Reader Retrospective: Trauma Center

Reader Retrospective: Trauma Center

We haven’t had a Reader Retrospective for quite some time, so when Kotaku reader Trjn sent me an email with his experience of playing through Trauma Center: Under the Knife, I thought this might be the perfect time to resurrect it. Much like Trjn, Trauma Center remains one of my favourite games on the DS – I actually bought my DS to play this game…

But enough about me – take it away Trjn.

[This article originally appeared on Trjn’s website, which you can check out here]

Trauma Center: Under the Knife
Video games are a disposable medium. You sit down, consume the game for hours on end and after you’ve invested a reasonable chunk of your life into it, you shelve the game both physically and mentally. Occasionally, just occasionally, a game will stick around in your memory weeks, months, even years after you’ve long since left packed it up between its similarly abandoned friends.

Recently, I’ve been feeling a slight twinge to play one of these games. So I found my DS, charged it and then went on a lengthy search around the house for my special extendable stylus. The game that had been pecking at my noggin, begging to be played again was Trauma Center: Under the Knife.

Trauma Center is a medical simulation game, although I like to consider it a puzzle game due to the scoring system, that is known for having an incredibly steep learning curve. According to my incredibly unreliable memory, the game was never unfair with its difficulty. Any mistakes you make were yours and yours alone. The controls were never at fault, because Trauma Center was controlled entirely via the touch screen of the DS and is easily one of the best uses the touch screen has seen.

For those that don’t know, in Trauma Center you play as rookie surgeon Derek Styles who performs surgeries, often referred to as missions, on various patients with ailments ranging from having glass embedded in their arm as a result of a car crash to removing a demonic spider from someone’s heart. Realism is not to be expected and although there is a plot to try and explain what is going on, I never really paid too much attention to that.

To perform the surgeries, you are given various tools, from scalpels, sutures, an antibiotic gel that I’m almost certain is powered by magic and other surgical appliances that come in handy from time to time. To use these tools you need simply select the tool from the edge of the touch screen and then perform a specific gesture with it. With the scalpel you need only drag it over the dots that appear, suturing a wound requires you to make a zig-zagging motion over it, the antibiotic gel is used by smearing it all over a patient’s internal organs and so on.

Using the tools themselves is not a remarkably difficult feat. The difficulty in this game lies in the trying to juggle multiple actions at once. Not only are you racing against a time limit, but the patient you are treating has vitals that will drop when things go wrong. Things often go wrong, so you have to frequently alternate between fixing what ails them and keeping them alive along enough for the surgery to have an effect. The surgeries can be quite complex as well, there are times where you might have to use the ultrasound device to spot a small object, then stop it moving with the forceps, slice the vein it is moving through open with the scalpel and then use the drain to extract the object before finally using that magical antibiotic gel to heal the wound made by your scalpel. All in a very short space of time, or you’ll have to start again.

At least, that’s my memory of Trauma Center: Under the Knife, a simply brutal but not unfair game, with a ridiculous plot that I don’t care for. Somehow, I’ve convinced myself that this is one of the best games that I’ve ever played.

Having now invested a few more hours of my life into the game, I can definitely say that it is an interesting experience to play.

The touch screen only controls mean that the optimum way to play Trauma Center is to have your DS resting on a solid surface, like a desk or coffee table, while you hunch over the screen making fast, precise motions with the two styluses you have clutched in your grubby paws. In terms of accurately simulating surgery, I’d like to think that they managed to portray the discomfort of being in a position like that for hours on end very well. Combined with the frenetic pace of the missions and the sheer difficulty, it was genuinely exhausting to play Trauma Center.

I mentioned that you need to use two styluses in this game and whilst the second stylus is not required early on, in the later missions the speed of the game is so fast that you have to either be the Flash or use two styluses to beat them. Although I haven’t reached those stages just yet, trying to play the game with just one stylus felt fundamentally wrong. I hadn’t played the game in years, but still this piece of muscle memory had been retained. Or it could just be that it felt odd using only one hand to play a video game, something that rarely happens.

Before I had started to play the game again, the one most definite thing in my mind was that the game’s controls were about as good as you could get on the Nintendo DS. This may very well be true, but they are still far from perfect. There were many occasions where the game simply did not register what I was trying to do and my scores suffered as a result. For example, at various points in the game you are required to suture wounds that cover a large portion of the screen. Attempting to draw a quick zig zag over the wounds should be enough to get the game to understand my intentions but more often than not, I would have to redraw the same zig zagging line over the wound over and over again, each time slower and more precise so that the game could see what I was trying to do.

