The Let's Play Archive

Trauma Center: Under the Knife 2

by 1234567890num

Part 3: Novice Mistake





Hmm... Well, it seems like it's just a typical case of food poisoning.

Patient: "Really? My stomach's been hurting for a really long time now..."

Your immune system is probably weak at the moment, but I don't think there'll be any complications. I'll write you a prescription for it, and we'll see how you do for the next two or three days. Also, don't eat anything else for today, and make sure you go gentle on your stomach tomorrow, too.

Patient: "...I understand. Thank you very much."

Take care.

*The patient leaves*

Whew... That was my 20th patient. This place is even more hectic than I thought... Well, onto the next one...

*Someone enters*

Ah, Ms. Thompson! Is the operation over?



Dr. Tulba, can I ask you what the results were for the patient that just left?
Huh? My last patient? It was just food poisoning. Enteritis, to be exact. Nothing out of the ordinary.

Enteritis is inflammation of the intestine, usually accompanied by diarrhea.

...I See.
Why, is something wrong?
No, it's just that he's been in here before, complaining about stomach pains... The previous doctor examined him, though.
Yeah, I saw his chart. It seems he was suffering from enteritis that time, too.
I see... Still, it might be a good idea to perform a thorough examination on him next time.
I don't think that will be necessary. This area's conditions are still unsanitary, so diarrhea and stomach pains are fairly common. And we don't have the equipment to perform a detailed examination like we could at a hospital.
That may be true, but...
...It would really be a hassle. Anyway, I should bring in the next patient. I've already seen 20 today, but that's probably just the tip of the iceberg. If you'll excuse me, Ms. Thompson. *leaves*
......

This sounds familiar...



Please, wake up! We have an emergency patient!
*yawn* But... It's the middle of the night...
He's a patient you saw this afternoon, Doctor.
Wait... What!?



I drove him here. I responded immediately to the radio call, but he's in a lot of pain...
......
Dr. Stiles...!?
I've transferred the patient with acute abdomen to the examination room.
What!? Don't tell me... It wasn't just food poisoning?
We don't know for sure yet... But there's a possibility it's a gastrointestinal stromal tumor.
GIST!? That can't be...!
Did you check the patient's charts carefully? He's showing the same symptoms as before, but it says that there was blood in his discharge this time.
Oh... N-no... Um... I thought that it was just diarrhea...
...I'm sorry. I was so busy that I must have overlooked it...
The onset frequency of GIST is low and it's hard to detect without a thorough examination, but still...



Numerous tumors detected in the small intestine. I believe that it's GIST.
...As I suspected.
Th-then, that means... I misdiagnosed him? Th-that... That can't be!

I mean, it's obvious from the title of this episode.

......
What are you waiting for, Adel?
Huh...?
We know the patient's condition. Shouldn't you be getting ready to operate?
B-But... I... I made a terrible mistake... I overlooked the cause of my patient's illness! I can't do it! I can't operate like this...
You've got to pull yourself together! He's your patient, isn't he!? If you're a real doctor, then take responsibility for your patients no matter what!
B-But I... I don't have the skill to succeed on an operation of this magnitude!
...Dr. Tulba, try to think about what you do as a doctor. What do you think that is? You're supposed to save patients. ...And gain experience, too.
I'll perform the operation. Rather than sulking, why don't you help me out? If you run away from this, you'll never be able to call yourself a doctor again!
Dr. Stiles...
Un-Understood! I'll prep for the operation!



You will be extracting tumors located inside the patient's small intestine. These tumors are not large, but hemorrhaging has been detected, so we have to act fast. We'll need to excise them before they get any larger. You should also know that when you treat a tumor, smaller tumors will form around it. I'll let you decide which to treat first, Doctor.

This isn't true, as we'll see later that some tumors has no smaller ones accompanying them.

You heard her, Adel. There are two main objectives in this operation: And that's it. We'll be using the Powell Procedure to extract the tumors. Have you heard of it?
Yes. We have to drain the tumor's cytoplasm to decrease its volume before we extract it. Am I right?
Exactly. Pay close attention to the procedure: you'll be doing this too, sooner or later.
Yes, sir!



Operation Video


It's a Trauma Center tradition that the second surgery has to be about tumors.

We'll be performing the operation on the abdomen this time, so please be extra careful. Disinfect the guideline with the antibiotic gel and then make the incision.



Same deal as before. The initial incision should be a free Cool as long as you put the gel and didn't miss.



The size of the small tumors that are visible makes them more difficult to excise. It's a better idea to burn them off with the laser.

So we select the laser...

Good. Burn off the tumors by holding the laser point on them. Keep holding the laser in place to apply it for a longer period of time. But, if you keep it there too long, the tissue could be damaged. Please be careful. Now, burn away the small tumors if you would, Doctor.



The laser works just like you'd expect. As in, not scientifically accurate. It's normally used to cut things more precisely (as far as I know since I'm not a doctor).

