Release Date: 05/20/10
From the first time I picked the first Trauma Center: Under the Knife, I was hooked to the series. With subsequent releases would come additions, including the introduction of another Healing Touch and a new character in Second Opinion and co-op in New Blood. By the time Trauma Center: Under the Knife 2 came out, however, the whole “bioterrorist organization” plot and zapping alien bugs was starting to get stale. In response, Atlus decided to try another direction. When I heard of all the changes there would be – five more specialties added, no equivalent of GUILT/Stigma, no Healing Touch – I was intrigued, but also a bit apprehensive that something would go wrong somewhere in the execution. Don’t fix what’s not broken… right?
This time around, the action takes place at Resurgam First Care, and you don’t just perform surgeries. Rather, you’ve got five new specialties to play through as well: first response, orthopedics, endoscopy, diagnostics, and forensics. Each character has their own storyline, though their stories often intertwine. CRS-01 is your surgeon with a 250 year sentence for a crime he doesn’t remember committing. Maria Torres is the emergency medical technician for whom diplomacy and teamwork are not strong points (to say the least). Tomoe Tachibana is the team’s endoscopist whose path of honor involves shoving gold (yes, she had a golden endoscope specifically made for her) into various orifices and being a ninja. Hank Freebird, the orthopedist, is a former US Special Forces solider who moonlights as a superhero called Captain Falcon – I mean, Captain Eagle. Gabriel Cunningham serves as the diagnostician with a sentient computer named RONI. Finally, Naomi Kimishima (whom those who played Second Opinion should recognize) is now a medical examiner and has a cell phone that allows her to hear people’s final words.
The story in this game does live up to its striving to its claims of being an interactive medical drama. While Atlus claimed to include more realistic procedures in this game, the fantastical elements inherent to the series ended up saturated into the story instead. A person using his body to complete a cut circuit for the duration of an operation and is still upright and coherent at the end of it? A butler transporting from the ground to a jet in midair? Still, despite these campy and over the top parts, watching the story unfold is still enjoyable, and there are some moments that may tug at heartstrings (especially Kimishima’s cases). The post operation/mission comments even change depending on what rank you’ve earned, and the game over messages (none of which involve notifying the medical board) differ depending on who you’re playing as and where in the game you are, which are nice touches.
However, while the game provides enough for you to understand the characters, it also could’ve given them more development. It also leaves plenty of loose ends hanging, such as anything pertaining to Gabriel’s family, Hank’s time in the military, or anything concerning CR-S01’s past (especially the incident that put him behind bars). I suppose such issues could be addressed in a sequel if that’s their plan, but the ending wasn’t quite satisfying. As a sidenote, for those of you wondering: yes, the famous Derek Stiles does make a cameo, but only a very small one – even smaller than the one in New Blood, to the point where his name is never mentioned and his face is never seen.
Like in New Blood, there’s also co-op play in all modes except diagnostics and forensics. In orthopedics, players take turns performing each step. In surgery, you distribute the tools among players pre-op, while in first response you do the same with patients. In endoscopy, control alternates between players every several seconds, which is probably the worst design choice they could have made for that part, as it’s rather disruptive since the switch can ofter occur while a player is in the middle of doing something. However, I think the co-op surgeries in New Blood worked better since both players had access to all tools, and I was hoping for some more of that in this game. Still, having the option to team up with another person in surgery is loads of fun.
Story scenes unfold in a pseudo comic book panel format, and the color palette is more vibrant compared to the one in every Trauma Center game from Second Opinion on. They look nice as stills, but the attempts at animation are minimal, and it shows. For example, in one scene one character pushes another, and they both look like paper dolls being knocked over as they fall to the ground. The pictures without lineart to indicate a character is farther away (like the people in the background here) looks a little creepy, especially those shadowed eyes. There is one point where the art shifts into a darker, more detailed style, which really fit the moment (you’ll see when you get there). Overall, though, the cutscenes do their job in conveying the story, and they’re more dynamic than the still character portraits, but they have their awkward moments.
