Trauma Center: Under the Knife (DS) review "Cavity Sam has dedicated his entire existence to the medical field. Perpetually prone with gaping wounds, he’s given millions the chance to poke and prod in order to develop the steady hand necessary to save lives. But we feel his pain, too. Every time one of his vital organs goes missing, his red nose lights up in distress, or his body emits a shocking buzz, we know Sam has sacrificed a little more of himself. Now, though, it’s time for a break, because Trauma Center: Under the Knife..."

Cavity Sam has dedicated his entire existence to the medical field. Perpetually prone with gaping wounds, he’s given millions the chance to poke and prod in order to develop the steady hand necessary to save lives. But we feel his pain, too. Every time one of his vital organs goes missing, his red nose lights up in distress, or his body emits a shocking buzz, we know Sam has sacrificed a little more of himself. Now, though, it’s time for a break, because Trauma Center: Under the Knife provides a new and improved way to approach an Operation.

Retirement isn't on the horizon, though, because this game's not about plucking out a charley horse or extracting butterflies from the stomach. Trauma Center places you in the sterilized latex gloves of young Dr. Derek Stiles, then asks you to use the DS stylus to slice open patients, excise and burn away cancerous tumors, and replace a child’s defective heart valve. Eventually, he must even thwart a worldwide plot to unleash GUILT, a destructive bioterror weapon that can rip a patient open from the inside. The game even includes a heavy-handed and morally simplified lecture on the evils of euthanasia. Yes, the youngsters might want to save this till they’re older.

It’s just as well, because Trauma Center is all about pressure, ratcheted up to require intense bursts of concentration and dexterity past what a normal child should withstand. Most of the 40-odd complex procedures have three ways to fail. A timer steadily counts down, usually from the five minute mark, forcing quick handiwork. Sloppy manipulation of the stylus will exceed the miss limit, though, which means you have to operate with, well, surgical precision (making this portable game ill-suited for traveling). Finally, the patients vitals continually plummet from ninety-nine to zero. Most of your deft maneuvering must be done on the razor's edge of a flatline, while you simultaneously scramble to inject life-restoring serum. Essentially, these components force a constant state of awareness where you must both recognize a problem and skillfully perform its solution within the same instant.

Needless to say, many patients will perish at your hands, even with Derek’s special maneuver, the Healing Touch. Think bullet-time with a scalpel; this ability allows him to temporarily move with unbelievable speed (a.k.a. slow down the clock) and makes the game a little less impossible. The technique is definitely required when dealing with GUILT, an aggressive virus with several mutations. One form looks like tiny fish swimming frantically just below the membrane, and it leaves deep cuts with every stroke. You have to find them using ultrasound, cut at their fleeing shadow to raise them to the surface, then fry them with a surgical laser. Another variation strangles organs with a self-replicating film. It must be removed a piece at a time, but for every malignant cell carried away with your forceps, two seem to take its place.

The challenge of simply performing these miracles is just the beginning. Every one of your actions is also graded on a scale of bad to cool, so the most heroic of efforts can still be capped off with a woeful rank. Here's the one prickly problem: even though the interaction between the stylus and touch screen is accurate, you can’t always be sure that your actions will yield high scores. For example, in zig-zagging over a wound to seal it up, there’s only a small margin between the highest-scoring stitches and a sloppy suture. I fear only years of residency in the challenge mode, where you can replay each completed surgery to beat your high score, could lead to a consistent understanding of the elusive criteria.

For a game that routinely features a person’s innards, though, Trauma Center’s anatomical array is absolutely benign. There certainly aren't buckets of blood or dangling tissue about; you won’t have to crack open a breastbone or saw through any ribs. Slicing into the patient’s gender-free palette of skin reveals a red organ where tumors are yellow and purple dots, and most lacerations resemble a nasty nick from shaving.

While the bottom screen is for carving, the top is for talking. The character designs are drawn with a touch of distinctive anime style – your beautiful blond assistant is even prototypically tsundere -- stubborn yet softhearted – but it’s what the characters are saying that’s more significant. Each springs to life with impassioned speech about saving lives and defeating disease, and who wouldn’t be moved when the people you’re healing are innocent children, friends, and colleagues. Place that energy against the backdrop of a terrorist threat aimed to collapse the medical profession, plus the sneaking suspicion that anyone may be aiding and abetting that cause, and you have the final aspect of Trauma Center’s appeal.

This game is definitely unique, and that alone makes it worth a try. But its exacting test of your concentration and coordination, coupled with compelling storytelling, is where the real value lies. I may be cutting for the very first time with Trauma Center: Under the Knife, but I hope it's not the last.

Featured community review by woodhouse (May 21, 2006) A bio for this contributor is currently unavailable, but check back soon to see if that changes. If you are the author of this review, you can update your bio from the Settings page.