Trauma Team
	Genre: Simulation Developer: Atlus
Publisher Region Released Atlus NA 05/18/2010 Atlus JP ??/??/????

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Staff Review

Review by Benjamin Woodhouse
May 17, 2010

Know this: saving lives will never feel the same. Previous games in the Trauma Center series focused solely on the quick thinking and precision reflexes required to perform miraculous surgeries. For better and worse, those days are over. Trauma Team retools surgery to make it more accessible, then folds it together with five other disciplines, promising an unprecedented amount of variety. But the eruption of ideas is almost too much for one title to contain, as each unique method and personality pulls the franchise's future in its own direction. You get a game that is the exact sum of its valuable parts, rather than something more.

In fact, evaluating Trauma Team really comes down to division. There is the obvious delineation of the six doctors and their six medical disciplines, but there's also a bright line between familiar treatment sections and brand new investigative portions of the game. Treatment includes surgery, first response (think: ambulance), orthopedics (treating bone injuries) and endoscopy (a less invasive way to perform surgery from inside an organ). As in previous entries, these are action-oriented and fast-paced procedures; none should take more than ten minutes to complete. Investigation includes diagnostics (think: House) and forensics (think: CSI). These sections are akin to a deliberate point-and-click adventure. They're heavy on dialogue and involve a longer process; by the end of diagnostics, you'll be required to uncover disease after disease in the same patient. Each case can take an hour to clear.

Based on the time differences alone, Trauma Team has some problems with balance. Each specialty has its own separate thread that contains exactly six episodes. That means you'll spend a disproportionate amount of time with the ornery diagnostician Dr. Cunningham and the detached forensic scientist Dr. Kimishima – a character reappearing from Trauma Center: Second Opinion in a new context. Technically, the same amount of comic-paneled cutscenes involve the other doctors: the hotheaded EMT Dr. Torres, the goofy superhero wannabe/orthopedic specialist Dr. Freebird, and the immaculate Dr. Tachibana and her golden endoscope. Without real equality in screen time, though, even someone as intriguing as the nameless surgeon, a convict who performs impossible procedures to chip away at his 250 year sentence, struggles to find the spotlight.

To be fair, you always have a choice of which mysterious character to explore. Each of the six stars' storylines are designed to be played independently from the others. This lets you tackle the game at your own pace, with the obvious benefit that you're not boxed into any procedure you don't want to tackle. However, it also prevents the proceedings from becoming a real Team effort for most of the game, as the events and patients don't always overlap. Even when they do, the user interface presents each timeline on a separate screen, so it can be hard to gauge where episodes fall in exact relation to the others. You can end up having to diagnose a disease long after another doctor has cleared up the problem. When that happens, Trauma Team really does feel like six separate games. It's not until a hidden seventh path is revealed – where the different disciplines are interleaved into a single storyline – that all the doctors become a cohesive unit.

That still doesn't mean the quality of the different specialties is equal. It would be natural to conclude that surgery still sits front and center, given the series' pedigree, so it's a shock that the radically different diagnostic and forensic sections are the most successful. In forensics, you're tasked with uncovering the causes behind questionable deaths, and the process stands out because it requires diligent logical analysis. For example, Dr. Kimishima's first case involves an apparent suicide in a locked apartment. Proving or refuting this claim begins with the examination of the corpse – a three-dimensional body that you can spin and zoom – to see if the wounds are consistent with the cause of death. That leads to looking for trace evidence on the victim's clothes, traveling to the crime scene to find blood and fingerprints, and breaking down witness testimonies for statements that conflict with the facts.

The pivotal part this process lies in the cards. Each clue you collect is represented by a card on Dr. Kimishima's computer desktop, where you have complete control over these clues. Cards that might require more analysis can be forwarded to her crime-solving contact at the FBI, who is represented by a cute little Mii-like icon in the upper portion of her screen. Related cards can also be combined to gain further insight into the situation, so you have to be aware of even the most minute similarities between facts. And all the while, the good doctor will pepper you with multiple choice questions to make sure you're paying attention. You can't cruise through any part of the case. At the end, you have to walk through Dr. Kimishima's conclusion step by step, choosing the cards that definitely prove each critical point of her hypothesis.

