Part 1: - Introduction

01 - Introduction

(Music - Main Theme)



Sure thing, Atlus.

Video: Title screen and Prologue.


Welcome to Trauma Center: Under the Knife. I wanted to show off the introduction and music to the title screen. It sets the tone rather nicely. But as you can see, in-game text suffers Ocarina of Time syndrome - very slow english text speed. There's no way to speed it up, unfortunately, and so the rest will be screenshots.

Prologue.

(No music.)



"Since its inception, Hope Hospital has continuously served the community. One of the young doctors here is still in need of guidance. But, because of his desire to help people, he strives to improve.

Dr. Derek Stiles will soon realize his full potential..."



(Music: Routine)



"Hope Hospital - Consultation Room."



"Mary Fulton, age 39: The Hospital's veteran surgical assistant. She's kind and well liked, but tends to ramble too much."

"The injury is on his forearm, and he's still fully conscious. Blood tests should be back from the lab any minute."



"I guess he got lucky, huh?"

"Dr. Greg Kasal: The head of the surgical department here. Nothing rattles him, but he's strict and expects perfection from others."

As you can probably already tell, this game is quite badly localized, despite Atlus' usual high localization standards. Everyone Japanese is turned American, the Americans are turned British, and in the sequels, the first American main character is turned Japanese. Greg's last name in particular should be an obvious reference. It's pronounced "Castle," as in "Greggory House."

"You'll be operating, Derek."



"Derek Stiles, age 26: A surgeon, and the story's main character. He just completed his residency and accepted a position here."

"I was just about to start my rounds, so..."

This is our player character, Derek Stiles, or "DS." Unfortunately this isn't the only platform pun in the series: the player character of the Wii version has the initials NW, as in "Nintendo Wii." Derek starts off a remarkable bonehead and exactly the sort of person you wouldn't want operating on you. Furthermore, seeing as general surgery has a residency of 5 to 7 years, I have no idea how he's completed it at 26.

"Worry about that later! You're not an intern anymore! Hurry up and prep for the OR!"

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

The screen fades to black and we get our first view of the Briefing Screen:

(Music: Patient Profile)



The Briefing Screen, other than having incredibly catchy music, will summarize every single operation you go into. Here, you'll often learn about the condition of the patient, or the disease you'll be treating, if any. The names of the patients are usually actor references or character references from other medical dramas. In this case, it's Kevin Turk, Christopher Turk's older brother, from Scrubs.

"The patient, Kevin Turk, just arrived in an ambulance. He lost control of his motorcycle and crashed through a glass door. His lacerations have begun to hemmorhage."

"There are glass fragments lodged near his right shoulder. Our cosmetic surgeon is out at a Medical Society meeting... But, you should be able to handle the stitching, right? There are two main objectives in this operation: Suture any lacerations, and extract fragments of glass from underneath the skin. Be thorough, and try not to leave any scars."



(Watch this Operation: Mission 1-1, S Rank.)

I will be providing videos for every operation in the game. They are intended to be viewed after the screenshots, only as a supplement to show how the operation is meant to be done in real time. The videos will skip over text quickly and I'll be going my natural pace: extremely fast.

(Music: Precision)



Anyway, this is our operation screen. In the top left-hand corner is the vitals. When they hit zero, it is game over. You have five minutes to complete every operation, and time stops during conversation. With typical DS graphics, this is nothing to get squeamish over, though I do remember feeling a little sick the very first time I got to one of the more tense levels. Apparently the reactions to this game were so strong that Atlus made it more cartoony in the later games so players wouldn't feel disgusted. With just screenshots, though, you should be fine.



"Select the needle icon to suture his wounds."

To suture, you must draw a zig-zag or wavy pattern over the wound, starting from just above the cut all the way to just below it. If you don't make enough criss-crosses over the wound, the game will give you a "Bad" score of 50 points. A "Good" suture will get you about 100, and and a "Cool" perfect suture will get you 200.



"Good work! Of course, this is basic surgery skill. Now do the same thing to the other laceration."

I do this, so we move on to the glass.

"Well done. The lacerations are taken care of. Next, select the forceps. We need to extract that glass."

"Grab the glass fragments with your forceps and slide them out.



