I’ve been an avid fan of Atlus’s Trauma Center series from the very start, when the insanely hard original Under the Knife showed up on the DS five years ago. I’ve followed Derek Stiles, Nurse Angie and their medical colleagues through the Wii remake Second Opinion, its significantly larger sequel New Blood, and the DS sequel to the first game, Under the Knife 2. Under the Knife 2 was the last Trauma Center game and it’s been two years since it came out, an unusually long stretch for a prolific publisher like Atlus.
I can see why they’ve taken a little longer than usual. Their latest medical-sim entry, Trauma Team, is a full-on reboot of the Trauma series, expanding the scope beyond simple arcade-style surgery to include a higher emphasis on simulation, story and even new genres like interactive visual novels. I’ve been playing around with the retail copy for about a week, and I can safely say Trauma Team is a much bigger and more ambitious game than any of the previous entries.
If you’ve been following the game’s rather public development through Atlus’s series of dev diaries, you know that Trauma Team adds five medical disciplines to the standard surgery: first response, orthopedics, endoscopy, diagnostics and forensics. Each field focuses on a different specialist, which is a more realistic setup than the Derek Stiles master-of-all whiz kid premise from the past. Each doctor has six or seven operations, for a total of over forty missions in the game.
The most familiar field will be emergency surgery, performed by the mysterious CR-S01. That’s his prison number; the surgeon is an amnesiac inmate who has been accused of a bioterrorism attack and slapped with a 250-year sentence. As CR-S01 works off his sentence bit-by-bit through high-risk operations, his track plays like a highlights reel of the previous Trauma Center games. You’ll be excising tumors, suturing weak heart walls and treating third-degree burns. While a lot of CR-S01’s gameplay is reminiscent of earlier games it’s been refined to near-perfection in Trauma Team. Atlus has gotten this part of the game down to a science (no pun intended) so they’ve fixed a lot of the nagging balance and precision issues.
In first response you play as the fiery and short-tempered Maria Torres. The gameplay here has many similarities to standard surgery but with several distinct differences and new procedures. Blood must be soaked up with gauze rather than sucked out of wounds with a drain, and you can’t use sutures outside of a sterile operating room so you have to seal injuries with trauma pads and medical tape. CPR and defibrillators are used much more often than in surgery, and you’ll often have to intubate to secure an airway—you didn’t think you’d get out of first response without performing a makeshift tracheotomy, did you?
First response is all about getting patients stable so expect to be using splints, bandaged, tourniquets and blood transfusion IVs. It’s a juggling act, requiring that you move back and forth between multiple patients, assessing which ones are in the worst condition and dragging them out of the jaws of death. It’s much more hectic than surgery and makes you think on your feet.
In contrast, orthopedics is all about slow, steady precision. You guide the hands of gentle giant Hank Freebird, an Army Ranger veteran with some lingering guilt about his previous profession. There have been occasional orthopedic operations in past Trauma Center titles but nothing on the level of depth or realism in Trauma Team. Shattered bones must be reassembled piece by piece, and any missing fragments must be carved out of synthetic bone with a laser. Once the pieces have been reassembled, you have to drill guidelines and then fasten the bone back together with plates.Bigger fragments like joints and sockets have to be held together with pins, which you hammer in with precise gesture taps. There’s no time limit, so orthopedics is very much a Zen experience and a nice change of pace from the frantic surgery and first response.
Endoscopy has some similarities to surgery but has a more three-dimensional feel. As wayward Japanese heiress Tomoe Tachibana, you’ll be threading an endoscope through a patient’s viscera with Wii remote gestures. It really feels like you’re feeding a cable deeper into someone’s guts. While you’re exploring you’ll do familiar tasks like draining blood and injecting medicine, but you have some new tools like haemostatic forceps for cauterizing hemorrhages and a cable loop to clip out those pesky polyps and tumors. The new perspective makes the standard tools and procedures feel fresh and challenging, even for a longtime player like me.
The final two fields, diagnostics and forensics, are a big departure and add a lot of new content. Both play out like visual novels but are more interactive than you usually get out of that genre.
Gabriel Cunningham is the hospital’s world-weary, chain-smoking diagnostician and in his track you’ll deal with a series of colorful patients. Diagnostics is all about looking for clues in the patient’s appearance, charts and mannerisms, and once you get them to consent to imaging scans you have X-rays, MRIs and CT scans to scrutinize. The similarities to "House, MD" are definitely in there but Gabe and his story have enough of their own personality to stay distinct and interesting. The later missions have compound diagnoses where the patient has multiple complications. Puzzling out the real problems, looking for clues with the stethoscope and EKG and putting the symptoms in order is pretty addictive, especially when the patient’s condition is degrading rapidly.
The enigmatic Naomi Kimishima makes a return to handle forensics. After being diagnosed with a terminal illness, Naomi gave up surgery to become a medical examiner. The forensics track is the most like a traditional visual novel and reminded me of Phoenix Wright a bit. However it’s much more serious than the DS’s goofy lawyer sims. As you collect evidence it is recorded in cards, which you combine to establish connections between murder weapons, suspects and the like. You gain evidence through multiple techniques, such as examining corpses and their personal effects, reviewing witness testimony and investigating crime scenes. Forensics takes keen logic and attention to detail, but don’t be surprised if you get hooked—the cases are never what they seem and as the persistent story gets deeper, you’ll be tempted to play through several of the long investigations in one sitting.Diagnostics and forensics don’t have cooperative play—they don’t really fit that kind of gameplay—but the other four fields have full co-op. The co-op in New Blood was a lot of fun, but Atlus has further refined the system in Trauma Team through organized division of tasks. In surgery you split up the tools between yourself and your friend before starting the operation; orthopedics has you taking turns with each action; first response lets you assign different patients to each player; and endoscopy swaps control back and forth with a set time limit. I haven’t played much co-op so I’ll cover that more in my full review.
I’ve played through about half of each discipline so far and the story has a much more serious tone than any of the previous games. It exists in the same continuity as Derek, Angie and the others, and it’s still just as melodramatic as a typical anime but there’s a lot less fantasy—no healing touch, no magical future technology or super-viruses used by terrorists bend on world domination. The six doctors all have emotional struggles they’re dealing with, making each arc more personal. The various arcs also occur concurrently and overlap a lot, so as you play through each one, the different storylines make a lot more sense. The amount of plot complexity Atlus has worked into Trauma Team is impressive and far surpasses the storylines of previous games in the series.
I’ve still got a ways to go in Trauma Team but what I’ve seen so far is very impressive. The game is just as addictive as the past Trauma Center entries, but the variety of gameplay makes it fresh and the more serious story makes it the most involving game, plot and character-wise. I have nostalgic feelings for the whole Trauma series so I’m a little hesitant to call Trauma Team my favorite game, but it certainly isn’t a stretch. Check back next month for my full review, Trauma Team is shaping up to be one of the year’s best Wii games.