"A port of the board game: Operation!"

Trauma Center: Under The Knife is held up as one of the reasons 'innovative games' is a strong selling point for the DS. Also, alongside Phoenix Wright, this game has earned the DS a reputation for quirky and offbeat anime styles in games.

For anyone who hasn't yet read anything about it, I'll explain the game quickly. You play a doctor, who must perform operations to progress through the plot. What this translates as is a stylus-based game which involves you using different medical instruments to stitch, cut, lazer, and use plenty of other 'techniques' to perform operations before a timer runs out.

If you read up on Trauma Center, you'll quickly come across the words: innovative, quirky, stulus-based, and tough. I'd also like to add 'limited' and 'repetitive' to that repetoire. The problem for me, is that when you get past the great story and presentation, the actual gameplay is pretty much just a tough and complex stylus minigame, a step forward from the minigames of Mario 64 DS or Lost in Blue, but still not worthy of being a complete and interesting game.

The story in Trauma Center is brilliant. The styling and graphics are simple but well-done. The characters are fleshed out and charismatic, and the dialogue is sharp and witty. The music is also very good, and keeps up a high standard throughout. However the story is extremely detached from the actual gameplay. On the one hand you have this great, thought-out presentation, then on the other you have this tough stylus-based minigame that could just as easily be about car mechanics or computer repair. They feel like two completely seperate entities: the story is never apparent in the gameplay, and the gameplay never propels the story. A good analogy for this is to think of a really good movie you want to see, then some frustrating little menial task, like balancing two coins on top of each other. Every time you balance the coins, you reward yourself with 10 minutes of the film. It makes the film unenjoyable, and it doesn't make the menial task any more fun.

The reason I mention the story so much is because if you took all of that out of Trauma Center, what you're left with is very poor. The operations are simple exercises that test your speed and accuracy with the stylus. Playing the game is a simple matter of prodding, scratching, and swooshing the touch screen in the right order, progressively faster. It's definitely innovative and quirky, but to me it didn't constitute a game, and the novelty wore off after a few operations.
What it does with the gameplay, it does well (although that doesn't mean it's enjoyable), but with the exception of a few instances, there's not much variation on the formula, and the game leans towards a tough, trial-and-error difficulty rather than any kind of strategy or thinking as it gets harder.

The difficulty is a big point to make. It's difficult in a frustrating and pedantic way. Failing an operation because you make a slight miscalculation with the stylus is a horrible way to fail a mission, and doesn't really make you feel like having 'one more go'. In no other game can I imagine the DS Lite's thicker and longer stylus making such a big difference. You really need to have a perfectionist kind of attitude to get some enjoyment out of this game.

As a game, Trauma Center isn't something you can wile away a couple of hours with, the gameplay is too repetitive and based on against the clock bursts for that. Although performing one of the tougher operations successfully feels like a great achievement, playing the game requires so much concentration and intense perfectionism that it's rarely fun getting there. Also, completing the game you won't be rewarded with much, and the replay value is restricted to being able to play one of the operations again, and trying to get a good rank, which simply means being even faster and more accurate.

Trauma Center is a very particular and 'cult' type of game. I imagine if I'd found it in a bargain bucket in a video store years from now I would regard it as a unique gem of a game. At the moment though, as a full price purchase competing with a lot of great releases for the DS, it's extremely limited and unfulfilling in comparison.

Reviewer's Score: 5/10, Originally Posted: 09/27/06