Trauma Center: Second Opinion (Part 1)

Who needs gloves, anyway?

One of the indie games I’ve played for this blog that I keep a soft spot for is Surgeon Simulator. It’s exactly as wacky as it needs to be. Realism? Forget it, just free the old heart, shove the new one in there, and here we go, patient’s good as new. Patching ‘im back up? We’re way too good for that. What? Those organs left on the floor? Those weren’t important. Who cares about a spleen anyway? Alright, next up we put a new eye in this guy's socket-whooops! Lost it! Good thing we had that miniature 8-ball lying around!

Point being, Surgeon Sim is a lot of fun, but we don’t really need a story to go with the kooky procedures. No need for that sort of glazing while we operate on poor ol’ Bob on the table, in the hallways, in the back of an ambulance, or in a zero-G environment. But what if we had a story? Well, as it turns out, indie gaming came to this second. Before the funny surgery game on PC, there was a series of funny surgery games... on Nintendo consoles.

Developed by Atlus, the Trauma Center franchise was a series of five games released from 2005 to 2010. Today’s game, Trauma Center: Second Opinion, is the second game in the series, but it’s a remake for the Wii of the first game, Trauma Center: Under the Knife, originally on the Nintendo DS. The original touch screen gameplay had to be adapted to the new console’s motion controls. Second Opinion is also notable in that it was a launch title, released on November 19th, 2006 alongside the Wii.

This series combines the stress of performing operations with a story delivered visual novel-style. You know the medical drama genre, right? House, ER, Scrubs, “it’s never lupus”? Well, it’s not gonna help much. Trauma Center is to the medical field what Ace Attorney is to practicing law. I hope you weren’t expecting accuracy and realism, is what I’m saying. What can you expect instead? Oh, just wait...

Dr. Stiles

By the way, I took my screenshots from the Let's
Play on the channel ProZD Plays Games.
Check it out to see the full game!

This 2006 game takes place in the faraway future of... 2018. Technology, including in the medical field, has seen leaps and bounds. We meet our protagonist, Derek Stiles, an up-and-coming new surgeon at Hope Hospital. He is led through his first operations by Nurse Mary Fulton, Hope's surgical assistant, and the hospital's director Greg Kasal (who’ll take on a mentor role and take over if an operation is botched). Derek is quickly shown to be excellent under the pressure of the operating room (...as excellent as YOU can be, that is), but lacking in all other areas of the job. Bedside manners, post-op care, reading and filling the patient files, actually getting to the hospital on time... Jesus, that’s a disaster waiting to happen. We’re starting on the right foot!

Pull these shards out delicately... wouldn't want
to make the wounds even larger.

On the Episode Select screen, you can select a new episode to play – most are operations, but some are cutscenes. The more notable element to this screen is the ability to change the game’s difficulty at will between Easy, Normal and Hard at any point. The first episode is a tutorial operation, in which we must extract glass shards from the arm of a guy who was in a motorcycle accident, and then suture the wounds. To the game’s credit, briefings before operations use proper medical terminology (“lacerations and foreign objects in upper right brachium”, laparotomy, etc.).

We’re taught the various tools at our disposal. You select one of the eight tools by tilting the Nunchuk’s analog stick in its direction. The tools we’re taught in the first operation:

-Stitches: Close a laceration by suturing it with the thread, by holding down the A button and moving along the wound in a zigzag pattern.

-Forceps: Required to remove foreign bodies and grab stuff. You hold down A and B to grab an item to remove and set it onto a tray, or put new things in. In the case of foreign objects, you pull them delicately out of their wounds.

-Antibiotic gel: Like I said, medical tech has advanced greatly This gel is so potent it will close smaller injuries instantly. Spray onto a wound with A. You use the gel to disinfect before making any incision on a patient’s body, and use the gel again after suturing, before applying a bandage. Its use also increases the patient's vitals.

-Scalpel: To cut open a body part or cut out something in the area being treated, hold down A and follow along the dotted line that appears.

-Bandage: Appears instantly at the end of all procedures; hold down A to apply it along the length of the operation wound after it has been stitched and disinfected.

And keep in mind that you don't have infinite
thread, so don't waste time making drawn-out
sutures.

Flirting's not gonna help much when the new
nurse comes around.

I’ll be snarky when the story goes crazy (because it will), and obviously we’re playing somewhat loose with the realism of surgical operations in the interest of gameplay, but so far, it feels great to do every step in the process. This blows Surgeon Simulator out of the water and exposes it for the extremely silly game it is – Trauma Center feels like a far more varied and interesting game in comparison.

Of course, it’s not all perfect. Trauma Center: Second Opinion is a remake for the Wii of a Nintendo DS game, which was bound to lead to issues. You cannot be as precise with motion controls as you could be on a touch screen. It’s most obvious when suturing a wound, but it’s also clear with every other tool, simply because you can see how the cursor twitches in place with your every action. Surgeons need steady hands; I guess I ain’t changing careers anytime soon.

