Lawrence.com

Everyone remembers the good 'ole days of Operation. If that title doesn't jolt a memory, it was a board game that attempted to simulate real life surgery, but in little kid form. That's the last game I can think of that came close to simulating surgery on humans. Now of course the game did not represent surgery in any realistic form, but it was all we had. With Trauma Center: Under the Knife, developer Atlus attempts to do what Operation failed at, making fake surgery not only fun, realistic.

Trauma Center would not be possible any other console as the game uses the touch screen to its fullest. You'll be using the stylus for controls the entire time and it will consist of doing the surgical procedures and selecting items. The game flows as you go from one surgery to the next with story progressing text in between. Yes, that game does have a story and it is quite dramatic. If anyone has watched such shows as ER or Chicago, they'll be familiar with the surgery room-drama taking place. The story elements are much welcomed though because it gives depth and a bit of insight of what's going on. Not to say this is the game's shining point because the actual surgery takes that claim.

I was quite surprised at how deep into the medical field the game got. Anyone who has never taken a biology class of some sort will have no idea what's going on. Not only does the game use realistic medical vocabulary, it also doesn't do a whole lot to teach the gamer what these words mean and instead rushes them straight into things. Believe it or not but many people don't know what a hemorrhage or a laceration is. The instruction manual does have a one-page glossary for a few dozen terms, but it isn't a full medical dictionary so you might be looking a few terms up on your own.

The actual surgery is not as complicated as some of the text. Atlus has done a good job of simplifying major surgery tasks so that us novices can perform them on the touch screen. The great thing is that not only is each procedure simplified, but also they each have their own characteristic feel. For instance, suturing someone up is simply done by drawing the suture thread over the incision, but draining blood, which is just as easy to do, is done in a totally different manner. The point coming across is that even if the gameplay is simplified, there is still enough variety in the simplification to keep the gamer happy and entertained. It also represents the many different procedures performed and later in the game when you are on your own, you'll have to recall these procedures. Sometimes you'll be caught off guard with a mishap and you'll need to keep your composure and quickly remember what procedure should be done and how to do it.

That's another area of the game Atlus really nailed. The pressure of working in surgery is realistically recreated. This comes down to the three ways to fail a surgery: either by running out of time, having too many misses, or having the patient's vital signs hit 0. It's incredible when crisis hits how hectic things can get. You have to watch all three of those factors and be able to recover if they get too low. So you'll be not only monitoring those three stats, but you'll also need to keep your eye on the procedure you are executing. One patient that came in from a car accident had multiple wounds on his body that were bleeding massively. His vital sign was quickly decreasing and I had to carefully and quickly remove the glass shards and then stitch up the wounds while the patient was tiptoeing on the line of life and death. Disaster can also occur in the middle of surgery too. In another example, I was simply removing a benign (harmless) tumor as routine surgery, when all of a sudden a vessel burst and blood was streaming out. Crazy incidents will occur all the time as it gives the game suspense and tension.

The main theme of the game is keeping your composure. You'll notice that when you talk to the other characters in the game, they'll give you tips on performing your duty and most of them will say to stay calm and work under control. The game requires you to work this way because if you rush your procedures, you'll end up goofing up by not following the incision line or lifting your stylus and interrupting a procedure because you were moving it too quickly. It's actually pretty tough to keep your composure when things go haywire, but it's all part of the fun.

Graphically the game uses the top screen for patient info during surgery and it also shows tips from your assistant or whoever is helping. It's a very intuitive interface and very well done. The bottom screen shows the actual surgery. The game isn't bloody and not even close to mimicking the gore of real surgery. Instead, a more textbook approach is done as the body has a computer rendered look to it. Blood is very minimal so letting an youth play with it shouldn't be harmful. The game also has a ridiculous way of avoiding deaths in the game. When you fail a surgery the patient doesn't die. Your head doctor or supervisor magically shows up to save the day. He can be out of town or just out of the office, but he'll still somehow know he is needed and show up just as your patient flat lines. Ridiculous, but convenient. Sound is virtually absent as most of it is cruddy sound effects of the surgery or the background music which isn't bad but also not great.

Trauma Center is definitely a video game experience like none other and can actually entertain those who aren't even interested in the medical field. It takes superb hand-eye coordination and self control to reach the end. Some of the surgeries can become extremely tough and take maybe up to 10 tries or more to beat them. The game takes around 8 hours to complete and does wear a bit thin towards the end with repetition, but not enough to ruin your experience or make you stop playing. All in all, this game is one of the best sleeper titles for the DS and hopefully creativity like this continues on the system.

Graphics: C-

Sound: C-

First Play: B

Last Play: B-

Gameplay: B+

Overall: 85% B