Review by BWoodhouse

"Cutting for the very first time."

Cavity Sam has dedicated his entire existence to the medical field. Perpetually prone with gaping wounds, he's given millions the chance to poke and prod in order to develop the steady hand necessary to save lives. But we feel his pain, too. Every time one of his vital organs goes missing, his red nose lights up in distress, or his body emits a shocking buzz, we know Sam has sacrificed a little more of himself. Now, though, it's time for a break, because Trauma Center: Under the Knife provides a new and improved way to approach an operation.

That isn't to say retirement is around the corner, because this game isn't about plucking out a charley horse or butterflies in the stomach. Trauma Center places you in the sterilized latex gloves of young Dr. Derek Stiles and asks you to use the DS stylus to slice open patients, excise and burn away cancerous tumors, replace a child's defective heart valve, and eventually thwart a plot to unleash GUILT, a destructive bioterror weapon that can rip a patient open from the inside. It even includes a heavy-handed and morally simplified lecture on the evils of euthanasia. Yes, the youngsters might want to save this till they're older.

It's just as well, because Trauma Center is all about pressure, ratcheted up to require intense bursts of concentration and dexterity past what a normal child could withstand. Most of the 40-odd complex procedures have three ways to fail. A timer steadily counts down, usually from the five minute mark, forcing quick handiwork. Sloppy manipulation of the stylus will exceed the miss limit, though, which means you have to operate with, well, surgical precision (making this portable game ill-suited for traveling). Finally, the patients vitals continually plummet from ninety-nine to zero; most of your best work must be done on the razor edge of a flatline. Essentially, these components force a constant state of awareness where you must both recognize a problem and skillfully perform its solution within the same instant.

Needless to say, many patients will perish at your hands, even with Derek's special maneuver, the Healing Touch. Think bullet-time with a scalpel; this ability allows him to temporarily move with unbelievable speed(a.k.a. slow down the clock) and makes the game a little less impossible. However, failure is still frequent, and it's additionally annoying because every retry means you have to read through the same exposition both before and during surgery. But the challenge of completing a task is just the beginning. Every one of your actions is also graded on a scale of bad to cool, so even the most heroic of efforts can be capped off with the lowest possible rank. The unfortunate flaw here is the mysterious grading scale. Even though the interaction between the stylus and touch screen is accurate, you can't always be sure that your actions are correct. For example, in zigzagging over a wound to neatly suture it up, there's only a small margin between the highest scoring method a complete miss. I fear only years of residency in the challenge mode, where you can replay each completed surgery to beat your high score, could lead to a consistent understanding of the subjective system.

For a game that routinely features a person's innards, though, Trauma Center's anatomical array is absolutely benign. There's certainly no buckets of blood or dangling tissue about; you won't have to crack open a breastbone or saw through any ribs. Slicing into the patient's sexless palette of skin reveals a red organ where tumors are yellow and purple dots and most lacerations resemble a nasty nick from shaving.

While the bottom screen is for carving, the top is for talking. The character designs are drawn with a touch of the distinctive anime style – your beautiful blond assistant is even prototypically stubborn and softhearted, but it's what the characters are saying that's more significant. Each springs to life with impassioned speech about saving lives and defeating disease, and who wouldn't be moved when the people you're healing are innocent children, friends, and colleagues. Place that energy against the backdrop of a terrorist threat aimed to collapse the medical profession, plus the sneaking suspicion that anyone may be aiding and abetting that cause, and you have the final aspect of Trauma Center's appeal.

This game is definitely unique, and that alone makes it worth a try. It's also becoming scarcer, which may make it worth collecting. But its exacting test of your concentration and coordination, coupled with compelling storytelling, is where the real value lays. I may be cutting for the very first time with Trauma Center: Under the Knife, but I hope it's not the last.


Reviewer's Score: 9/10 | Originally Posted: 05/22/06


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