Organs and various body parts have a phosphorescent look to them. While that’s in line with previous games in the series, the graphics have taken a turn for the absurd, with blood that resembles red Jello and tumors that appear gem encrusted; even some of the organs themselves bear some resemblance to jewels. I realize that they wanted to tone things down for the squeamish (as some would get grossed out by strictly realistic graphics), but this clashes with the move towards more realistic procedures and just doesn’t work. Feeling like I’m tunneling for gems while I’m inside a patient doesn’t exactly do much for suspension of disbelief. It just doesn’t work as well as the ones in previous games, which manage to avoid triggering the faint of stomach while still retaining some semblance of plausibility. It doesn’t interfere with the playability of the game, but it’s inconsistent with the darker tone of the rest of the game and the claims of realism. The top and bottom of the screen also changes color depending on how your patient is doing – green if they’re doing well, yellow if they’re borderline, and red if they’re in danger (which is a sign to reach for that stabilizer and hustle).
Some familiar themes return in remixed forms, and they generally sound good. The themes that play suit the character you’re playing as – Maria’s tends to be more frenetic, Tomoe’s more on the serene side, and Hank’s more steady (though it increases in tempo the better you do). The music that plays during the final operation really helps set the mood, and the switch to a slower tune at the last part added more impact. It helps that the track itself was pretty, but you don’t really hear it for long – well, unless you want to fail the operation and start over. The song that plays during the credits also caps things off well. Like in New Blood, there’s a lot of voice acting in every cutscene and during stages, and it ranges from decent to good. The characters’ voices fit them, though some of the comments during stages can get a bit repetitive to the point where they have the potential to turn into memes, if they haven’t already.
Each of the six doctors have their own set of stages, with all the events in them taking place on one timeline. If two events are next to each other on the timeline, that means they’re happening concurrently (though Gabriel’s always come first). Though you can choose the order to play each chapter in and go through one specialty at a time, doing so can cause you to stumble on spoilers, either storyline or gameplay wise. For instance, I initially played according to what specialties I felt like trying, as I was excited at being able to try them all out. As a result, I ended up already knowing what diagnosis I was aiming for in a couple of Gabriel’s chapters. But then, I still had to do the legwork in proving it, and seeing the process is always fun, so it wasn’t too big a deal.
Surgery is what you know and love if you’ve played the previous Trauma Center games, with one exception: no Healing Touch. Yes, you read that right, though in this game it’s not really needed. Everything else stays the same – select tools with the nunchuck’s analog stick and use them with the Wiimote (some in conjunction with the nunchuck as well). However, the surgeries now have guidelines (such as zigzag lines on lacerations), little icons that indicate which tool to use, and tutorial windows to help you on your way. Those new to the series might appreciate these, while veterans could find them intrusive. Pressing the – button makes them disappear – though not the tool icons for some reason- but only if you’ve already beaten the stage once.
First response plays much like surgery lite in that you only have half the tools you would in surgery at your disposal (antibiotic gel, syringe, bandage, and forceps). If that sounds too limiting, know that you do get access to other situational tools as you need them, like gauze for mopping up blood, splints for broken bones, and scissors to cut off clothes to get them out of the way. At times you’ll also have to give chest compressions (fun fact: the timing for swinging your Wiimote while giving chest compressions actually is in line with how you’d do it in real life) and chest pounds .This mode tests your ability to juggle patients and multitask, and you’ll likely end up having to switch back and forth between patients to keep them alive. One difference between surgery and first response is that you can actually lose patients and still be able to complete the stage, though only up to a certain number. Naturally, this will deep-six your rank, but it helps if you’re still getting a feel for a stage.
Orthopedics consists of following guidelines while doing tasks such as drilling holes, screwing on plates, and swinging a mallet as part of the process of repairing bones. You also often have to cut out a piece of synthetic bone to replace a broken piece of bone. Drilling involves pulling an arrow in front of the drill bit and letting go just before the bottom. For securing the screws, you have to hold down the A button and stop within the yellow silhouette of the screw. With cutting synthetic bone, you have to keep the laser going along a guideline without going beyond the red lines on the sides. To hammer rods into place, you swing the Wiimote, though if you overdo it on the swing, you’ll get dinged for it. The focus is more on precision than speed, and emphasis is put on chains. Some of these stages can turn into marathons, which can take some endurance to get through, and while it’s fun to play through, having to start over will cost you more. Instead of vitals, there’s a meter consisting of five hearts on the upper left corner of the screen, and every time you make a mistake, you lose half a heart.
