Carpetbagger
Remind a colleague of the Hippocratic Oath—and fail

When you enter Rubin's apartment you will discover "Bachelor." After your discussion with him you need to exit Rubin's house where two children will be waiting outside for you to speak to. When the dialogue ends, re-enter the house to try convincing Bachelor that he should provide help to the children.

*Note: this must be done before locating Notkin's warehouse on your playthrough


Wonder Bull
Wait for the bull to speak

While exploring on the path to your fathers house you will see a man trying to sell a bull on the side of the road for 300 coins. You must purchase this bull on day 1 and on day 11 it will be in the back of the factory for you to speak to.


On the Run
Come now, you haven't given us any time to change the set!

Before 20:00, you need to complete Rubin, Lara, Notkin and Grief's storyline quests. Once done a marker will appear outside of Lara's house where you need to speak to the reflections.


In Kind
Repay kindness in kind
Located in Notkin's warehouse is a little girl sitting on a wooden crate to the right side. Speak to her where she will give you a bottle of milk and some toast. You need to save this toast and return on day 2 after 06:00 to speak with her.


Fate No More
Refuse fate—and face the consequences
After you go to sleep, you will have a dream with 3 people attacking you. Just stand there and let them beat you up to earn this achievement.

Pantomimes
Watch every pantomime

While wandering the street you will see a red light shine down on one of the cylindrical theater advertisements in the streets. You need to visit the theater daily from this point on until day 11 to earn this achievement.


Clear Conscience
Return what you didn't deserve

Upon entering the Termitary you will see a group of individuals and one man sitting on a cart. Speak to this man and accept his money. On the early morning of day 3 you will then need to give the money back to this individual where you can find him at Aspity’s house in a room sitting on the floor.


Mute Curse
Become cursed to remain silent… sometimes

Upon entering the Nutshell you will find Maria and Capella arguing inside. Speak to them both and advance through their conversations. Once you leave you will find Clara waiting for you outside. Speak to her and earn this achievement.


We're Only Looking
Meet Measly and Thrush in a dream

After 06:00 you need to sleep where you will awaken to a dream with children surrounding a door in front of you. Turn to your right and you will find Measly and Thrush sitting above you on a rock. Speak to them to earn this achievement.


Heavenly Train
Try your hand at train-summoning

After 18:00 at the Station you will find a group of children sitting on the dock the building. Speak to them and they will share a tale of a ghost train. To earn the achievement you'll need to walk along the nearby curving train tracks until you reach the end and wait there against the track barrier until you hear the sounds of a train approaching.


Time waits for no one
Time waits for no one

Survive day 2.

Alarm Bell
Hear the alarm bell tolling

At some point in the day you will get a cut scene of a bell ringing and rats flooding the street. For me this happened at 13:00 This cut scene will unlock the achievement.


Magic Lantern
See the Town's history on the walls

Go to the Nutshell building and you will see a lantern in need of repair. Speak to one of the children and then activate the lantern sitting on the stool. You need to use a piece of scrap metal that looks like a cog to repair the lantern and earn the achievement.


Time is merciless
Time is merciless

Survive day 3.

Victoria's Trace
Find out if the immortal soul exists

At the start of the day when wandering around you will hear the sounds of a piano playing from a house. To begin this quest speak to an NPC in one of these houses. Repeat this at three more houses emitting piano sounds across the city and you will earn the achievement. I found the three pianos across days 4 and 5.


Parcels of Life
Save two children from infected houses

To earn this achievement you need to rescue at least two children during day 4 and 5 that are located in houses with the plague. You can gain this quest by visiting the Town Hall and speaking to the woman inside where she will inform you of the babies. Wandering through town you will hear a baby crying and you need to enter that house to find the crib. Once rescued you need to take them to the Town Hall for safety. I found one baby on day 4 and one baby on day 5.


Three Graces
"Why? What was the purpose of my life?"

Starting on day 4 and continuing through day 6 you need to speak 3 women; Eva, Anna and Maria. You can only speak to one individual per day. On day 6 after the final conversation with Maria this achievement will be earned.


Life has become shorter yet
Tick-tock

Survive day 4.

Rotten Tooth
Find a house suffering from an ailment other than sand pest

After you speak to "Sticky" you will receive a mission bubble requiring you to visit the chemist located in Bridge Square. Once you arrive you need to locate and converse with the chemist and then speak to Victor. Concluding that you need to speak to Maria at her residence and you will earn the achievement.


Days grow shorter
Tick-tock

Survive day 5.

More Than Meat
Lock up a shop to preserve a memory

At the Backbone meat shop across from Town Hall you will find Big Vlad. Speak to him and convince him to continue keeping the meat shop closed. After that you will earn this achievement.


Umbilical Cord
Wait with a friend for the next day to come

After 18:00 speak to Measly and Thrush at the train platform and pick the dialogue option that suggests that you know someone who can help destroy the train tracks. Speak to Grief, and then meet him on the tracks after midnight on Day 7.


