Review: Trauma Center: Under the Knife 2 (Nintendo DS)

Trauma Center: Under the Knife 2
Genre: Puzzle
Developer: Atlus
Publisher: Atlus
Release Date: 07/02/08

The original Trauma Center, which saw its US debut a little more than two years ago, was a surprisingly interesting, addictive, well-paced puzzle game that featured interesting characters, a decent concept, and a whole mess of challenge crammed into one tiny DS cartridge. It was generally well-received, fairly popular, and all in all, worth all of the praise and adulation it received.

Two years later and we’re on the fourth game of the series (the second being a Wii port of the original, and the third being another Wii release featuring completely different characters and two-player co-op), which is more or less the first “true” sequel to the original DS game. At this point, it certainly seems like the well has run dry; after introducing multiplayer mechanics, motion-controls, all sorts of weird puzzles, and over a hundred different missions, at this point, it certainly seems that the franchise would have run out of new and exciting ideas, especially with there being so many games in such a short span of time.

This, surprisingly, ends up not being the case. While Trauma Center 2 certainly follows in the footsteps of its predecessors, it also manages to introduce enough new elements to be worthwhile, and actually does something that the other products did not that may very well make it worthwhile to those who were not fans of the original. It’s not all wine and roses, of course, but nothing ever is.

Trauma Center 2 opens up three years after the events of the first game, and we find Derek Styles and Angie Thompson hard at work in the fictional country of Costigar. The game uses this setup to introduce us to some new faces, as well as to give new players a small tutorial as to how the game works, before dumping the characters back into Caduceus to help work on curing the symptoms that are coming up in the wake of the GUILT crisis of three years ago. GUILT, for those who did not play the prior title, was a man-made virus that caused all sorts of fatalities across the world, only to be brought down by the combined efforts of Caduceus, Dr. Styles and Nurse Thompson, and now it seems that those who suffered from GUILT are suffering additional problems after the fact. This is only the start of things, however, as old and new enemies make their presence known, forcing Derek, Angie and Caduceus on the defensive once again, with the fate of mankind on the line.

The first Trauma Center, storyline-wise, was acceptably corny, in that the good characters were good and moral, and the evil characters were evil and twisted, but it all worked well enough and wasn’t wall-banging so much as charming. Trauma Center 2 more or less tries to rekindle the magic of the first game, but it doesn’t quite manage it because this time, all of the clichés are a bit harder to swallow. Early on in the game, Derek is approached by Reina Mayuzumi (and by approached, I mean “molested”) about leaving Caduceus to go work for her company, under the explanation that she will “make worth his while”, from which you may infer whatever you like, which Derek considers before ultimately refusing. This is further coupled with a televised surgery he’s not consulted about (but seems interested by), a situation where he agrees to be monitored so his skills may be taught to other doctors, and general back-patting and peer appreciation. Nurse Angie responds by publicly dressing him down twice; once by noting she would never date him because he’s a big-headed egotist, and once by noting that his reaction to a horrible traumatic event (which was, for the record, to freak out and try anything in his power to avert it, which I’d kinda like to think is what anyone would do in that situation) was him being an egotistical prick and how it’s essentially his fault.

This, then, is the problem: in a world of black and white morality where people are essentially either good or bad with no in-between, people who live in a world full of variable morality look at Angie’s reaction and go “Wow, what a bitch”, and by extension, look at Derek as he essentially takes all of the abuse and THANKS HER FOR IT and go “Wow, what a loser”. In the first game, this situation was completely merited, and it was basically the maturing point of the character; he slacked off and was taken to task for it because he deserved it, and it allowed him to mature as a character into a good doctor. In this game, the situation feels forced and stupid; it feels stupid for Angie to be so mad at Derek for such little infractions, especially to the point where she tells him off twice (once, in particular, after a hideously traumatizing event, in such a way that everyone who knew her should have immediately responded with disdain at the thought of associating with such a heartless person), it further feels stupid that he takes this so badly that it more or less ruins him for almost an entire chapter, and it feels especially stupid on top of that that he essentially says at the end, “No, you were right again, I suck,” when the differences between the first and second game’s “major infractions” were the differences between crashing someone’s car and hitting someone’s car with a foam bat.

Oh, yes, and the plot borrows a bit from Spider-man 2 (the movie, not the game), in addition to borrowing an element from Trauma Center: New Blood (which I suppose you won’t notice if you never played that game) that it plays more or less similarly. Oh, yes, and while the game spends more or less half of its time building up the “Derek and Angie are SO TOTALLY GETTING TOGETHER YOU GUYS” plot point, it pays it off in the most ambiguous way imaginable instead of actually having the characters finally just say “I love you” and be done with it.

That’s not to say the plot is all bad; most of the time, the plot moves forward well, the characters are engaging, the Big Bads are menacing and devious, the surprise plot twist doesn’t occur to you for a while and is handled surprisingly well, and the final Big Bad actually has a motivation that DOESN’T amount to “I’m an evil bastard”. By and large, the storyline is MOSTLY decent, the characters are MOSTLY likable, and the elements that are annoying/badly handled are largely self-contained across two or three of the seven chapters, meaning that they’re not the focal points so much as just parts of the overall plot. It’s just sad that the plot in Trauma Center 2 isn’t as good as the plot of the first game, or for that matter, the plot of New Blood.

