Trauma Center: Under the Knife 2

"Derek Stiles and Angie Thompson are back to save the world from GUILT once and for all!"

In 2005, Atlus released a really different game, called Trauma Center: Under The Knife. The game presented the players to Derek Stiles, a young surgeon who just finished his medical residence and started to work on Hope Hospital. From there, he would become the best surgeon anyone had seen, with a special ability called Healing Touch, which allowed him to have superhuman concentration for a short period of time to overcome hard situations in the middle of a surgery. With this ability, he and his nurse assistant, Angie Thompson, successfully fought Gangliated Utrophin Immuno Latency Toxin – GUILT –, a new disease that was apparently incurable.

But the most interesting part of the game was not the story (although it is a very good part of the series). The way you played the game was simply unique: using the touch screen, you did incisions, sutures, injected serums, treated tumors and aneurisms, etc. Doing operations was really fun and they focused mainly on the seven GUILT strains. And, of course, there were normal operations, like car crash victim, tumor removal, internal hemorrhage and even some crazy puzzles to solve using the medical tools. It was a total success. A remake of the original version was released for the Nintendo Wii, with the name Trauma Center: Second Opinion, with a new art and some new features. Some time later, Trauma Center: New Blood, with a totally different storyline, but the same idea of game play, was released for the Wii too. Both games were also successful.

And now, three years after the release of the first DS installment, a new one is released, and with A LOT of improvements. Quickly naming them, the art used here is highly inspired on the two Wii games, and so are the musics. The control is more precise, there are three difficulties available and some new tools to use. This game is also a little longer than the previous one and the story also continues from where the first one left.

So, let's start with the story: Under The Knife 2 starts three years after the events on Under The Knife and we find Derek and Angie on a camp in Africa. There, a new doctor, called Adel Tulba, arrives on his first day of work and Derek becomes his mentor. Some time later, Derek and Angie are required to go back to Caduceus, taking Adel with them, because of the new threat: PGS, Post GUILT Syndrome. And, with it, the GUILT terrorism attacks started again and it's up to Caduceus, the new medical organizations and, of course, Derek and Angie, to save the world once again from GUILT.

You'll notice that, this time, the story focus a lot more on character development, ambitions and behavior. Consequently, the operations are a lot less focused on dealing with the GUILT strains than it was on the first Trauma Center. Of course, I'm not going to tell anything here. Also, every now and then, the Derek and Angie relationship will have its spaces in the script and I think most people are going to cheer up for them to get together.

As for the GUILT, you'll be facing three old strains and four new ones. The way to deal with the old ones, Kyriaki, Tertrati and Pempti, is basically the same from the first game, but don't think it's going to be so easy: they all mutated and have some new tricks for you to deal with. The four new strains, called Neo-GUILT, are completely different from everything you've seen before and are way harder than the old ones, even in their mutated form. But you'll have a lot of fun trying to beat them, trust me.

As already said, the non GUILT operations are a lot more common now. And there are a lot of new things to do (maybe not new for the ones who played New Blood). For example, the very first operation requires that you remove some bone fragments from the body of the patient and then reconstruct the bone in its original place. There's lung transplantation, a pacemaker to connect to the heart and a lot more. Remember the operation you had to do in the middle of a flight and that one you had to disarm a bomb? There is a similar operation for both situations in this game, but you'll have to play to find out. There's also a puzzle to solve, similar to the one Victor, the chief of Caduceus Research Division, asked you to perform.

Of course, some of these new situations requires new tools to use: the magnification tool has been greatly improved: now, it does not just zoom the place you need to see: it goes wider into the organ you are operating. So, imagine that you are suturing a laceration in the left side of the lung and suddenly the patient's vitals drop. Something is probably wrong at the right side of the lung, so you'll have to go all the way to the right to fix the problems there by selecting the correct tool and moving the stylus in the direction you want to go. Also, when you have to use the magnification tool, the ultrasound comes together with it, making it a 2 in 1 tool: just tap the screen like you did before and the ultrasound will do its job.

Remember some operations where you needed to resurrect a patient? You used gel and followed a line with your hand tool, by making massage. Now you use a real defibrillator and you need to be very precise using it, or it won't work (but won't make the patient die, only make you lose time, sometimes precious). A line will appear with a green point on it and it will start to fill. You'll have to press the touch screen (and, therefore, use the defibrillator) in the moment it reaches the green point. Also, you'll need to resurrect by using your own hands when the defibrillator is risky to the patient's life. A circle will appear and another circle will start to close. When the two circles matches, press the screen and Derek's hand will massage. Ouendan/Elite Beat Agent players will have an easy time with this.