Endoscopy entails inching along inside a patient’s organ. To move, you hold down the A and B buttons and push the Wiimote forward. To move back, you can either pull the Wiimote towards you – also while holding A and B – or press down on the Wiimote’s control pad. The endoscope moves depending on the position of the onscreen cursor (controlled by the nunchuck’s analog stick). There’s a radar at the top right corner to help you locate injuries and other problems. When you come upon an injury, there’s an autolock which helps you aim your tools. Selecting tools involves holding the C button and tilting the nunchuck’s analog stick to the tool you need. While the controls probably closely approximate how an actual endoscope would be used, they aren’t the smoothest, and wind tunnels (where you get pushed back and can’t use any tools) are especially tricky to navigate. It can be easy to get lost or disoriented, as the passages tend to all look the same, and trying to backtrack if you’ve gone the wrong way can get a bit precarious since vitals go down if you bump into a wall. The radar can help, but it’s also a bit vague. I wasn’t fond of endoscopy at first, but it grew on me the more I tried it, though it never rose to favorite status.
Diagnostics has you digging for information about symptoms from your patient and test results. One part of that is questioning, wherein you go through and select any statements (kind of like pressing a witness’s statement in the Ace Attorney games) that indicate abnormalities. You also need to visually examine them for any overt signs of illness (such as swelling and shaking) and auscultate them, meaning use a stethoscope to listen to their heartbeat, breathing, and gastrointestinal sounds. All these sounds play through your Wiimote speaker, which actually helps since you can hold it right up to your ear if you’re having trouble hearing them and comparing them to the normal sample. You also have to look at lab results – which contains things like blood pressure, white blood cell count, and so on – and mark anything that’s outside of the normal range. In addition, you’ll need to compare MRI, x-rays, and other such scans to a normal sample so as to find anything out of place. Finding any abnormalities in the images can feel like looking for a needle in a haystack, especially if the only difference is some mildly darker shading. Naturally, not every area will have an abnormality, which can make narrowing things down a bit trickier. Once you’ve gathered enough information, you head back to RONI and match up the symptoms you’ve gathered with different candidates. Once you’ve matched them all up, it’s time for the diagnosis. However, like with orthopedics you get five hearts, and any mistakes you make will cost you a whole heart. You can save in your office, and if you fail you’ll start over from your last save with all your hearts restored.
I had the chance to preview the forensics portion of the game a few months ago, so I was excited to be able to play through it firsthand. Forensics plays much like the Ace Attorney series, anything by Cing, and any other point-and-click adventure games. Each chapter starts with Naomi receiving a call on her cell phone and hearing a person’s last words before their untimely deaths. After that, you’re briefed on the case, then it’s off to examine the body and the person’s personal effects for any clues. Evidence is stored as cards on your computer, and you can have Little Guy analyze some of them for more information on them or combine them to create a new tidbit of information. You also listen to voice recordings, and you can click on each statement for some commentary from Naomi and at times a new piece of evidence. You comb through the crime scene with a magnifying glass (I would hope it’s obvious what this is for), spray to check for bloodstains, powder for fingerprints, and an ALS light to reveal anything the latter two picked up. As is the potential downfall of point and click games, it can turn into a pixel hunting fest looking for that one little thing you need to move on. At various points questions will pop up about a detail of the case, and there’s also a recap Q&A at the end of each case a la the aforementioned Cing games. At some points you’ll also have to reconstruct bones, which works much like a jigsaw puzzle. Like with diagnosis and orthopedics, you start off with five hearts and lose half a heart for each misstep. The first case didn’t draw me in as much as the later cases, and it becomes obvious who the culprit is early on, though like the rest of the cases it still had a dramatic ending. The other cases are more compelling, and they get pretty tragic (and somewhat disturbing).
Once you complete the game, you can earn doctor’s medals for fulfilling certain conditions, such as not using the auto retract during an endoscopy procedure or extracting things without locking on them with the ultrasound, as well as completing every operation with an XS rank (good luck with that). During Kimishima’s cases, you have to find Medal Challenges hidden in various places and answer the questions contained within correctly. Each doctor – as well as the closest thing this game has to an antagonist – also get a bonus audio track (which are basically outtakes) that sheds a bit more light on that character. Earning Doctor’s Medals will likely take a while, and replaying through the stages for a better rank does give that bit of satisfaction (who doesn’t like seeing a whole column of S/XS ranks?), so the game can last you for at least a little while after you beat it. The lack of X missions does hurt replayability a bit, but then there wouldn’t really be much to base X missions on.