The forcep tool. To extract glass and other objects, you must pull out perpendicular to the laceration until the object is all the way out. Then, you have to put it in the arbitrary middle of the nurse's tray to get a "Cool." It's easier to do using muscle memory on a DS than on an emulator, so I'll probably screw up finding the middle in the videos more than I should.

"All the visible glass has now been extracted. We need to take care of the smaller wounds now. Select the Antibiotic Gel on your left."

This mission actually teaches an essential skill players tend to forget: always treat the big ones first. They'll knock down the vitals the most in an emergency, while the fragments hardly do any damage. Once the patient is stable you can worry about the smaller cuts.



Antibiotic gel treats small wounds. Not only that, but it has a secret ability, too - it will freeze the patients vitals for as long as it's on screen. Of course, you shouldn't always treat patients with antibiotics, and we'll see that later...

"Medicine has come a long way. This gel cures small cuts instantly. In the past, cure-all ointments were just gimmicks and scams... but someone finally created a real one."

"Oops... I shouldn't be talking so much. Let's continue... Some glass shards are embedded in the patient's arm, as well. We'll need to extract those -- make an incision in the upper epithelium."



Easy enough. Disinfect the area and cut along the dotted line. Move off the path, twitch or hesitate too much and you'll cut the patient, get a "miss," and lower vitals substantially. Forget to disinfect, and you're guaranteed a "Bad."



We zoom in to patient's arm muscle, where glass pieces that broke off are lodged inside.



And we do what must be done: Pulling out the glass and applying antibiotic gel. That's all there is to do here. Now...

"Alright, everything looks good here. Let's close it up. Suture the wound the same was as before. Make sure the stitches aren't too wide or too narrow."

The game registers only three things when measuring your suture score after surgery: whether or not you started a little before the incision begins, whether you crossed the whole length of the incision, and whether or not you stopped a little past where the incision ends. This means you can just draw a straight squiggle and get a Cool, no criss-crossing required. Most people do to save time, but I won't.



Now we zoom out to apply the bandage.



"Disinfect the sutured area with the antibiotic gel."

You need to slather about a quarter of the can on. This would be a good time to mention that the ticks beside the object show you how much of it you have left before you run out. It regenerates as your assistant gets you more, but it's irritating in a pinch. Anyway, I do this.

"That should heal up nicely. Now, we just apply the bandage. The fixing tape is the icon in the bottom right corner."



Too little, a miss, and you have to remove it and start again, taking a hit on the Vitals. Yes, you can kill your patient with the bandage. I know this because I've done it once.



"Make sure you review what we went over today."





Fanfare plays, and we cut to our overall score.



Surgeries are scored mainly in four different categories: time completed, mistakes made, base score, and secret bonus requirements (that you are required to discover for yourself). Vital bonuses (how much your patient's vitals dropped during the operation) become so miniscule and unnecessary that they aren't worth thinking about - there will be plenty of operations where we will hover just above 0.

The scores are C: Rookie Doctor, B: Specialist, A: Senior Surgeon and the elusive Rank S: Master Surgeon. Generally, you'll always get a C Rank the very first time you try a level because you'll be learning the ropes. Accessing "Challenge" mode from the main menu will let you try for a better score. B is a decent score, A means that you didn't make any major mistakes. S is going above and beyond, getting a perfect score, moving quickly (and sometimes missing conversations entirely), doing more than you were expected to do, and never missing once. While there's a score threshold for S Ranks, missing or not having enough time left will always award you with a worse letter grade, no matter how well you did. S Rankings range from easy to get to throw-your-DS-across-the-room hard. I'll be trying for all of them, but no guarantees even if it kills me.

In the video I S Rank this level. There are no special requirements and time is the most important factor. As you can see, you can even have a few "Goods" instead of "Cools", which is unusual for an S Rank.

So... Congratulations! We've finished the tutorial mission. Things get a lot more interesting later, but that wasn't so bad. For now, we cut back to the Map Screen.

(Music: Routine)



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

"I definitely see improvement... but flirting isn't everything."

"Seriously though, keep practicing and you'll do just fine."

By the way, Mary is voiced by Wendee Lee. Actually, there are only two voice actors in this game: All the men are voiced by Spike Spencer, and all the women are voiced by Wendee Lee.

Next Time: We do some more tutorial missions, and Derek slacks off. Cancer is involved.