Trauma Center: Under the Knife 2
A direct sequel with refined surgical gameplay and a deeper narrative.
Trauma Center: Under the Knife 2, a 2008 simulation title for the Nintendo DS, was developed by Vanguard and published by Atlus. As the fourth Trauma Center game and a direct follow-up to the 2005 original, it takes place three years later. The story follows Derek Stiles battling a revived Delphi and the GUILT disease while dealing with personal doubts and corporate schemes. Gameplay uses the DS touchscreen for surgery, with a visual novel narrative.
Quick Facts
- Developer
- Vanguard
- Publisher
- Atlus
- Director
- Daisuke Kanada; Hirokazu Toyama
- Writer
- Satoru Taniguchi
- Artist
- Masayuki Doi
- Composer
- Manabu Namiki; Noriyuki Kamikura
- Series
- Trauma Center
- Genre
- Simulation, visual novel
Facts from the source article.
Gameplay
Trauma Center: Under the Knife 2 blends surgical gameplay with story segments presented as visual novel-style cutscenes. These non-interactive sequences use static backgrounds, character portraits, and text, with only occasional voice clips. On the Nintendo DS, the top screen shows these story moments and operation statistics as 2D art, while the bottom touch screen displays the surgeries themselves in 3D. The player controls Derek Stiles, a young surgeon who possesses a mystical ability called the Healing Touch. Each operation requires curing the patient of one or more ailments before a time limit runs out. Difficulty settings range from Easy to Hard. Ten surgical tools are available, including a scalpel, laser, ultrasound, and defibrillator, the last used to revive a patient whose vitals flatline. Tools are selected via icons on the touch screen’s edges and used with the stylus. Players treat surface wounds and internal injuries, apply antibiotic gel to minor wounds and incisions, and inject serums to assist during operations. Some operations involve destroying strains of the artificial virus GUILT in boss-style fights, with new variants requiring different procedures. Operation types include skin grafts and bone repair from later games. Stiles can activate the Healing Touch to slow time briefly, allowing faster treatment. The operation fails if time expires or the patient’s health reaches zero. After each surgery, the player receives a performance ranking. Completing the game unlocks a new difficulty level and challenge missions.
Synopsis
Three years after the events of Under the Knife, Doctor Derek Stiles and his nurse Angie Thompson are sent to the war-torn African nation of Costigar. There, they befriend local doctor Adel Tulba, and Stiles uses his Healing Touch ability for the first time in years. They are soon called back to Caduceus to handle a new condition called Post-GUILT Syndrome, which affects anyone previously exposed to the man-made disease GUILT. A reformed version of the terrorist group Delphi resurfaces, determined to spread GUILT strains and achieve the original group's aims. Caduceus gets help from two other medical organizations: Acropolis Pharmaceuticals and the Hands of Asclepius (HOA). During a GUILT outbreak, Stiles becomes overconfident and causes a patient's death. This shatters his confidence and he loses his Healing Touch, forcing him to retrain. He regains the ability only when he must save Angie's father, Kenneth Blackwell, the repentant former head researcher of the original Delphi, from a GUILT infection. Stiles' loss of confidence confuses Tulba, who then joins the HOA. Acropolis and the HOA develop an artificial version of the Healing Touch, quickly gaining government support while Caduceus falls out of favor. Stiles grows suspicious of Acropolis leader Reina Mayuzumi and HOA leader Patrick Mercer, and allies with Mercer's stepdaughter Heather Ross. After the new Delphi kidnaps Stiles and Angie, they escape and help Caduceus rout the group. Caduceus then uncovers HOA's shady dealings when athletes become infected with new GUILT strains called Neo-GUILT, which HOA had been using to create performance-enhancing drugs.
Development
When players felt uneasy about the series moving from the DS to the Wii, the team responded by making Under the Knife 2. Although the overarching story continued with New Blood, this game was built as a direct follow-up to the first Trauma Center in both plot and gameplay. Vanguard led development, with Daisuke Kanada, who had directed the series since Second Opinion, and Hirokazu Toyama of Vanguard sharing directing duties. Masayuki Doi, who had contributed to Second Opinion and New Blood, handled character designs. Toyama had worked on earlier titles as a programmer but was surprised to be asked to direct, making this his first time in that role. Most systems from the original Under the Knife returned, with the main effort going into refining the existing experience. New features included more voice clips for characters and an Easy mode. The voice clips took up a large chunk of the DS’s ROM, alongside the music. The story covered not just the usual life-saving surgeries but also topics like treating the poor, doctor shortages, and anti-aging medicine. Manabu Namiki and Noriyuki Kamikura of Basiscape, the studio founded by Hitoshi Sakimoto, composed the music. Miki Ito handled audio direction, and Kentaro Nakagoshi managed sound design. Series composer Kenichi Tsuchiya was asked to work on the game but could not due to other commitments, so Basiscape was brought in. Because the music was streamed rather than played directly through the DS sound hardware, the sound quality was much higher than in the original Trauma Center. Neither composer had worked on a Trauma Center game before. Namiki wrote his tracks to convey the excitement of saving lives, using a sense of weight for the surgery scenes and a feeling of human praise for the story parts.
Reception
Under the Knife 2 did not show up in Japanese sales charts for 2008 or 2009, nor did it appear in Atlus's list of top-selling titles from August 2008 to July 2009. On Metacritic, the game scored 79 out of 100 based on 29 reviews, which the site classifies as generally favorable. It was nominated for Best Action Game on the DS in IGN's 2008 video game awards and was listed among the best Nintendo DS games by GamesRadar+ and GamePro. Famitsu praised the refined controls and elements that added to the game's sense of speed. Andrew Fitch of 1UP.com was hesitant going in because earlier reviewers for the site had expressed high frustration, but he was won over by the pacing and smooth controls. Bryan Voor and Jeremy Parish of Game Informer liked the inclusion of easier difficulty options and a more grounded tone, with Parish calling the operations more interesting and varied than in any other entry. GameSpot's Shiva Stella said the game successfully mixes a creative medical theme with bizarre but enjoyable puzzle gameplay. Dave Kosak of GameSpy praised the improvements to gameplay and story but criticized the cutscenes and repetitive music. GamesRadar's Alan Kim appreciated the general improvements over the original but was let down by the lack of multiplayer. Raychul Moore of GamePro was not impressed overall, enjoying some gameplay elements but finding the narrative and difficulty off-putting. IGN's Mark Bozon highly praised the story and gameplay but thought it lacked the content and replay value of New Blood. Jonathan Metts of Nintendo World Report was less positive, faulting the lack of improvements and new features and calling it a complete rehash that made him question its reason for existing. Edge staff noted that while it borrowed from the first game, it took only the best parts, appreciating the clean visuals from the Wii games and the return to stylus controls, which they felt were better for slicing and stitching than the Wii Remote.
More in Atlus Games of the 2000s
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