It's Time We Had a New Trauma Center

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Those of you who have played and loved the Trauma Center series as much as I have over the years will probably need no convincing of the statement I make in this article's headline. The rest of you, however, might be a tougher sell. But let's go for it anyway.

Atlus has built up a very respectable bank of in-house franchises over the years, and some of them have naturally become more well-known and fondly regarded than others. People have been very excited to jump back in to the Shin Megami Tensei series with its recently released fourth installment, for example, and Jeremy will happily talk your ear off about Etrian Odyssey if you let him.

Trauma Center, meanwhile, is arguably one of the underdogs in Atlus' lineup. Originally appearing on Nintendo DS back in 2005, the series has since enjoyed a total of five releases, though it has, for some reason, always remained locked to Nintendo platforms -- initially DS, then Wii, then briefly back to DS before the most recent entry, 2010's Trauma Team, landed once again on Wii.

In case you've never played one of these games, here's what to expect -- from the first four games, at least. You'll be doing a lot of reading -- each game's story unfolds through non-interactive visual novel-style cutscenes -- and every so often be presented with a surgical procedure to complete. Initially, these are relatively "routine" (or perhaps "believable" would be a better word) operations such as removing polyps from a singer's throat, stitching up accident victims or fitting a pacemaker to someone's heart. As the various games' stories progress, however, there's usually something of a sci-fi/disaster movie component that usually comes in the form of a mysterious (and fictional) virus that is difficult to defeat with traditional medical science. In typical Japanese fashion, by the end of the game the outcome of your operations will generally determine the fate not just of your patient, but of the whole world.

Trauma Team -- the fifth and, at present anyway, final game in the series -- took a slightly different approach. Eschewing the usual overblown anime-style sci-fi for the majority of its narrative as well as abandoning the visual novel presentation in favor of motion comic cutscenes, Trauma Team took a lot of its action out of the operating theater. While you still had to perform a significant number of operations over the course of the game's narrative, the expanded cast of specialist cast members also meant that you'd be sent out as a first response paramedic to accident sites, have your steady hand tested in orthopedic and endoscopy procedures, and have to put on your battered "adventure game" hat to complete the diagnostic and forensic investigation segments. It was an incredibly diverse experience, and somehow managed to tell a coherent and compelling story despite its disparate gameplay elements. Yes, it got a little crazy towards the end, but prior to that point it successfully wove together six separate but related narrative threads, each of which centered on a particular character and their specialism.

The Trauma Center series is, for me, so interesting because it presents the opportunity to do things that you don't often get to do in video games. We've all played games in which you shoot people with a gun, slice them up with a sword or use the thing on the other thing to make something cool happen, but how often have you had the opportunity to slice into someone's abdomen with the intention of healing them rather than inflicting horrific injuries? How often have you performed open-heart surgery on your DS' touchscreen? When was the last time you used a motion controller to simulate carefully feeding an endoscope into one of the body's various orifices?

The idea of an interactive medical drama is an underexplored concept in gaming, and the Trauma Center series as a whole has shown that it's something that can really work. The very fact that it was such an intriguing concept for a game meant that it was not only the first game I picked up for my Nintendo DS, it was, along with Phoenix Wright's courtroom action -- something else I'd never seen before -- the reason I bought the system in the first place.

Trauma Center wasn't the first game to explore this concept, however. That honor belongs to 1988's Life and Death, a PC game that cast players in the role of an abdominal surgeon, and was followed up two years later by a neurosurgery-centric sequel. Life and Death took a more simulation-like approach to its gameplay, however -- the procedures you were performing in the game were based on how real surgeons would do it, and required you perform every step along the way from diagnosis to suturing. You had a bewildering and frightening array of tools to work with, and there was a real sense that if you messed up, you were an awful, awful person.

Trauma Center's surgery sequences, meanwhile, are considerably more "arcadey" than Life and Death ever was. While that may sound like a curious description of a game that ostensibly simulates some of the most delicate procedures the human hands can perform, it's absolutely true -- Trauma Center is not at all about pinpoint accuracy or accurate simulation, it's about speed. And it's all the better for it.

The early missions in each game teach you a variety of techniques to deal with "common" (in the game, anyway) ailments such as tumors, polyps, lacerations and sharp objects embedded in the skin; as you progress, you'll have to remember the simple "moves" required to deal with these injuries and conditions and apply them as quickly as possible, because time is inevitably not on your side. By the end of the game, the gestures and movements you're performing with either the Wii Remote or the DS stylus become second nature; the game becomes one of skilfully using the techniques you've learned as quickly and efficiently as possible -- kind of like a shmup or fighting game, in many ways.

Despite its unrealistic mechanics and abstract presentation -- the patients you're operating on are represented as faceless, featureless mannequins outside of story sequences, mirroring the professional detachment a real doctor has to feel when performing a potentially life-saving procedure -- the Trauma Center series as a whole consistently fosters a genuine feeling of emotional engagement. And, while its narrative sequences are generally well-written and explore some interesting characters, not just through the "story" side of things, either -- Trauma Center also grabs hold of you during the "game" parts with the combination of its incredibly tense music, urgently and constantly beeping EKG readout and frantic action. It's not unusual to feel physically and emotionally exhausted after playing through a few missions -- particularly during Trauma Team's 20 minute long orthopedics operations, which will often leave you with an aching arm after being tense for so long -- and this feeling of engaging with the series physically as well as mentally is, for me, one of the things that makes it so memorable.

So why, then, has it been three years since the last game in the series? Why did that game never get a European release? While you could argue that the surgery gameplay has been well and truly run dry after five games -- though making clever use of the Wii U Gamepad in conjunction with other stuff happening on the TV could be very interesting indeed -- there's plenty of scope for further exploration of other medical procedures and disciplines. I'd happily play a whole game based purely on the diagnostic and forensic components of Trauma Team, for example, and I'd also be happy if a new game in the series took some cues from the rather underrated Ace Attorney-style DS adventure Lifesigns: Surgical Unit.

Video games are often about pure fantasy and exploring things that just aren't possible in the real world. But members of the medical profession are among the closest things we have to genuine "heroes" in reality -- wouldn't it be fun to have more opportunities to put ourselves in roles a little closer to home? (And no, Surgeon Simulator 2013, while incredibly amusing, emphatically does not count.) Make it happen, Atlus.