He'd probably create something along the lines of Pathologic. And that's meant as a huge compliment, whether you consider his movies things of beauty or unbearable borefests.
Pathologic is sold as a survival horror but it's much more than just a Russian take on Silent Hill. A better comparison would be Cosmology of Kyoto, a forgotten game / gem that lets the player explore Japan's ancient capital, which certainly wasn't a zen garden back then. Pathologic has a distinct, bleak atmosphere, with shades of grey & orange on every corner. If we're still in nostalgia mood, throw in Perihelion, an Amiga classic that also deals with plagues and the apocalypse.
Yes, plagues, or to be exact, a plague. A plague haunting some unnamed small Russian city is what draws our three main characters to the scene. You can choose from the two men and later, if you complete the game, play as the girl. Each of them will take you through the same story but experienced from a different point of view. And my, what a story it is. This is Gaiman born in Chelyabinsk, this is City Of Lost Children, only those children speak Russian, collect fish hooks and bury their teddy bears.
The focus is on simulation rather than combat and you need to take good care of your character. Getting clean food and fresh water is very important, as well as maintaining a solid reputation - otherwise, townspeople will recognize and attack you. Did I mention that each time you kill someone, a baby cries in the distance? Progress is divided into days and as those days go by, the situation gets worse and different kinds of hell break loose.
By no means it's a perfect game, not at all. Gameplay would certainly benefit from a better (= modern) engine but not in terms of visuals, which set the mood like few other games do. Weakest link is the English translation, if one could call such atrocity translation. There are parts where it's nearly impossible to decipher the correct meaning and that's a major letdown.
Still, if you strive for an unconventional game that is both intelligent and beautiful, with a bold, original narrative, Pathologic is just it. A ten is way too much but then again, it's one of the strongest experiences I've had on the PC.
Tarkovsky's work was labelled as either "cinematic poetry" or "cheap & boring". Go figure.
10 / 10