Visually, Trauma Center 2 is a solid improvement over the first game. The 3D surgeries are all very well done, and most of the visuals have either been touched up nicely or have been completely re-done. The patient models, organs and such look good, and the various viruses you’ll have to face (some of which are holdovers from the first game) have completely re-done visuals as well, making them look and feel brand new. The art style has also changed, for the better; while the first game had something of an anime feel to it, this time around the characters have a more serious look to them (if a look that’s reminiscent of Persona 3, though it appears the artist for this game also worked on P3 in some capacity) which generally makes them more convincing in their roles (though fans of the Wii titles will note the artistic style is the same here as in those two titles). Aurally, the game is also mostly good; the music is strong and powerful and works well with the product, the sound effects generally sound good, though some are more appropriate for the “game” part of the experience than the actual concept of the game (IE they sound good for a puzzle game but not so much for a game about surgery), and there are snippets of voice acting here and there, which are mostly used as audio cues during surgery and THANK GOD FOR THAT because it’s easier to hear “use the drain” than to look to the top screen to see what Angie wants me to do next.

Now, if you’ve played the first Trauma Center, hey, guess what, this plays the same! If not, however, here’s the deal: you are presented with a situation, be it a broken bone, polyps on the intestines, an infected gall bladder, killer viruses, or whatever, and you have to surgically solve this issues with the tools presented to you. Your work station is the DS touch screen, where you will see the various organs and body parts that you’ll be working on as you play, and all of the tools available to you will appear on the right and left of that screen. By tapping the tools, you take control of them, and by using them as instructed on the main screen, you perform your surgeries. Tools like the laser and the antibiotic gel generally require little more than simple tapping motions, while tools like the sutures and the drain with require some dragging or drawing of lines and such. Generally, some tools are liberal about what you and do and where you can place things, while others (the forceps, for example) are a bit more exact in their requirements of straight lines and precision. In any case, performing an action will generally be graded on the sliding scale of “Bad” to “Cool”, with Bad meaning you did it, barely, while Cool means you aced it. Screwing it up, of course, is what it is, which in this case is a “Miss”, which is not only bad in general but also dips your patient’s vitals. The vitals, as one could expect, dictate how alive your patient is; as you perform surgical work in general your patient will begin to lose vitals (which can be boosted with a shot, mind you), and a Miss will deprecate them even further, so it’s generally advisable not to miss.

This is all reasonably simple to take in, of course, and you can more or less make it through most surgeries with this knowledge, but getting high scores and passing certain missions at all will require some more advanced tactics. Now, Dr. Styles isn’t considered one of the best surgeons EVAR because of his awesome poses and catchphrases (“I WILL SAVE THIS PATIENT” really should be on a t-shirt somewhere), but rather because of his Healing Touch. Simply put: when you’re in a position where you need the game to slow down a bit so you can catch your breath, you can select the Healing Touch icon at the bottom left of the screen, draw a star on the screen, and BAM, you go into bullet time, more or less. The game environment slows down to a crawl as you are allowed normal action speed, meaning you can resolve the various problems going on at the time (in case, say, the patient is hemorrhaging like crazy and you can’t stop it fast enough or a virus is tearing their vitals up or what have you) and pull out a win where certain defeat was the only option. This can only be used once in a surgery, mind you, so you have to make it count, which can mean the difference between a win and failure. Success isn’t the same thing as acing a surgery, of course; making it through an operation by the skin of your teeth will probably merit you a C or B rank from the game, while breezing through an operation and absolutely owning the problems presented will earn you an A or an S, with S being the most desirable rank to achieve. Part of the way to do this is to max out your combos; as you successfully complete actions in the operation, your combo meter goes up as you string together successful actions, while Bad scores or Missed actions reset your combo to zero (much like in DDR, for instance). Thus, stringing together a series of Good or Cool actions keeps the combo going, earning you higher scores post-op. Also, based on how you perform in the operation, you’ll receive awards at the end, based on how many mistakes were made, the patient’s vitals, how much time was left (as all surgeries are timed) and other case-specific objectives, which in turn influence your ranking.

Now, most of this is old-hat to Trauma Center fans, but Trauma Center 2 has a few other interesting set pieces and changes to make it a worthwhile investment for fans and newcomers alike. The biggest addition, and the one that’s most friendly to all players, is the new option of adjustable difficulty. The original Trauma Center and the two Wii releases had set difficulties which were, in all honesty, punishing to unskilled players (which is, in an odd anecdotal story, how I acquired my copy of the first game, as my ex-girlfriend bought it and was unable to advance beyond the fourth chapter, and ended up giving it to me to beat… which I’m positively certain you don’t care about, but whatever). Trauma Center 2, however, offers up the option of three difficulties, in Easy (which is pretty simple to blow through), Normal (which is about on-par with the first game difficulty-wise) and Hard (which is significantly more challenging than the original game). These difficulties mostly affect patient vitals (higher difficulties mean faster drops in vital signs), but this still makes the experience a good bit more or less difficult as you progress as it means more or less monitoring of shots and such. There are also several interesting new strains of GUILT and other infections to face off against, as well as a few novelty missions to take on (including one in the back seat of a moving car where your only source of light is a PENLIGHT, which is about the most absurd and awesome mechanic ever), meaning there’s enough novelty for old fans to not feel this is a retread of the prior game.

