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Trauma Center: Under the Knife

by Mike Sklens - October 6, 2005, 11:02 pm EDT


"Let’s play doctor" takes on a whole new meaning.

Doctors don’t have the easiest job right about now. Medical school is expensive, and the rising cost of malpractice insurance is scaring potential M.D.s away from the profession. Short of the classic board game Operation, or doing something with the girl next door that will get you in all sorts of trouble, there’s no way to really “play doctor...” until now. Trauma Center: Under the Knife, from Atlus Software, puts you in the role of Derek Stiles, a rookie surgeon with amazing potential, and has you operating on patients through a plot with as many twists and turns as your small intestine.

Derek Stiles has just started at Hope Hospital in the fictional city of “Angels Bay.” His job starts out simply enough, treating minor injuries, though he quickly moves on to more advanced cases such as excising tumors and clearing throat polyps. However, he’ll quickly be swept up into a world-wide epidemic of “medical terrorism.” He’ll also discover a hidden talent that will help him join the ranks of the surgical elite and save the world. The game takes on a definite science fiction feel after the first two chapters, as the operations you’ll be performing involve bizarre parasites.

Trauma Center is a unique game. It is heavily story based, but the real action takes place during the operations. Each one starts with a detailed briefing explaining the procedure. You’ll actually feel quite like a doctor, as the game uses real medical terms to describe the operations. From the briefing you’ll jump to the operating table. There are a total of ten different tools used in operation. They’re not exactly the same as you’d find in real life, as Trauma Center takes place slightly in the future. Some of the tools you’ll have access to include the standards such as the scalpel and suture kit, and then there are more exotic ones like the cure-all antibiotic gel.

The first few operations will get you used to the standard procedures you’ll end up performing in every operation of the game. These form the base of your surgical skill. Your assistant nurse will brief you on the more advanced procedures during the actual surgery. Some of them will become commonplace later on, but almost every operation has some unique aspect to it that hasn’t appeared in earlier ones. Some of the crazier things you’ll do in the game include pulling a four-inch piece of glass out of a guy’s heart and performing an operation during an airplane flight riddled with turbulence.

The DS’s touch screen does a great job of brining the operations to life. The graphics, while not amazingly detailed, do a fine job of representing the inner workings of the human anatomy. It’s actually probably for the best that they aren’t super realistic, as gruesomely accurate visuals might make some gamers cringe. The various tools are lined up along the sides of the touch screen, and your assistant occupies the top screen. Your patient takes up the majority of the touch screen, which you’ll be using to operate. For the most part, the operation maneuvers work very well. Slicing into patients and performing the various procedures actually feels quite realistic. You don’t have to be incredibly precise, but doing so will net you extra points for doing a “cool” job. There are a couple of tools that can be a problem sometimes. Maneuvers that should be simple to perform will randomly not register correctly. The zoom tool in particular can be quite a bother. Often times it simply will not register your motions as correct, forcing you to try over and over again, wasting valuable operating time.

Another of Trauma Center’s problems arises from the game’s difficulty. For the most part the difficulty curve is just fine. It starts out easily with simple operations and ramps up at a nice pace until you get to the crazy parasite stuff. Once here, the difficulty evens out until the end of the game, with a few exceptions. There are a handful of operations later in the game that are unspeakably hard. Failing over and over again until you finally get lucky enough to complete the operation is the only viable way of beating them. There’s no excuse for such incredibly hard operations to be interspersed in an otherwise perfectly balanced game.

One thing Trauma Center does that really makes you feel like a doctor is the sense of tension it creates. The operations are all timed. There’s usually plenty of time to get the operation done on the first try, but the beat-the-clock element forces you to think faster that you might want to. There are also only a certain number of missed moves allowed. Too many mistakes will kill your patient. The real sense of tension comes from the patient's vital signs. A meter in the corner of the screen keeps track of your patient’s overall health. The number drops as scripted events or your botch ups affect the patient. Plus, they drop faster as they get lower. Keeping track of the vital signs is... well, vital. A green medicine can be injected to raise them, and it will quickly become your favorite tool. In the really intense operations it’s not uncommon to inject some of the green stuff after every other maneuver.

Things can get even worse from there, too. Many of the operations hit some intense points where not even the green juice can save you. These times will require the "healing touch," an ability Derek uncovers hidden inside himself. Drawing a star on the screen will trigger the touch, which can be used once per operation once Derek discovers the talent. The touch slows everything down, giving you plenty of time to make decisions and perform intricate maneuvers.

Trauma Center is a wonderfully unique game that does an excellent job of sucking the player in through both the tense operations and intricate story segments. This wholly original concept is, barring a few amazingly hard operations, a fantastically fun game and a breath of fresh air from the derivative titles put out by so many other companies.


Graphics Sound Control Gameplay Lastability Final
8 8 8 8.5 7 8

The sprite design of the characters is great, and the bodies you’ll be operating on are fine enough representations of the real thing.


The background operation music adds to the game’s tension, and voice samples are scattered all over the place.


Most of the time the controls are just fine. A few hiccups arise from tools (very rarely) not working as intended, and the zoom tool is a real mess.


The tension created by Trauma Center is amazing. Operating on people is lots of fun, and pulling off a difficult operation leaves quite the sense of accomplishment.


The main game clocks in around five or six hours, which is decent for a handheld title. A challenge mode lets you replay the operations for high scores.


Trauma Center: Under the Knife is a fun and unique game that deserves to be played. The original premise and tense gameplay put it at the top of the Nintendo DS’s “must buy” list.


  • Interesting, slightly zany story
  • Very tense and very enjoyable
  • You get to cut people up
  • A few operations are insanely hard
  • Zoom tool does not work well
Review Page 2: Conclusion

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Chou Shittou Caduceus Box Art

Genre Simulation
Developer Atlus

Worldwide Releases

na: Trauma Center: Under the Knife
Release Oct 04, 2005
jpn: Chou Shittou Caduceus
Release Jun 30, 2005
eu: Trauma Center: Under the Knife
Release Apr 28, 2006
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