There’s three difficulty levels available: Intern, Resident, and Specialist. However, the Specialist difficulty is only available after beating the game once. I’m a bit confused as to why Atlus chose to do it this way when in previous games (excluding the first Under the Knife) all the difficulty levels besides the X missions were available from the beginning. I know they wanted to make this game more beginner friendly than previous entries, but it just seems a bit asinine to do it like this when those who wanted to could just pick the easiest difficulty anyway. In addition, time limits are gone except for select missions, which is actually a relief since that means no more instances of failing an operation while you’re putting the final bandage on the patient. The game is overall easier, especially than New Blood, as the surgeries in that game seemed designed for two people, though it feels like they swung the other way a bit too much in this game; even the final operation wasn’t as challenging as the ones in previous games (with Alethia in Under the Knife 2 being up there). It’s possible that I’ve just had a lot of practice from playing the previous games, but I was able to S rank all the surgery stages on the first try on Resident mode. The Specialist difficulty does at least provide more of a challenge (especially if you’re shooting for XS rank), so there’s that. Diagnostics and forensics have no difficulty settings or scoring, and there’s no real penalty for losing all your hearts other than having to start from your last save, so you can basically go wild. In those missions, it’s entirely possible to get stuck if you miss even one thing. However, they do indicate whether you can find anything more out when you go somewhere or look at something, which helps point you in the right direction. RONI will also give you a hint if you talk to it in the office during diagnostics mode.
I loved having all the different specialties rather than the same viruses regurgitated in slightly different forms. While taking various GUILT/Stigma strains to town was enjoyable, having the more normal operations to vary things up was nice. I kept wanting to continue to the next stage to see what happened next as well as complete another stage. Plus, cutting into people and fixing them up is addicting in a way (even if I probably wouldn’t handle it that well in real life). The diagnostics and forensics stages took the longest to do, but I still enjoyed going through them, and their length didn’t deter me from wanting to keep going once I was done with them. The only drag was endoscopy, especially in stages where you had to roam around the organ and meander through a mazelike setup to find when you needed to fix. Even then, I still liked playing through those well enough. The perfectionist in me would also keep going back to previous stages and trying to earn a better rank.
The move towards more realistic procedures (well, as realistic as they can get in a video game) and elimination of the Healing Touch and GUILT/Stigma like strains stemmed from people clamoring for both, and the difficulty was geared towards luring the more casual players – and people put off by the difficulty in the other games – in. On both counts, this game succeeded somewhat, though with some mixed results. This game does a good amount of handholding, which helps new players acclimate themselves to the controls and general flow of the game but can potentially irk and alienate longtime players. I do question how many people from the casual crowd would be interested in playing a game centered around surgery, but then the series has done well enough to spawn five games, so it must be appealing to a large enough group. There should’ve been an option to turn off the guidelines and little tool icons from the get-go, but at least Specialist mode can sate anyone looking for more of a challenge. For anyone who misses GUILT/Stigma: don’t you worry, there’s still a final big virus that everyone takes on, though it doesn’t show up until near the end of the game (even if it’s alluded to here and there beforehand). Overall, though, they did a good job balancing what would appeal to longtime fans, what would draw in new players, and what would keep the series from becoming too stale while retaining the aspects that draw people in.
Graphics: Above Average
Control and Gameplay: Very Good
Balance: Above Average
Appeal Factor: Enjoyable
FINAL SCORE: GOOD GAME
Short Attention Span Summary:
Trauma Team was a deviation from the usual Trauma Center formula, and for the most part it worked well. Some of the controls can take some adjusting to, especially the ones that involve tilting the Wiimote or nunchuck a certain way. The graphics and some of the more outlandish plot elements detract from the claims of “more realistic situations”, though they don’t hamper enjoyability much as long as your suspension of disbelief is intact. The game does lean a bit more on the easy side than previous games, and it could benefit from less handholding, or at least the option to turn it off for those who don’t want it. Overall, though, this was a strong entry in the series, even if it is technically a spinoff.