The small tumor that was treated has hemorrhaged and a blood pool has formed. We won't be able to continue burning the small tumors like this. Let's drain the blood pool and clear our view of the area first. Place the drain on the blood pool. If you've selected an affected area that can be drained, like blood, a tube will be displayed. Slide the fluid up the tube continuously until it has been drained.



Because this is a DS game, we have to slide upwards to drain it. Unlike in the Wii games. Or in real life, for that matter. It only takes slightly longer, but in longer operations they will add up.

Anyway, after draining the blood pool (that looks more like gas to me), we have to use the gel to seal the wound before doing the same for the other small tumors. Each of them has a random chance of being one that creates blood pools. If drained but not treated, those blood pools can form again.

All of the small tumors have been treated. Let's move on to the larger tumors. We'll be using the ultrasound to locate the affected areas.

We use the ultrasound by tapping. It'll then reveal the shadow of hidden things. For now, we'll look at the area between the small tumors.



The affected area is confirmed! Amazing, Doctor! You found it on the first try!
Tumors can be treated without finding the shadow, but it's safer if we know where they are.

In NB or TT, the ultrasound will automatically be used at the cursor's position while pressing A will lock in the shadow's position. Not here, though! In the DS games (and SO) we have to lock in the shadow's position if we use the ultrasound. Which will result in us getting a Good instead of Cool for removing the tumor.

That means that we, like any good doctor, have to memorize/guess their locations!

Anyway, our next step is to cut the shadow, which in this case is a tumor, with the scalpel.


The tumor has been confirmed. It's much more swollen than I expected. You'll need to drain the tumor's cytoplasm in the same way you drained the blood pool.



So we do just that.

The cytoplasm has been drained.But, it may start to seep out again if you wait too long, so make sure to excise the tumor before that happens.



In addition to adding more work, having the cytoplasm reform will also break our chain.



After the tumor is drained, we need to actually remove it.

Excision of the tumor is complete, but we aren't done yet. We'll be using a synthetic membrane to stop the excised area's bleeding.



Our final step is to apply the membrane and gel to affix it. In UtK, we also need to massage it, but I guess they realized that it's too finicky and decided to remove it. I support that decision.

The membrane is fully affixed now. We're done treating this one. Now let's move on to treating the next affected area.

*The camera pans to the right*

I'm getting reactions from tumors here as well, but they're not visible on the surface.
Use the ultrasound like before to find the affected areas and continue the treatment.



Fuck that. I want to get those Cools, so it's better to memorize their locations instead.

I'm going to be glossing over the process since the game now has freed us from tutorial zone and hand us access over all our equipments.




Small tumors will form whenever we remove the large ones because. I like to gel them all at once since it saves time from switching equipments.

You know, unless a blood pool forms and block us from lasering another tumor underneath it.


The tumor treatment is complete! Let's close the patient up.



Closing up the patient as (soon to be) usual...



If there's time to spare, it's a good idea to raise the vitals before applying the bandage. It'll boost our final score and might even be the push needed to get a better rank.

By the way, the bottom right spot is reserved for very situational tools. Which is why the bandage didn't appear during most of the operation.


Operation complete! Well done, Dr. Stiles.
I-I'm so glad it went well...





The vital and time bonuses are the vital and seconds at the end of the operation multiplied by 5. One shot of stabilizer raises 8 vitals while spending 1 second.

I'm not going to try to get the top rank for all of these because




Dr. Stiles... Ms. Thompson... I'm very sorry. I shouldn't have troubled the two of you with a mistake like this...
...Adel. Why did you become a doctor?
Huh? I-I...
Ever since I was a child, this country has been at war. I've always had people around me that are suffering from diseases and injuries... My father and mother, brothers... Even my friends.
......
I wanted to save everyone from that kind of pain... I became a doctor because I wanted to help you rebuild this country.
...I see. Adel... Doctors are human too. There are times when we make mistakes. I made a mistake just like this in the past, and Angie got very angry with me. She even questioned my ability to be a doctor.
......

Oh yeah! I remember why this sounds familiar.



After finishing an operation about tumors (pictured above), Angie still suspects something is off. Derek, however, just fucks off instead. It turns out that there's more complications and the patient almost died.

That caused Angie to chew him out. Her faith in him is restored one (very difficult) operation later, after Derek has learned his lesson. It changed Derek from being an irresponsible ass into a proper doctor.




...when in reality, that's the most important part of what we do.
I guess being too busy is no excuse, huh...
Doctors need to have skills, but patience and compassion are equally important. Today was your day to learn that. Adel... don't forget the reason you become a doctor.
Y-yes, Dr. Stiles!
Thank you, Sylvia. That was some great counseling earlier. It would have been a shame to lose such a promising doctor.
...I just did what I could. *smile*

Would've been better if Derek didn't steal her thunder, though.