The Nintendo DS has several unique features that allow savvy game developers to create experiences that simply aren't possible on other devices. Most of these features revolve around the touch screen and the stylus input, which is quicker, more accurate and even more natural than a typical PC mouse. Your standard console control pad doesn't even come close. Although it flew under many gamers' radar during the system's amazing release schedule this year, Atlus's Trauma Center: Under the Knife is one such game, using the stylus for rapid, precise control and placing useful information on the upper screen where it's out of your way but still available.

Trauma Center is, at its core, a timed puzzle game masquerading as an ‘arcadey' fantasy surgery simulator. You assume the role of Dr. Derek Stiles, fresh out of residency and thrust into the big, bad world of thoracic operation. Fortunately for Derek-and you-he's not alone, as you have nurses/anesthesiologists, mentors and colleagues to assist you via in-game tips, suggestions and guidance, but they don't actually do any of the work for you like a real nurse might.

And work you will-you start off with some routine procedures to learn the various tools available to you and the protocols for dealing with various problems like tumors. These introductory levels seem innocent enough, but eventually strange things start happening, like a patient with no exterior cuts having severe lacerations on her lungs that return after you've successfully treated her once. This is where the fantasy element kicks in, as you eventually learn about a medical-terrorist group and their engineered viruses around the same time that you discover that you possess a special ‘healing touch' that can increase your focus and allow you to perform at superhuman speeds for a short time (think of it as Trauma Center's equivalent to ‘bullet-time'). Which is a good thing, since these bugs are so insidious that your Healing Touch is often the only thing that allows you to stop them.

This is also where the difficulty ramps up considerably. Trauma Center will require a lot of trial and error on your part, and demand that you have some epic levels of patience. There will be times when a particular challenge is thwarting you again and again and again, to the point where you have to force yourself to give up and take a mental rest. And these times are only about halfway through the story; it only gets harder after them. If/when you finally complete this game, you may very well feel like an actual surgeon (with the important difference that real-life surgeons don't typically get to retry surgeries until they get it right).

Fortunately, the frustration that you will feel is due to genuine difficulty and not an artifact of the play control (although some specific viruses are almost unfair). Using the stylus, you'll be able to spread antibiotic gel, bust out the scalpel, grip with forceps, administer sutures, deliver injections of various sera, employ an ultrasound scanner, drain fluids, apply bandages, zap with a surgical laser or even get your gloved hands dirty. The ultrasound tool doubles as a zoom feature on some missions, and the ‘touch' icon gives you access to your once-per-puzzle Healing Touch once you've reached that point, giving you a total of 12 actions that, combined with your technique and knowledge, are all that stand between your patients and an unfortunate end. Of those 12 actions, only the zoom is problematic, as you must draw a circle in order to zoom in and out; until you realize that the trick is making sure you end at the same point you began, you might lose precious time trying to get it to work on a very early level. But once you get that down, it's just a matter of figuring out what you need to do-and being fast enough to beat the time limit without screwing up so many times that the patient dies anyway.

All told, there are seven different viruses that you will have to defeat. Several of them mutate and become tougher each time you face them, and eventually you'll have to eradicate the sources of each, which represents the purest, toughest version. Combined with the more routine operations at the outset of the game and a few special curveballs that I don't dare spoil, there are little under 40 missions for you to tackle. Each one you clear is added to ‘challenge mode,' which is sort of a time-attack mode (also useful for practicing your skills if you get rusty) and the game's only other play mode. Beating the story mode will unlock extra-hard missions in challenge mode that are only for the hardest of the hardcore.

The game isn't perfect, of course. In the tradition of puzzle games, the graphics aren't all that special (and not as graphic as the surgery-based content would suggest; this game is only rated T), but they get the job done, and having to sit through the same damned cut scenes every time you retry a mission will become irritating. You can use the select button to slam down the fast-forward button and skip to the next scene, but you'll still have to do some waiting. Also, whoever is assisting you will repeat the same advice every time you play the mission, even though you already know what they're going to say, which can be distracting, but at least the timer (and your patient's vitals score) stops counting down while they're blabbing at you. Finally, the plot is just sort of there as a setting-you can't make any decisions affecting it at all, so just enjoy the ride or ignore it until control returns to you.

The sound is also largely unremarkable, with many of the tools having an almost cartoonish sound effect associated with them as you frantically dance the stylus across the screen, and the few voice clips that are provided are either quickly dismissed (like ‘Doctor … ?' when someone has something to tell you) or outright demoralizing (‘What are you doing?!'). One sound, however, is (with apologies for this necessary pun) vitally important for drawing you into the game: the constant beeping of the patient's heart monitor that doubles as their vitals score, pushing the haunting BGM even further into the background. There are few sounds as pressure-inducing as the ‘beep … beep … beep …' of an EKG, and none as defeating as the ‘beeeeeeeeeeeeeeeeeeeeeeeep' of a flatlining patient.

Trauma Center is a worthy addition to any DS owner's library that (like most Atlus games) didn't receive a lot of the attention it was deserved upon release. Given the deluge of quality DS games that has been unleashed in the last six months or so, this is understandable, but not excusable. It belongs alongside its Advance Wars, Mario Kart, Meteos and other dual-screened brethren.

Jan 19, 2006 | 0 comments
Chris Ingersoll