Then, there is the penlight and the air compressor. The first one is a little lantern, in the form of a pen, which will illuminate a small section of the screen. You'll use it in a few operations and works just fine: just select the correspondent tool and move it to the area you want to light with your stylus. As for the air compressor, it is the most interesting new tool: your screen will get filled by air that will block your vision of the entire organ. To remove it, you use… an air compressor. How are you supposed to simulate an air compressor? Thought of the microphone? Just blow the air away!

To finish with the new tools, this is not exactly a new tool, but anyway: there is a skin graft serum that is used to make artificial membranes with the patient's natural skin. Some small with squares will appear and you'll have to use your syringe to inject the skin graft into the small squares and the membranes will form instantly. Just cut them in the borders with the scalpel and they are ready to use. Also, it's not necessary to massage the artificial membrane after using the antibiotic gel to fix the membrane into the organ: the gel does it for you now, saving you some precious time.

The game play is also better. Some sutures are a lot easier to perform this time, the gel requires a little less to work when it is needed, although they raise vitals in a smaller amount this time and you still need to use it a lot when dealing with Kyriaki. Draining also feels a lot easier and, somehow, all the tools feel more precise. Therefore, you'll have easier times getting “cool” scores. The rank system also changed a little and affected game play: in the first Trauma Center, using your Healing Touch in an operation would cost you some precious bonus points so, if you wanted to get an S rank on every operation, you had to beat them without using it. Now, the Healing Touch is considered fair to use in the storyline operations, allowing you to have an easier time getting and S rank in operations (or XS if you are playing on the Hard difficulty).

As for the difficulty, many thought the first Trauma Center was hard (including me), specially the X missions. In this second game, you will have the option of choosing between easy, normal and hard difficulties. The only difference between the difficulties is that the harder it is the faster vitals drops and the more obstacles you'll have to overcome. The operation objectives remain the same for all the difficulties though. For example, Kyriaki will do a lot more lacerations in the hard difficulty than it would do in easy or normal. This is a very good addition, since it was natural for casual gamers to dislike the first Trauma Center because of its hard default difficulty. These people can now play on easy mode and won't miss anything in the storyline. Also, it's a good idea to play on easy if you want to rush with the storyline just to see what happens before diving into dying to the challenges of greater difficulties.

And, as in the first game, when you beat the game for the first time (in any difficulty) you'll have accesses to the Confidential Operation (or the X Missons, as they are known from the first game). These are extremely hard versions of the seven GUILT strains and are only available in the Extreme difficulty (only those operations have this difficulty). So, a player that went through the game on easy will have A LOT – again, A LOT – of trouble with these operations, so it's advisable to try beating at least the normal mode of difficulty before trying these operations for real. Notice that if you want to get an S/XS rank in these special operations, you cannot use the Healing Touch. Do you understand why it is Extreme now?

But failing is inevitable, and it will be more common than you think. In the previous game, when you failed in an operation, a doctor would take Derek's place and finish the procedure. Now, this happens only in some operations and the game over screen appears with a different message depending on which part of the game you are. But they all tell you the same idea, something like: “Modern medicine was not able to stop GUILT from killing people. Derek has been forgotten as time passed. ”

Graphically, the game is beautiful. Not the best graphics you are going to see in your DS screens, but they are very pretty. For some reason, Atlus decided to change their artwork and now the game looks more similar to the Wii games. Things are more realistic now and less “anime” oriented. The organs are a lot more real, the characters are more real, the blood is more real, Angie is even more beautiful, the whole game is more beautiful. But, some people preferred the way the first game was, so this is just a personal opinion. And, sadly, there are no cutscenes in the game. There's one before the Main Menu screen, but it just presents the characters and shows one or two seconds of some operations. But, the text is more readable now; I found the font used much better to read.

The music goes in the same way: in the first Trauma Center, they were more dramatic and did its job greatly, but I think these new songs are far better: they feel more “happy”, and are more “electronic” oriented, techno if you want to call it that way. Again, some people prefer the first game's soundtrack, so you will have to listen to the new songs for yourself to decide which soundtrack is better. But almost everybody that has played agrees: the last operation song is just epic. Yes, epic, there's no other word to describe it. Also, the sound test option becomes available after you've beaten the game once. For people who liked the songs, it's a nice way to spend the DS battery.

To finish, Trauma Center: Under The Knife 2 is a true masterpiece, very addictive, and is a must have for every single DS owner. Buy it as soon as you can. You won't regret following this advice. Of course if you haven't played the series before, it's a good idea to play the first game before this one, since the story continues here.

Reviewer's Score: 10/10, Originally Posted: 07/10/08

Game Release: Trauma Center: Under the Knife 2 (US, 07/02/08)