Part 1: Prologue

Prologue





Since its inception, Hope has selflessly served the community.

As long as the community can pay its bills.

One of the newest doctors here is still in need of guidance. But, he strives to improve out of an earnest desire to help people. Dr. Derek Stiles will soon come to realize his full potential...

End of Prologue

Well, that was not-at-all-unnecessary. On to the actual game.

Chapter 1-1: Standard Procedure







Note: This chapter is titled "Standard Procedure 1" in Under the Knife.

-Hope Hospital, Consultation Room-





She's kind and well-liked, so nobody mentions she tends to ramble too much.

Mary, oh Mary. The Wii art style was not kind to you. Her face is an amorphous blob, about to slough off her head.

Mary: The injury is located on his forearm and he's still fully conscious. We should be receiving blood test results from the lab any minute now.



Dr. Kasal: You might say he got lucky.



He's not easily rattled, but he's strict and expects perfection from his subordinates.

His design is a lot less ugly, thankfully. Some of the designs actually look better than the DS ones, but a lot of them are just "off" in various ways.

Kasal: You'll be operating, Derek.





The writing is so sharp they feel the need to specifically tell you that he's the main character, as if his prominent position on the box and general idiocy didn't give it away.

He just completed his residency and accepted a position at Hope Hospital.

A Resident has a medical degree, and is studying under a fully-licensed physician. They get in-depth training in a specific branch of medicine, instead of the broader scope of medical school. Derek is no veteran, but he's been practicing medicine for a while, according to this.

Derek: I was just about to start my rounds, so...

Mary: Worry about that later! You're not an intern anymore! Hurry up and prep for the O.R.!

Kasal: This is a simple extraction procedure. There's nothing to worry about. Just take your time... Stay calm and keep it steady. You should be able to handle this on your own by now.

Of course, there'll be plenty of tutorial anyway.



Here's our first briefing. In these, you'll get an overview of the procedure, your arbitrarily-imposed time limit, and some inconsequential flavor information. Speaking of that, many patient names in the game are references to Scrubs, this one included. I've never seen the show, so I can't elaborate much.



Mary: Our patient, Kevin Turk, just arrived in an ambulance. He lost control of his motorcycle and crashed through a glass door. He received a number of lacerations, which have begun to hemorrhage.

Meaning his cuts have begun to bleed.

Mary: There are glass fragments lodged here, in his right forearm. Our cosmetic surgeon is out at a medical society meeting. But, you should be able to handle the stitching-it's fairly straightforward.

Oddly, the hyphen here appears as two short dashes in the game. Like this: - -

Mary: There are two main objectives in this operation:

-Suture any lacerations.
-Extract fragments of glass from underneath the patient's skin.

Be thorough, and try your best not to leave any scars.





And this begins the first operation. At this point you should check out the video.

OPERATION VIDEO
Gamevee
Viddler

If you can't, or won't, do that, then an abridged summary follows. You may also find them useful when we start hitting repeat operations, or if there was text in the video you missed.



Since this is a blatent tutorial, most of your tools are locked out. The first they make you use is the sutures. All you need to do to use them is hold A and zigzag along the wound. In fact, the game isn't very precise with how it ranks you here. You'll be told not to make them too wide or narrow, but the game is more interested in the number of stitches you make. As a result, you can do things like this:



The game accepted this just fine, but gave me a "Bad" on the task. Some tasks are unranked, and will just give you an "Ok" upon completion. Ones that are will rank you Bad, Good, or Cool, from worst to best. Cools are worth the most points, and are essential to gaining a high ranking. For suturing, I'd recommend getting a feel for how wide the game wants you to make the stitches. Memorizing isn't very practical or fun in tough operations.



The next lesson is on forceps.



Sorry about all the blurry elements in the picture. So many things are always glowing, fading, and moving that getting clear shots can be impossible.

I've seen a few different answers regarding how the game ranks this. Some say that it depends how close to the middle of the tray you place the shard, but as far as I know, it's based on how straight you can pull it out.

Either way, once you've removed the glass, you learn to use antibiotic gel to instantly close the small cuts.



Mary: In the past, cure-all ointments were just gimmicks and scams, but somebody finally created a real one.

I'm not sure what you need to invent to have your name remembered these days.



Kindly disregard how we just sewed up the arm, because the next step is opening it up again. You'll need to make an incision like this in almost every operation, so it's important to be able to Cool is every time. To avoid a Bad, you simply need to use antibiotic gel to sterilize the area. To bump yourself up from good, you need to do it without making a mistake. If you drift off the guideline, you will get a "Miss." You can get a Miss from any major fuck-up, like dropping a shard of glass on the patient instead of the tray. They hurt vitals, and will ruin your score. In Under the Knife, too many of them would result in an instant loss, but the limit was removed from Second Opinion, and hasn't made a return yet.



I've typed a lot about the operation up to this point, but there's not much to say about this section. You just need to remove some more glass, and gel the wounds.



Once everything is fixed, the final step of the operation is nearly always stitching up your incision, disinfecting it with gel, and applying a bandage. The bandage is also ranked. Generally, you'd be surprised at how small you can make it without getting a Miss, so you should try and keep it small. Missing or making it too large will hurt you. Be careful that you don't pass a tough operation flawlessly, only to screw up on this part.



Here's the final tally screen for your score. Vital and time bonuses are simple enough: five points for every point of vitals and every second on the clock. The special bonuses vary from operation to operation, but there are usually four of them. The one I missed was "Complete with 270 (seconds) left." Getting these bonuses is key to getting the best ranks. If you can obtain all of them in one run, you're almost guaranteed an S-rank.

As a side-note, the actual numbers for the goals change depending on difficulty. If I were playing on hard, I'd need to finish with 275 seconds left. On easy, I'd only need 240.



And finally, here's my rank. The ranks go like this:

C - Rookie Doctor
B - Specialist
A - Senior Surgeon
S - Master Surgeon
XS - Medical Prodigy (Only available on Hard Mode.)

And with that, it's back to the story!



Stiles: I couldn't have done it without my lovely assistant.

Mary: I can definitely see improvement, but flirting isn't everything. Seriously though, keep practicing and you'll be just fine.

End of Chapter 1-1