Trauma Center: Under the Knife (Nintendo DS) (Atlus, 2005)

Trauma Center: Under the Knife, the second game I ever played on the DS, was the one that most excited me early on as representing the revolutionary potential of the touch-based handheld. It was quite the contrast to Mario Kart DS, popularly the system's killer app, but it sold the DS's innovations better than any game before it. Mario Kart DS was familiar and predictable comfort gaming, showing off none of the DS's unique features, other than its wireless capabilities, which it admittedly took advantage of to outstanding effect. Trauma Center, which had players wielding the stylus as a surgical knife, was all touch, and in the most intuitive way. It's hard to believe that it took almost a year after the system's launch for this proof of concept to come along and legitimize it as more than just a quirky experiment. Even by the end of the DS's life cycle, I don't think there was any other release that more plainly made the case for touch-based, stylus-based gameplay.

Of course, the promise of getting to play with the stylus was never the lure. Rather, it was the promise of getting to play as a surgeon—as likely a fantasy, I should think, though far less represented in gaming, as assuming the role of a gun-toting killing machine—which the stylus was merely to facilitate as never before possible. It has always struck me as so peculiar that such an overwhelming majority of games seem to be no more than glorified murder simulators. As a child having to occupy myself at the daycare, I often turned, not to video game role-play, but to real role-play with other kids, using our imaginations, and while, sure, we would act out the cowboy, bank robber, and super spy scenarios, we would also just as often role-play more normal occupations—doctor, teacher, barber, waiter. For whatever reason, in video games, the selection of scenarios to role-play is far narrower, and slanted toward fulfilling violent fantasies, with those more normal roles mostly relegated to handheld and mobile platforms.

Trauma Center may have been small in screen size and production, but not in scope. Not a casual game, and not so much a surgery sim as a medical drama sim, it had a story, told through extensive non-interactive visual novel-style sequences composed of still images and text. For better or worse, it was quite a lot more verbose than the average triple-A first-person shooter. I found it engaging enough overall, and I especially enjoyed the earlier chapters, which focused on main character Derek Stiles, young but gifted surgeon (superhumanly so, as it turns out—his skills are said to be descended from the Greek god Asclepius), performing on patients at a local hospital. These parts were exactly what I personally was looking for out of a medical drama game—getting to feel like a more real-world hero (as opposed to some spiky-haired swordsman), saving lives for once, instead of taking them, no greater gratification than seeing your patients doing well. It's not long into it before the game decides this isn't enough, however, and the larger part of the story focuses on Derek's joining with an international organization called Caduceus to combat GUILT, a parasitic organism created and distributed by bio-terrorists. It's pretty ridiculous stuff and, ultimately, still a good-versus-evil melodrama, but it was, for its time (with not exactly a lot of competition in the medical drama game genre), a refreshing departure from the soldier and space marine narratives that have long typified the triple-A mainstream.

For all the artifice of the scenario and the input apparatus, the basic experience of playing Trauma Center rather resembles that of an action puzzler, or even just a straight-up arcade action game. It may be packaged differently, but the gameplay flow is fairly old-school. It's a lot of repetitive high-speed manual input and reflex. There's a health meter, which is constantly under attack, either by wounds bleeding out or by malignant parasites. There are restorative health items in the form of antibiotic gel. Derek's "Healing Touch" ability, which magically slows down time at critical moments, functionally takes the place of a desperate screen-clearing bomb. There are even boss battles. And, once again, I cannot stress enough that this is not a casual game. It gets pretty intense toward the end, and, considering it's stylus-based, it may not be the best game to play in public if you're very self-conscious, as I learned the hard way.