One memory I had of Trauma Center turned out to be entirely accurate though, and that was of the game’s unforgiving difficulty. At first, I blamed some of my failures on the game not giving me clear direction. It didn’t take me long to remember that I had mastered practically every mission in this game before without the help of a guide, my failings were because I wasn’t paying attention. Even when I was paying attention, I would still sometimes fail because I simply wasn’t good enough. Sure, the touch screen controls weren’t perfect but they weren’t at fault when I failed missions.

Despite the exhaustion, the occasionally faulty controls and my troubles dealing with the difficulty, if I had to use one word to sum up Trauma Center, it would be: satisfying.

You see, Trauma Center is a great example of what gaming can do that other forms of media cannot. Games can present a challenge to the player. Truly difficult games like Trauma Center are incredibly satisfying because you earn your successes. Every bitter failing, every stylus thrown in anger, every new swearword invented because that stupid twatwaffle parasite moves too fast; all of them add up so that when you finally pass that hurdle, it is a truly satisfying feeling.

Many difficult games are not challenging because they are designed well, but rather because they are designed poorly and the player must overcome that. But when you encounter a game that has been designed to be brutally difficult, a game that will beat you down while you beg for more, you’ve encountered something special. I’d like to think that Trauma Center: Under the Knife is one of those games, a game that would simply not be as good as it is without the satisfaction it provides those who conquer it.

Thanks Trjn – you’ve totally convinced me to dig this game out again! Did any of you play Trauma Center? I actually managed to get the last level – only using one stylus – but I just couldn’t finish it. The last mission was incredibly difficult. What about you guys?


  • I forgot to mention the epic hand gestures, good thing the pictures demonstrate that quite nicely.

    Thanks for putting this up Mark and for the record I’ve beaten every mission in the game, including the X missions and have S ranked all but X1, X5 and X7.

    All with two styluses, because I honestly don’t know how to play this game with just one.

  • Ah what still ranks as one of my favorite games of all time despite its difficulty curve, loved the plot, the characters, the gameplay, everything about TC I fell in love with.

    Then I played the remake on the Wii and loved it even more, the controls just worked better on the Wii than they did on DS. Then came New Blood and I had to relearn how to play the whole game over as the difficulty ramped up in NB, still it didn’t stop me from mowing through the games toughest difficulty setting and acing absolutely everything I could in the name of completionism.

  • I remember being so ridiculously excited to see this on the shelf at EB, thinking it was never going to come out. Pretty much bought it straight away, I think. Speaking of which, where the hell is UTK2…?

    Anyway – two styluses? Wha? I loved this game, and the end missions were pretty brutal. Not impossible though, after about a billion attempts I finally managed to snag it. But what about those X missions? I DON’T FREAKIN UNDERSTAND HOW THEY ARE HUMANLY POSSIBLE. I have seen youtube vids of guys playing them, and still don’t understand how they are possible. Even when I was at the peak of my Trauma Centre abilities, I still died within the first few seconds of attempting even the first one.

    Still, awesome, awesome game.

    • UTK2 never came out here, neither did Trauma Team on the Wii. I imported UTK2 but didn’t love it as much as the original and I haven’t played any of the Wii games.

      As for the X missions, they are humanly possible, you just need to use two styluses and in some cases a few tricks.

      Okay, there are some very abusable glitches in this game. The most important is that there are a set amount of lacerations that can appear on screen at any time. If you simply let them build up and keep applying antibiotic gel, then they stop being formed by the GUILT and it makes it a lot easier to finish things off.

      I had to exploit that to beat X7.

      Other tricks I’ve seen are all based around using two styluses to confuse the DS because the touch screen can only read a single input. So you can remove objects instantly with the forceps, and do anything that requires perfectly straight lines with two quick taps. Never been able to master that one though.

  • I never finished 1 because it was too hard. =(
    Also, I used to rage at this game so hard because whenever I would draw a circle for zooming or whatnot, it would always deny me.
    But even with my horrid reflexes, managed to beat 2, and that last mission of 2; the music, the character interrupts, that was amazing.

    These games where also great for showing off what you could do with the DS. This is how you really used the touch screen. The first was released in what, 2005, with the DS coming the year before? All we got until this was gimmicky crap, like RPGs with touch screen options, or fluff like “Touch the Touch Screen to Start!” but this is a game which showed off how you used the touch screen effectively.

  • I never got past the mission where you have to stop the dividing worms from reaching the woman’s heart- after struggling through every challenge up to that point, that was the one that finally broke me. Great game, but HELL is it hard!

Show more comments

Log in to comment on this story!