The same methodical principles apply to the diagnostics portion, where Dr. Cunningham has to determine a patient's exact affliction starting from zero. It just requires an even more exceptional attention to detail. Narrowing down the disease is a matter of isolating the symptoms through observation. This may be as simple as having the patient flat out report their chest pains, or it could be through a closer physical exam where you notice a person's trembling hands. Later, the clues will come from poring over MRIs, CT scans, and x-rays to find the most minuscule detail. Any of these medical tests can return an array of four or five images, accompanied by a control image for comparison. Most pairs will be identical, but the faintest shadow or smallest swelling can be the key to unraveling the diagnosis. The real key, though, is that you don't get automatic credit just for clicking on a suspected abnormality. The game always asks if you really think something is significant. With a limited number of mistakes before game over, you have to be certain.

There's no margin for error. If you need a reason why surgery is no longer the centerpiece of this game, it's because surgery in Trauma Team doesn't make you feel that pressure at all. On the surface, the mechanisms remain largely unchanged. You still toggle between your tools with the analog stick, then perform the appropriate actions with the remote. The changes start with(out) the clock. Trauma Team ditches the time limit, a huge source of stress, and leaves you to inject a load of healing serum into the patient as often as you like.

Of course, the Guilt virus is also gone. These supernatural organisms always provided the utmost challenge, requiring you to memorize and execute tricky treatment protocols. Memory is no longer necessary, though, as little icons appear over each wound to indicate exactly when to utilize the scalpel, laser, or forceps. To see just how accommodating the game has become, consider one of the most basic skills: suturing. This was so difficult to consistently master in previous titles, since you had to space the stitches perfectly while making movements quickly. Now you can go as slow as needed, and there are guidelines to the exact zig-zag needed for the best score. The game's legendary difficulty is dead. Surgery is the only mode with cooperative multiplayer – every other applicable discipline makes you take turns – but it's barely challenging enough for one person.

All is not lost, though. The first response section saves the treatment portion of the game, as it's the specialty that most thrives on frantic pressure. The stress comes from juggling multiple patients at the same time. While you're cleaning a wound with gauze, splinting a broken bone, or pounding the remote down to restart someone's heart, the vitals are continuously dropping on the four or five other patients that need urgent care. Each one is represented by a status icon in the upper portion of the screen, so you can watch as their layers of life detach and drop away. You can switch between patients at any time; it's like walking a tightrope when everyone reaches critical at the same moment. This is the one exhilarating discipline where you always feel like failure is imminent, and that it's absolutely not an option.

Orthopedics captures a bit of that magic, too. Here you're preforming delicate procedures: hammering pins into bone with the right amount of strength, drilling holes without deviating from the guidelines, and twisting screws to just the right tightness. There are also cool cutting sections. They differ from regular surgery because the screen moves in addition to your remote. Basically, the camera begins to follow a complex curve, and you have to keep the pointer within a certain margin. As long as you don't miss, the movement continues to accelerate. Sometimes the margins even begin to pulse, like in time with a heartbeat. Thanks to a strict limit on mistakes, orthopedics retains an edge over the course of its meticulous operations. This section also features the most brilliant graphics in the game, with clean representations of skeletal structure.

Compare that to the queasy view from inside a green intestine. Endoscopy takes you deep into the bowels of the body, but the bland experience is more sickening than the surroundings. The action boils down to controlling the endoscope. The image on the screen actually serves as a camera for the instrument, so you're snaking it through narrow spaces with a first-person view. Movement is accomplished by constantly pushing the remote towards the TV while steering with the nunchuk. Maneuvering through the maze of organs without touching the sides is the main challenge; at times the walls will palpitate and reject the endoscope, so you have to stay steady. Keeping track of the areas you've visited and which remain unexplored is a nice memory exercise as well. Those are the tough parts. However, delicate movements are rarely required once the instruments come out, and like surgery, healing is always only a syringe away. It's the antithesis of the edge-of-your-seat procedures this franchise usually provides.

By now, though, you should realize that the old rules just don't apply to Trauma Team. It's as if the vital qualities of previous games have been distilled and distributed amongst these different disciplines. Forensics inherents problem-solving, diagnostics the attention to detail. First response takes its hectic nature, while orthopedics grabs its precision. Endoscopy and surgery get only the short end of the stick. That's sure to temper the enthusiasm of most skilled amateur surgeons out there, and it leaves a rather large question: where does Trauma Center go from here? With all of its new and retooled modes, Trauma Team feels like a daring experiment. Atlus is implementing several different ideas here, seeing which directions will ultimately work best in charting new courses for this well-established franchise. Given how well most of the components work, it looks like they'll have their choice of paths to follow.

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