One segment of the gaming market that seems to be lacking representation is games based on doctors. Sure we’ve had plenty of doctors and healers represented in games but not many have allowed you to operate on patients. One particular issue has been having the pinpoint precision in the controls to accurately represent just how delicate surgery can be. Fans of portable systems probably would have never imagined that one-day they would be able to play doctor on the go. Well, that time has come with Trauma Center: Under the Knife for the Nintendo DS.

The premise of the Trauma Center (TC) involves you playing the role of Dr. Derek Stiles, who just completed his residency and is anxious to start operating full time. He is assigned to Hope Hospital and is assisted by the hospital staff, which you will interact with during the game. Stiles soon discovers that the requirements of being a full time doctor are almost too much for him to handle. Dr. Stiles is prone to not paying attention and having to focus intensely during preparation and surgery to almost too much for him.

The game plays in a manner that reminded me of a soap opera. Yes, I will admit that long ago I had the tendency to watch a few daytime soap operas. But since this is an Atlus game you can think of this as an anime soap opera. All of the characters have the classic anime look to them but instead of spiky blue hair you have characters dressed up as doctors.  The plot unfolds as the characters in the game discuss upcoming operations with Derek or talk down to Derek about his lack of attention. There are other plot developments in the game but it’s nothing that fans or gamers haven’t seen before in anime or a soap opera.

Even though the plot plays out like a soap opera, the gameplay is definitely something that we haven’t seen in before in other games. With the touch screen capabilities of the DS, the “act” of operating is given a unique feel that has never been done before in a portable game. The game briefs you before the surgery to offer an overview of what to expect during the surgery. Nurses are available to help you during the surgery and will offer step-by -step assistance during the first few surgeries. In order to open up a patient to begin the surgery you will need to use the stylus as a scalpel. A line will appear on the patient to indicate where you need to cut with the scalpel. Simply use the stylus to draw the line will open up the patient.

However you will need to pay close attention when using the stylus because if you don’t follow the line (or pattern) exactly as what appears on screen then the cut will be unsuccessful. Some of the cuts that were unsuccessful won’t remain on the patient to allow you to make a quick correction. Instead you will have to repeat the cut again from the beginning. The rest of the game uses the stylus liberally since all of the procedures during the operations are performed with the stylus.  

Once a cut has been made then the next step in the surgery varies depending on the type of procedure. For example if you’re dealing with a tumor that needs to be removed then you will need to locate the tumor in the patient. You can use an ultra sound tool to find the tumor by clicking on the scanner icon on the screen and then touching parts of the infected body part. The scanner icon allows you to use a magnifying glass to get a closer view of a part by drawing a circle on the screen. The point of drawing a circle is to represent you circling an area that you want a closer view.

Other tools that you will use during a surgery range from a laser, antibiotic gel, stitches and forceps. The forceps are used to pick on pieces during a surgery to remove them from the patient or connect them to other body parts. If you want to remove a tumor then you will need to cut the tumor out by following a pattern around the tumor with the scalpel. Once you have the tumor cut out then you will need to use the forceps to pickup the tumor and place it in a pan. Simply click on the tumor and then drag the tumor to the pan by using the stylus. Then to drain blood from the patient you will need to use the drain tool and rapidly push move the stylus up on the touch screen.  The majority of the procedures you perform during the game are very similar to each other involving different motions on the touch screen with the stylus.

The touch screen gameplay is both the blessing and the curse of the game. It’s a fun experience actually playing doctor during the game by performing different procedures using the stylus. But the problem is the touch screen sometimes doesn’t respond to the motions you have to recreate using the stylus. For example there were several occasions when I was using the magnifying glass tool where I wasn’t able to zoom out or in during a surgery. I kept drawing a circle on the touch screen but nothing would happen. Another issue I had with the touch screen was trying to use the stylus near the top portion of the screen. If a pattern had to be created or a certain motion had to be used near the top of the touch screen the game wouldn’t recognize hits from the stylus.

Other problems I had with the game were the amount of repetition of the gameplay and the timing limits. After the first few surgeries you will become comfortable in performing the different tasks involved during the surgeries. But then you start to notice that you’re performing the same movements with the stylus over and over again. The DS is a good system but it can be difficult holding the unit and using the stylus at the same time for an extended period of time. My hand started to cramp up after about 20 minutes of gameplay because of the repetition in movements.

The other problem is the time limits of the game. Most procedures have a five-minute limit but you’re always under pressure to keep the vitals of a patient up. So why have a time limit when the ultimate goal is to keep a patient alive? Then you will run into operations where the vital signs of the patient will drop immediately to a critical level while you’re frantically moving the stylus around. The game can be very unforgiving during certain operations, which requires more than pinpoint precision when using the stylus. One little mistake can cost you the patient and have you replaying the operations over again repeatedly.

In the end I really believe that Trauma Center: Under the Knife is a game that you will either love or hate. We all know how innovative the touch screen and using the stylus can be during a game but for some gamers the touch screen can become too much. Sure it’s a fun and unique experience that hasn’t been seen before in a portable game but the gameplay is very repetitive. I was only able to play the game in small doses because of cramps in my hands. I would say playing the game on a table or flat surface is probably the best method of playing the game. Holding the unit and playing the game with the stylus could become a bother for some gamers during long gaming sessions. But let’s be clear that this is another great example of why the Nintendo DS is fast becoming the favorite portable system of choice for many gamers. TC: Under the Knife is the type of game that we probably would have never imagined playing five years ago on a portable system.

Gameplay: 7.4
The core gameplay is dependent on using the stylus during the operations. All of the procedures that must be performed during a surgery are done using the stylus and the touch screen. After the first few surgeries the game becomes repetitive with you performing the same movements/motions with the stylus. The game tries to keep the game fresh by putting you in tense situations but no amount of drama can change the fact that you’re moving your stylus on the touch screen like a maniac in order to keep up.

Graphics: 8.0
Anime-style graphics for the main characters gives the game the classic Japanese animation look but set in a hospital. The graphics during the operations won’t impress anyone but get the job done.

Sound: 7.7
The music in the game sounds similar, once again, to a soap opera or TV show. The music does the job well of setting the tone and atmosphere of the game. The sound effects during the operations sound like someone cutting on something but I’m not sure if it’s human tissue. The game includes a few short voice phrases that you will hear repeatedly during a surgery.

Difficulty: Medium
I mentioned earlier that one of the problems of the game comes from the timing of the gameplay. Certain missions require you to work as fast as you can in an instance because a patient’s vital signs drop immediately. No matter how efficient you try to be during a surgery nothing seems to work. It’s all about timing which means you will play several missions over and over again just to find the right pattern in the timing.

Concept: 8.3
I’ve mentioned this earlier but I would have never expected to play a surgery game on a portable system. The touch screen offers to ability to perform the surgery with precise precision using the stylus. Unfortunately the patterns and movements that you perform during surgery will probably feel repetitive to most gamers after a few missions.   

Overall: 7.9
If you don’t mind the repetitiveness of using the stylus during the gameplay then you should love this game. If you’re a fan of anime or the quirky games that have become a staple of Atlus then this is the game for you.  But if you’re looking for the newest revolution in gaming with incredible gameplay that will having you coming back for more then Trauma Center: Under the Knife will disappoint. It’s a fun and entertaining game that really doesn’t have the cure for the common gaming cold. The interactive part of the game is also the downfall as well since you’re performing the same moves using the stylus over and over again.

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