Doctor's Risk
Test the new serum on yourself

Test the Panacea on yourself to earn this achievement. I got this after meeting Murkey's "friend" and using the Serum that you can brew.


Nights grow shorter
Tick-tock

Survive day 6.

Comes the Inquisitor
Witness the arrival of Aglaya Lilich

At 7:30 Aglaya will automatically show up in town for you to earn this achievement.


His Grace
Find Grace's new home

You need to finish Grace's quest and instruct Dora to have Grace taken to a safe location in town. After this you can travel to Peter's home and speak to grace to unlock this achievement.


Seconds slip through your fingers
Tick-tock

Survive day 7.

Another Sky
Witness another Sky

Once it's been opened to you, climb the stairs of the Polyhedron.


Whee!
Jump from the Polyhedron

To earn this achievement you need to jump off the Polyhedron near the paper origami bird sitting on the floor near the top. This can be done right after climbing the stairs.


You can't hold to the past
Tick-tock

Survive day 8.

Comes the Commander
Witness the arrival of Alexander Block

At 07:30 you will get a cut scene of the commander arriving on a train and will earn this achievement.


Big Heart
Be cured of sand plague by touching the Heart of the Town

You must be infected from the plague when you speak to Zurkhen's Big Heart while wandering through the guts of the town during the Abattoir mission. From your starting place once falling down the hole, take the first path on the right to find the heart.


Not a Dream
Bring something invaluable to the outside world

To earn this achievement you need to keep some of the Living Blood in your inventory and complete the Abattoir mission bubble.


You'll soon run out of time
Tick-tock

Survive day 9.

Farewell
Return to the Town once again

At 20:00 you will get a map marker at the Chapel and need to speak to Aglaya. Agree to leave town together. On day 11 at 02:00 you need to meet her at the train station and interact with her to board the train and leave. Once the cut scene occurs make your way back to town for the achievement to pop.


Adam
Give names to all who are tongue-tied and mute

Sleep to have the dream of being back in the Abattoir. When going up to each of the skull stick men you must offer to name them to earn this achievement.


And nothing will remain
Tick-tock

Survive day 10.

There is an achievement for each of the different endings you can see below:


Nocturnal Ending
Preserve monsters, wonders, and the plague, reviving the past

Burn the Inquisitor's orders in the fire barrel outside the factory door.


Diurnal Ending
Preserve the Town of humanity and warmth, giving it a future

Deliver the Inquisitor's orders to Block located in the Town Hall.


Late
Be late to the ending of your own story

Do not pick up the Inquisitor’s orders and reach the 22:00 deadline for when the army was going to take off.


Time has worn out
Tick-tock

Survive day 11.

Day Specific


Dream On
Witness all dreams—including those you'd rather not

To earn this achievement you must participate in each of the dreams. The dreams and their associated days are listed below:

• Day 1: 3 punks in train yard dream
  
• Day 1: Rat dream - sleep after 17:00
  
• Days 2: Children near a door dream
  
• Day 3: Herb bride dream
  
• Day 7: Theater dream
  
• Days 5–6: Classroom Dream
  
• Days 5–6: Termitary dream
  
• Days 7–11 Murky dream - you must let Murky's "friend" take her or alternatively you must not visit the Crowstone on the early morning of Day 7.
  
• Day 7: Another herb bride dream
  
• Day 10: Abattoir dream - you must have completed the Abattoir quest from day 9.

No Reflection
Disperse all Reflections

To earn this achievement you must locate and converse with the reflections across town that you come into contact with and the character specific ones listed below:

• Day 1: Grief
  
• Day 3 - early morning: Aspity
  
• Day 5: Alexander and Katerina
  
• Day 7: Oyun
  
• Day 10: Aglaya
  
• Day 10: Lara

One for All
Face the future with Lara, Grief, and Stakh

To earn this achievement there are multiple steps below to take and you must be going for the Diurnal ending. You must also ensure that Greif, Lara and Rubin do not die at any point in your playthrough.

• You must test out the panacea on day 7
  
• Complete Lara's mission during day 10
  
• At the train station convince Rubin to stay on day 11
  
• Speak to Greif, Lara and Rubin on the destroyed cement structure on day 12

Non Day Specific


Imago
Finish the game on intended difficulty

To earn this achievement you need to start a game and complete it on Imago difficulty without touching the difficulty slider under the games options.


L'appel du Vide
Hear the Plague's voice

You will earn this achievement after becoming infected and hearing the whisper of the Plague. I did this after meeting Murkey's "friend" and becoming infected.


Clockwork
Touch the thing that produces time

Once you gain access to the Cathedral, travel up the spiral staircase to the second floor and use the large pendulum to save your game.


Tag
Trade with children twenty-seven times

Make 27 different trades with any of the children around the city.


Deal
Make a deal with the Fellow Traveller for some relief from death's burden—and find out what it cost you

You can earn this achievement after day 1. You need to die at least 7 times and then accept the Fellow Traveler’s offer. The achievement will unlock after you complete the game.