Angie

Still not feeling the weight of his position, Derek still fails to be attentive prior to operations, leading to errors. This time, we must excise a tumor in a patient’s distal stomach. (I bet the patient’s family name being Laurie is not an accident.) Over the following operations, we learn to use the other tools:

As the end credits will helpfully tell you, this
game doesn't substitute for med school. Don't
go think you can remove tumors just because
a game told you to drain out the cytoplasm.

-Syringe: The patient’s vitals are represented at the top of the screen by a bar that goes down regularly – to increase their vitals, press A to dip a syringe into the vial of green stabilizer and then just inject it anywhere. Anywhere, no danger, no problem. The future! The same tool is used whenever other solutions have to be used to treat the patient.

-Zoom/Ultrasound: Used to first zoom in on a smaller area of the part we’re working on. Then, the ultrasound must be used to detect things to deal with that are hidden within the body part. After which you'll generally cut those out with the scalpel.

-Drain: Before working on some health problems, sometimes stuff must be drained out (ex. Cytoplasm for tumors, blood over cuts, or gases). Hold the A button while keeping the drain steady over the stuff to drain it.

-Synthetic membrane: Like the bandage, this appears on-screen after a health issue has been treated, you pick it up with the forceps, apply it to the freshly treated area, and spray some gel on it to meld it with the tissue.

-Laser: Is required to hit very specific spots that are affected, like polyps. Also activated by pressing A. Prolonged use tends to hurt the patient’s vitals, and in some operations, can even cause bleeding.

Hello, nurse Thompson. How long till Derek
also calls her his lovely assistant? Nah, this is
gonna be like an anime, it will take seven
seasons before they really get together.

Give him a chance, this is still Chapter 1!

Nurse Mary announces that her husband is moving away for work and so must she, but she’ll remain loyal to the cause and be hired at another hospital. A promising new nurse named Angie Thompson is hired to assist Doctor Stiles. Angie quickly shows her colors, being well-meaning enough but having zero patience for Derek’s skill gaps in all parts of the job outside of operating.

This culminates into a catastrophic event where Derek, who has just operated on a patient, doesn’t do his due diligence in post-op and goes to relax, only to be called back in a hurry later that evening as the patient’s situation is worsened. It's corrected in the nick of time. He gets rightfully called out on it and feels no end of guilt over this grave mistake, and Angie even questions his skills as a doctor if he’s so careless outside the O.R. and willing to dump the post-op workload onto his assistant so quickly.

Only 16? This calls for stabilizer, right now!

Despite this, that same night, Derek hears about a bad car accident and, knowing that the victims will be taken to their E.R. and that his superior is out of town, he returns to the hospital to tend to them right away. This time, Angie is overwhelmed, but Derek shows his saving grace: Complete self-control and focus while in the O.R., which allows them to save those lives and redeem him in his colleagues’ eyes. (This also brings another tool, the defibrillator, used by holding down Z and B, holding the remotes forwards towards the screen, and pressing both buttons when the gauge reaches the green area. “CLEAR!”)

This medical drama is getting good! I hope they don’t jump the shark with weird anime powers or diseases or over-the-top villains or something!

The Healing Touch

The Healing Touch is going to turn Derek
into a star surgeon.

During the previous operation, Derek exhibited a strange skill; it’s as if time slowed from his point of view, allowing him to perform super-fast for a short moment. In the next operation involving removing thrombi in a spleen’s blood vessels, Derek activates that ability by accident again. When footage of the operation is reviewed, Derek is called in by Hope Hospital’s director, Robert Hoffman, who explains that Dr. Stiles may have the Healing Touch, a skill seemingly passed down from Asclepius the God of medicine himself and allowing doctors to treat even incurable diseases.

...what did I just friggin’ say about weird anime powers?!?

Wouldn't be the only time you guys run in and
save my patient because I screwed up!

Derek is advised against using it because he is told it will consume his life, as explained by Hoffman himself. The director swore off operating when a procedure during which he used the ability went horribly wrong. Derek opts not to listen and instead practices the skill. During an operation, you activate Derek’s Healing Touch by holding down Z and B and drawing a star shape on the screen. Our protagonist later uses the ability while treating multiple aneurysms on a large intestine. After the operation, Derek blacks out for three days, further highlighting the skill's risks.

Much as I appreciate the creativity of the
diseases we'll fight later down the line, I do
wish we had more of these "mundane"
operations in the game.

We are also introduced a second story path, Chapter Z, featuring a different character, Dr. Nozomi Weaver. She also has a Healing Touch, but in her case, doing healing actions successfully while the ability is active will increase the patient’s vitals, without a need for the stabilizer. For now, only one level features her per chapter, and they tend to have gimmick elements. Her first operation involves reconstructing an arm’s bone, placing the broken fragments together in the right position and turning them with the forceps.

