First impressions

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  • DavidN

    I’ve recently been reminded of how much I like the Trauma Center series of games by Atlus, so I was interested to finally try this game to see how it compares! Trauma Center starts off relatively then takes a hard turn into fantasy fairly quickly, but this seems to have similarities despite being more grounded in reality.

    I was impressed right from the outset despite the CGA graphics, because I was surprised to see real world time awareness in a game from 1988 – the receptionist greeted me with “Sorry you had to work on the weekend” and “Happy Sunday!” The presentation is also interesting, with no real menu to speak of and the game being controlled by hovering around a set of rooms and clicking on filing cabinets and bookshelves.

    Naturally I was terrible at the actual diagnosis and operating part because I had no idea what the game wanted from me at first – an unusual amount of online help is provided in the game, but curiously it’s only provided to you after you’ve made mistakes. Toolworks General Hospital is more than happy to sacrifice a few dozen patients at the hands of a rookie doctor for the sake of medical education.

    Speaking of which, something that’s quite nice about Trauma Center is that they’re quite good at euphemizing when you fail an operation – usually a senior doctor will barge in and say “I got here just in time, let me handle this!” Here, it’s very unambiguous that the patient dies, you get a view of their body in the morgue, and yet no matter now many times you do that, you’re offered encouragement like “Give it another try, I’m sure you’ll get the hang of it”.

    A manual exists and is downloadable here (it’s for the Atari version): – but it’s very wordy and you have to have a bit of imagination to interpret what it’s saying into actions you have to perform in the game.

    Wish me luck.


    Good luck! I imagine that coming to this cold will be tough going at first.

    I bought this one new back in 89. My first impression going back was just how much stuff is crammed in the box. There were 4 manuals, David’s link is a combination of the only 2 that will actually help you out. There was a history of surgery to set the scene, rubber gloves and surgeons mask just in case you fancy dressing the part while playing, the game on both floppy sizes, a paper pager for copy protection and about a dozen leaflets trying to sell you things. It’s a far cry from the Speccy games on cassette I was used to at the time.

    I just about remember playing this back then. I was definitely impressed with it graphically – CGA was all I had and this makes extremely good use of that palette with lots of gory detail in the ops. I do remember it being a very short lived experience. Once you can perform the two operations, the game is over and there isn’t a whole lot of point to going back to it. Doing exactly that 30 years later, I’d forgotten a lot of it but I’ve still made it through in a couple of hours. I definitely still knew a lot of the basics and all the diagnosis steps.

    The classroom material is very well done pointing out any mistakes and how to correct them. The game is very much trial and error though. I got slightly further in each surgery before having to guess again, usually getting it wrong and being told what I should have done. There is nowhere near enough info in the manual. Teaching surgery in Toolworks General is akin to learning how to beat Dragons Lair.

    A couple of tips for newbies. Remember the keyboard shortcuts for Atropine and Lidocaine (A & L). It’s way easier and quicker to correct heart beat irregularities.

    On similar lines, the best way to make a nice neat cut is to use the number pad. Straight lines every time. Also when you are stitching back up, you can just hold down a direction and tap away at 5 to get them sewn up in no time.

    I’m giving the sequel a go which I’ve never played before but involves brain surgery instead. I’ve absolutely no idea what I’m doing and the patients are dropping like flies. I expect this is very much the same experience for anyone playing the original for the first time. Learning brain surgery by guesswork has to be one of the most morbid things I’ve done in gaming. It’s only being emphasized by a screenshot of doctors chatting about my mistakes while eating a pizza off the corpse.


    Hah, that’s incredible with the surgical gloves and mask – I can only imagine someone walking behind you while you’re playing it in full gear, saying “It’s only a computer virus, you idiot”…

    I was going to follow along with a walkthrough to help me through the details of the operation, having failed to tell what I was meant to be doing from the manual, but it sounds like that would spoil the experimentation that’s meant to be part of the game. But what a bizarre way to require you to experiment! In Richard Cobbett’s article on the games, he mentions that they were thought up by a surgeon, and it’s odd that they would have paid so much attention to the realism of the operation procedure but then throw you right in with “real” patients before training you. It’s almost like that Surgeon Simulator game with the floppy physics, just blundering into doing a heart transplant somewhat correctly.

    There’s a TADS text adventure I had ages ago called Rematch, which was famous for manipulating the parser to make the solution to the game a hugely complicated sentence – but on every action you take that doesn’t solve the puzzle, you die and have to restart. (Walkthrough to working it out is here: ) I remember people saying that it was an amazing thing technically, but that they didn’t like the exploration being so punitive, feeling that you had to die many, many times to continue. Life or Death feels a lot like that – you’re encouraged to experiment, but doing so feels like you’re failing at the game miserably. It’s so strange that they didn’t build up to practicing on dummies and so on before then expecting you to perform operations on your patients. (You send them away with a referral for kidney stones, you don’t attempt to vibrate them out of their kidneys manually!)


    I’ve had a few attempts with Life and Death 2 now but I can’t say that I’m getting on with it particularly. It’s very much more of the same and brain surgery by guesswork is proving difficult believe it or not. Without the benefit of foreknowledge, I’ve not managed to get near to completing an operation yet. I’ve mastered the diagnosis stage but it’s really tedious compared to L&D1, with lots of banging of knees and elbows and the like. I’ve noticed in L&D1 that once you’ve mastered certain diagnoses, they are much less likely to come up. So if you keep failing at surgery, the next patient will usually need the same op so you can quickly give it another go. That doesn’t seem to be happening here and repeating the same steps over and over is seriously frustrating.

    I’m also having technical issues. There is some sort of buffering problem with the mouse input and holding the mouse button down for a while often sets the PC speaker off beeping like I have a stuck key. Worse still, when drilling into the skull you have to hold the button down to drill the right distance and then release when it breaks through. Except the release never happens so I end up drilling into the brain instead. I’ve tried slowing my PC down which hasn’t helped – I may resort to trying DOSBox instead.

    It’s certainly more of a challenge than part 1 anyway and the graphics are a lot better in VGA. There is in game documentation now to help with the diagnosis which is a nice touch but curiously no guidance whatsoever on the surgery sections.


    I remember trying this game at a friends house as a kid and just being completely perplexed by it.

    Trying it again even the walkthrough’s online don’t really help much since the majority of them are text based. I don’t like the trial and error approach but the game certainly pushes you down that path. Going to give it another shot but even after helping a patient I’m not feeling a sense of accomplishment but rather just feeling I was lucky.


    I remember buying a backup of this game, but I couldn’t make heads or tails on how to not to kill the patient, so I re-purposed the disk and never looked back at it.
    I’m curious about this month’s episode of the club to learn more about it.


    I must admit I’ve used a guide when playing this, but honestly I don’t feel it’s as different as without, except it saves a whole lot of visits to the classroom, haha.

    Honestly I love this kind of novelty game. It’s utterly weird and arguably barely any fun, but I just imagine I’m an actual doctor and have a great time with this sort of thing 😀

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