Matt Keller
29 Apr, 2006

Trauma Center: Under the Knife Review

DS Review | I hope you've got insurance.
Many people in the world are familiar with the board game Operation!, where players must extract vital organs from a patient with precision to win cash. It was a fun game all around, but it is certainly showing its age. However, Atlus has seen fit to expand the fundamentals of the board game, as well as adding a bit of future medical technology into it to create a Nintendo DS game, Tramua Centre: Under the Knife. Though certainly a unique approach to the surgical process, Tramua Centre is kind of like an operation where the anaesthetic wears off a bit too early.

Players take on the role of Dr. Derek Stiles, a scrub fresh out of medical school. Dr. Stiles is a bit nervous and makes a lot of mistakes, but with a little bit of assistance, he begins to settle down. After you’ve completed a few introductory surgeries, which are relatively routine procedures, such as removing glass from internal organs, the game will shift into its real focus, which is basically the Hope Hospital folk against a bunch of bio-terrorists and their manufactured disease GUILT. If that’s not offbeat enough for you, the game shifts into Super Saiyan Doctor mode as Dr. Stiles begins to learn about his unique ability – the healing touch.

Operations are routine to start with

Tramua Centre is really just a cleverly disguised puzzle game at its core, with each of the game’s 40-odd operations having one distinct method of clearance. Players are rated on the time they take to complete the operation and the level of care they give the patient – you can only make so many mistakes before you lose your patient, and you’re constantly racing against both the overrunning game clock, and the patient’s vital signs. Dr. Stiles has a number of tools at his disposal, such as the ever-handy scalpel, sutures, fluid drain, laser, a magic injection that suddenly brings a patient’s vitals up and an all purpose healing gel.

The game will throw a number of different types of operation at you, and you’ll have to use all of the tools at Dr. Stiles’ disposal to treat the patient and complete each operation. Operations featured in the game range from routine procedures such as tumour removal and laser incisions of polyps to the really bizarre procedures that arise when treating GUILT patients. Tramua Centre is entirely stylus driven, which means that players have to take the utmost care with each operation, as being a few pixels off can mean disaster. The game can be fairly picky in how it recognises the player’s strokes, particularly when suturing a wound at the end of an operation, but smart players should be able to easily identify how the game does this, and work it to their advantage.

Operations are fairly enjoyable when they’re routine, but the game gets to its main plot fairly quickly, which is the somewhat absurd battle against bio-terrorism. This is triggered by Dr. Stiles learning about his unique ability, the Healing Touch, which is basically the medical equivalent of bullet-time. Simply put, the player will need to draw a 5 pointed star in one consecutive motion on the touch screen, which will cause time to stop, and Derek will be able to perform various procedures without the threat of lowering vitals or the disease fighting back (in most cases). You only get to use the Healing Touch once per operation; early operations let you have free choice over when or if you use the technique, while the more complex GUILT procedures will basically require the player to use Healing Touch at a specific point in the operation in order to proceed. Of course, the game never tells you these things – it is pure trial and error, but thankfully, due to the relatively short time required to do a procedure, it never becomes too frustrating.

Until the bio-weapons come.

The GUILT procedures range from simple to absolutely terrifying, and the level of difficulty progression is just not satisfactory. A player can get stuck on the thorny GUILT variation for days, but once they manage to clear it; they could bust through 3-4 more operations without breaking a sweat. The game then completely abandons its structured nature for the final mission, throwing a virus at the player that acts completely randomly, giving the player almost no hope of being able to attack the virus – this is basically the equivalent of anaesthetic wearing off when you’re in the middle of getting a tooth filled. The last mission is so utterly absurd that it will put many people off the game before they complete it – it’s a really dirty mark on what’s otherwise a good game.

Tramua Centre is a fairly short-lived experience – while 40 operations may sound like a lot, many are over in less than 3 minutes, with only the last half of the game providing any sort of significant challenge (before it becomes outright broken). The game feels very padded – players will have to repeat the same type of procedure 3-4 times throughout the course of the game. There is a challenge mode where players can attempt to get perfect ranks in each surgery played throughout the story mode, but it’s only a quick diversion in the long run.

Thrilling conversation from characters such as Colonel Sanders and 80's Surfer Dude fills the time between operations

An anime style of art has been chosen for Tramua Centre’s graphics – it comes across as being pretty generic, but it is quite serviceable. Most of these anime figures appear in the game’s story scenes, but they never animate, which is disappointing. During the game, the DS’s top screen will display the patient’s vital signs, the time left to do the operation, and the amount of mistakes you can make before losing the patient. Occasionally, one of your assistants will pop up on the screen to give you advice or warnings. The bottom screen is where all of the action takes place. The game provides a good representation of the internal organs of the human body, though we would have liked to have seen better effects for blood, pus and so on. The level of 3D graphics used in the game is certainly among the higher end stuff on the DS. Tramua Centre’s sound is limited mainly to the sounds of cutting flesh, and the nurse yelling “Doctor!” when you do something wrong, but there’s a fairly dramatic soundtrack that runs in the background of the game, which assists in getting the blood pumping and the hands sweaty.

It’s good to see developers putting a lot of thought into what sort of unique titles they can offer on the DS, which is evidenced by Atlus’ efforts with Tramua Centre. However, in creating new experiences on these specialised consoles, the developers still need to keep in mind some traditional gaming conventions such as proper progression of difficulty levels and reasonable expectations of a player’s abilities – the game would have easily rated higher if it were properly balanced. Nevertheless, there’s still a lot of good stuff in Tramua Centre, even if the last half of the game lets it down. We feel that there’s still plenty that Atlus can explore with a game of this nature, and hope that the game is successful enough to warrant a sequel.
The Score
Trauma Centre is much like any other medical procedure - it feels fine until the anaesthetic wears off. 7
Looking to buy this game right now? PALGN recommends www.Play-Asia.com.

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1 Comment
7 years ago
Agree... the games get very hard in the middle, and worse was the control is not very good. Sometimes the stylus can fail to respond to your touch... like magnifying, draining...
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