In addition to the new operation novelties and difficulty modes, there are also several things that keep Trauma Center 2 worthwhile insofar as long-term replay is concerned. For one, replaying missions allows you to skip the cinematics and go straight to the operation, even on higher or lower difficulties, meaning you can breeze through the game on Easy, then go back to missions on Hard and just get right to the operating, making playing your favorite operations less tedious and more action-oriented. This is also nice for not just trying to get through missions on higher difficulties, though; it’s also nice for those of us who want to improve those missions we got B’s and C’s in up to an S rank, since, again, there’s no need to go through the storyline the second or third go-round. Beating the game on any difficulty also unlocks EX missions, which were a staple of the older games; basically, these are HIDEOUSLY difficult missions against Guilt strains that test your surgical skills to the max, thus giving players something to improve their skills for, as even the best players will find something of a challenge to fight through in them.

This, of course, only helps to further point out the biggest problem with Trauma Center 2: it’s more of the same. Now, in the sense of fairness and all things being equal, it bears noting that on a personal level, I don’t really care; I love the franchise to death and if they released ten more games I’d be all sorts of pleased to be buying them and playing them practically to death, but on a professional level, it’s sad to see that Trauma Center 2 really only does one or two “new” things to make it different from its predecessors. The mission that takes place in a moving car is neat, as is the virus that asks you to blow into the DS mic to blow away smoke covering your view, and the adjustable difficulties will certainly be helpful to players who found the prior entries frustrating, but these are really the only new additions to the game, as the rest of the things that pop up were either in the original game or they were in New Blood, and thus will only feel “new” to people who haven’t played that title.

The experience is also fairly short; a player of decent skill who plays on Easy or Normal can blow through the game in a few hours, and even with the ability to go through the EX missions and retry missions for higher scores, there’s not very much actual original content in the game, which might be something of a turnoff for those looking for a broader experience. A lack of multiplayer is understandable, as the game isn’t designed in the same fashion as the Wii games, but it might have made the game a bit more of a value; as it stands now, those looking to get through the storyline missions and be done with the game will probably plow through the experience in a few hours, and only those who actually want to come back and improve their skills will get their money’s worth from the experience. That said, Trauma Center 2 IS a puzzle game first and foremost, so really, that’s really an inescapable part of the appeal, so if you’re not into that sort of experience, you might not be interested in the game anyway, and since puzzle games do good business on the DS, well, that might not matter to you.

In the end, while Trauma Center 2 treads the familiar ground of its predecessors, it does so in such a way as to continue to be interesting to series veterans while making itself more accessible to newcomers. The core gameplay is mostly the same, and even with a few new tricks it won’t be a whole new game to many people, but the option of adjustable difficulties will allow veterans to punish themselves with Hard difficulty while newcomers and those who gave up on the first game should be able to slip right in to Easy. It’s still a visual marvel on the system, it still plays fine, it’s still challenging and fun, and it’s still an entertaining little puzzle experience all in all. The presentation is solid, the plot’s more good than bad (though the bad is noticeable at times), and it’s fun in both short bursts and over long play sessions, so the casual and the hardcore gamers should be able to have plenty of fun either way. Trauma Center 2 still remains an entertaining, enjoyable and fun DS experience, and while it doesn’t deviate too far from the formula of the prior titles, it doesn’t really need to just yet; the experience is still fresh and fun and there’s nothing else quite like it.

The Scores:
Story: MEDIOCRE
Graphics: GOOD
Sound: GOOD
Control/Gameplay: GREAT
Replayability: GOOD
Balance: GREAT
Originality: MEDIOCRE
Addictiveness: GOOD
Appeal: GOOD
Miscellaneous: GREAT

Final Score: GOOD.

Short Attention Span Summary:
Trauma Center: Under the Knife 2 is a worthy sequel to the original DS title, and while many of its improvements are borrowed from the Wii titles in the series, it adds enough to be interesting, if not enough to be innovative. Trauma Center 2 looks, sounds and plays well, the gameplay is simple to learn and the surgeries are addictive and challenging enough to keep you playing long after you’ve beaten the game. The experience isn’t as original as it was two years ago, some of the plot elements don’t work as well as others, and if you’ve played the original titles you might not want to come back to the franchise a fourth time for more of the same, but hardcore Trauma Center fans and newcomers will find a lot to love thanks to the selectable difficulty and ability to skip storyline to just get to playing. Trauma Center 2 isn’t as revolutionary as its predecessor was, but that doesn’t make it any less entertaining and enjoyable, and whether you’re a hardcore fan, a new player, or someone who hated the challenge of the first DS title, this game should have something to give you a reason to check it out.