A Look Back at Trauma Center: Under The Knife


Have you ever played the board game Operation? Growing up, I used to always wonder when someone would take the idea of making surgery a game and make that into a video game.Thanks to the advent of the Nintendo DS and touch screen gaming, the idea of surgery-based gameplay came to life in 2005 thanks to Trauma Center: Under the Knife.

This game came out near the start of the golden era of the Nintendo DS. Developers were coming to grips with what new and innovative gameplay concepts could be done with the touch screen, which spawned some innovative games like Kirby Canvas Curse, Nintendogs and Brain Age. Atlus, primarily known for their work on the Persona series, started anew on the DS with one of the first-ever video games based on surgery as far as I know.

If you’ve never played Trauma Center, you’re definitely in for something unique. While the thought of a video game based around surgery could make some squeamish, Trauma Center actively strays away from being a realistic surgery simulator. Instead, it almost abstracts the process of surgery into an arcade puzzle game.

Does it still feel like surgery? More so than any other video game at the time, yes. Being able to play this game with a stylus really makes the experience pop, as you’re using it to cut open hearts, inject medicine, stitch up wounds, remove broken glass and more. Every moment felt tense, as the game did an amazing job of making you feel like the patient’s life was in your hands.

Up until a certain point, I had a ton of fun with Trauma Center: Under the Knife. I loved the concept and how it was executed, and even the overly-dramatic story sequences that tie each surgery together were alright. However, I never did finish that game for two reasons:

1) The use of sci-fi elements

I know that Atlus didn’t necessarily set out to make a realistic surgery game, but I had a lot more fun in the first half of the game, when all of the surgeries were grounded in real-life scenarios. Removing glass from someone’s insides after a car accident or open-heart surgery were very exciting to me.

However, the game takes a sci-fi turn, where a new man made disease is introduced into the game. At a certain point, all of the operations revolve around fighting off different strains of this man made disease from patients. It’s at this point where the missions felt more like I was playing high-tech whack-a-mole or something like Space Invaders rather than operating on a human being. Not having at least a false sense of realism once the man made disease is introduced really took me out of the moment.

2) That game gets hard

By the end of that game, it requires you to memorize every step required in the surgery and have lightning fast reflexes to do them. Even when I knew exactly what it was I was supposed to do, I eventually got stuck at a point where I simply couldn’t beat the level I was on.

Since then, the series has had a number of sequels, though my two chief complaints have for the most part, carried over into every other entry. With that said, there are a lot of people who love the fact that the game is almost masochistic in terms of difficulty.

At the time, I loved that game. When it’s not delving into sci-fi, it does an excellent job of putting you in the moment and making you do things you’d never done in a video game before. In hindsight, I still have a soft spot in my heart for it, but the love has cooled somewhat. I really would love to see Trauma Center series ease the difficulty and find a way to make more realistic procedures fit into this framework, but I don’t think Atlus sees it that way. If you’re in the market for unique and landmark DS games, this is absolutely worth a look. Should you take the plunge, I really hope you’ve developed steady hands and lightning quick reflexes by the end of that game, as the challenge is intense.


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