Back to Derek, the next patient we help is a teenaged girl suffering from severe wounds, who also exhibits suicidal tendencies. We rescue her, but even after she has recovered her well-being is still put into question. It appears she took experimental treatments that may have impacted her mental well-being. This time, Derek works to bond with the girl and bring her in a better mood. His bedside manners end up helping her wellness tremendously. However, her status worsens shortly afterwards, and this time she does want to survive, therefore we work extra hard to save her.

And when it's cut out... eradicate it like an ant
under a magnifying flass held by a kid!

So, we patch up the girl’s new interior wounds, but then more appear. Oh great, what’s this now... Wait. Did I see something move? Are we dealing with parasites now? Dr. Kasal recognizes this as a variant of GUILT. We must kill it by spotting it with the ultrasounds, excising it with the scalpel, and then shooting it with a laser. When we kill one, another pops up. There’s four of those in total. Though we successfully save the girl, we can only dread what comes next.

GUILT is the collective name for the many strains of a nasty disease created by a medical terrorist organization called Delphi, which considers modern medicine an unnatural way of prolonging the lives of those fated to die. So, y’know, instead of just letting life run its course, they instead invented ultra-deadly diseases and inject them into a whole bunch of people to kill them faster, even though this means they’re literally toying with the fates of others, just in the opposite direction that doctors do. The hypocrisy is real. I already hate these villains and want to kick the shit out of them.

Weird diseases? Check. Over-the-top villains? Fuckin’ Check. We’ve gone full anime. And we’re just at the end of Chapter 2 out of 6!

GUILT (Gangliated Utrophin Immuno Latency Toxin)

Clearly this guy wasn't the fun twin of the two
when they were growing up.

Having shown his skills against the new dastardly threat, Derek is offered a place at Caduceus, a center focused on research on intractable diseases, including GUILT and its many forms. Our protagonist eventually agrees to join them, and Angie comes along. There, we meet several new characters: Sidney Kasal, twin brother of Greg and chief director of Caduceus; Stephen Clark, the place’s veteran surgeon; Richard Anderson, the Secretary of Health and Human Services; Cybil Myers, anesthesiology specialist and ex-cop; and Victor Niguel, the grumpy head of the research division, who’ll get the job done but never with a smile.

The more surprising one is Tyler Chase, who studied alongside Derek at med school. A short arc involves him hiding his role as euthanasist at Caudeus, facilitating death on what looks like hopeless cases. He’s snapped out of it and chooses to dedicate himself to try and make even the toughest cases survive after his kid sister is rescued from a GUILT strain by Derek.

The Deftera strain of GUILT would be cute,
were it not for... y'know... those thing existing
to kill innocent people, children included.

You have the experience! YOU do it!

For his work, Doctor Stiles is selected to speak at an international conference held between the branches of Caduceus across the world. Derek attends, but the meeting is interrupted by a Delphi terrorist attack with a bomb left at the conference. Well, guess what? We operate on the goddamn bomb to turn it off... with help from Cybil, who learned a thing or two from bomb squad back in her days in the force. Jesus, and I thought surgeons needed nerves of steel! I’ll stick to the OR, thank you very much! (I hated that level's difficulty, but I appreciate its creativity.)

Took me a while to figure out the pattern and how
to safely break the hexagon panels.

If you pull a triangle while there are two thorns
next to each other on a separate triangle, and
they're not on the edges, those will spawn
new triangles (new triangles can't spawn outside
the edges of the organ). You have to remove
every thorn you can (though you can ignore the
edge ones) before pulling out triangles. Then, you
can focus on the edge thorns and triangles, when
that's all that's left. Beware of thorns turning into
gas, drain it out fast. Oh, and thorns respawn
regularly, so you need to act fast. (If you ever
play this game, I hope this was useful!)

Following the conference, we’re taken to Africa to investigate a research lab where GUILT strains were seemingly created. Of course, because a doctor never gets to take a day off, we operate on someone on the plane (while there are turbulences!). In Africa, the team finds the lab, which contains a lot of important info on the new diseases... and then they operate on another new strain in a young child found in the area. That strain, Triti, is the most annoying one, being puzzle-based on top of requiring extremely fast reflexes. Most guides about it comment on how stupidly complicated and difficult it is. You might eventually figure it out, through heaps of trial and error, but it can take a long while. Forget the bomb, THIS is the level I hated the most. It has no business being that complicated - but if you want the abridged version, I left a mini-guide with the picture here.

After the boy is cured, the team returns to America, only to learn that Greg Kasal, Derek’s mentor at Hope, has been hospitalized at Cadeuceus due to a GUILT strain...

Good shows know when to pull a cliffhanger, and so do I – let’s continue with Chapter 4 in Part 2.