Trauma Team

Written by Sean Colleli on 5/3/2010 for Wii  

Atlus is one of Nintendo’s best third party supporters and a lot of people probably don’t even realize it. From the DS onward, Atlus has been onboard with Nintendo’s “creativity first” approach, delivering strange but undeniably unique experiences on Nintendo consoles even when Nintendo and many others were phoning in their work. Atlus brought their successful Megami Tensei RPG to Nintendo hardware, handled the localization of Chunsoft’s Shiren the Wanderer to the Wii, and even started new IPs on the DS like Etrian Odyssey and of course, Trauma Center. Atlus’s quirky Trauma Center series has been quietly using the Wii and DS in creative, engaging ways for years.

That said, the series has gotten admittedly stale in the last couple of entries. I reviewed the past two Wii Trauma Centers and played the direct DS sequel extensively, and while each one was a marked improvement over the last—adding co-op, full voice acting, new controls and more creative operations—they all retread a lot of ground. Within the constraints of the Wii controls, there’s only so much you can do with emergency room surgery, at least until you’re playing Asteroids in a guy’s intestines again.


Per usual, Atlus has listened to their fans and understood what they want: a wider variety of more realistic operations, a less fantastical story, and fresh gameplay ideas. Atlus has hit on an effective solution to all these requests—if they’ve reached the limits of one field of medicine they’ll just explore new ones, five of them in fact. The aptly titled Trauma Team adds endoscopy, first response, diagnostics, orthopedics and forensics to trauma surgery for a total of six medical disciplines. In this way it expands the scope of the series far beyond what any of the previous games did. In the process of adding these new gameplay styles, Atlus has improved almost everything about the series.

Past games dabbled in fields like EMT response or orthopedics and mixed them in with a linear series of operations performed by only one or two doctors. However you never saw the level of focus or detail you get in Trauma Team. Each field works as a separate story arc, following a specialist in the field as they run through a series of six or seven operations. Resurgam Hospital has a lot going on, making Trauma Team the biggest and most varied Trauma game so far.


The standard surgery is back but the character is unique—a brilliant surgeon afflicted by partial amnesia, he’s been accused of a horrific bioterrorism attack on a college and incarcerated for a 250 year sentence. He’s known only by his prison number, CR-S01, remembers nothing but his medical training, and is working off his sentence one high-risk operation at a time. CR-S01 is a refreshingly solemn character and his track plays like a “greatest hits” selection from the entire Trauma Center series. You’ll still be excising tumors and suturing lacerations, but Trauma Team’s operations benefit from several games’ worth of tweaking and refinement. The surgery here is the most focused and enjoyable in the series by far.

Resurgam’s head EMT is the hot-headed Maria Torres, a woman with anger and self-confidence issues. Appropriately all of the first response operations are fast-paced and chaotic. You only have four basic tools—healing gel, stabilizer syringe, tape and forceps—but you must use them much more quickly than in surgery. First response is about juggling multiple patients and getting them stable for transport. You’ll patch up cuts and burns with gel, trauma pads and tape instead of sutures and soak up blood with gauze instead of the drain. There are also broken limbs to set and splint, blood transfusions to inject and good old fashioned CPR. Your job is to get the patients stable as quickly as possible, but don’t work too hastily—sometimes the guy you’re working on can tell you about other casualties you’d otherwise miss. First response is like surgery on steroids—if you thought working on one dying person was hard, imagine five, all with grievous injuries and two of them going into cardiac arrest.After working on some crazy first response emergencies, it’s always nice to take it slow and steady with orthopedics. Hank Freebird, Army Ranger-turned surgeon is Resurgam’s resident sawbones with a masked vigilante streak. You won’t be doing any of his superhero moonlighting but you will get behind a drill, saw, plates and screws. Trauma Team’s orthopedics is the most realistic in the series, and probably the game’s most creative use of motion controls. It’s all about lining up your instruments just right and using fine control and pressure and when you nail a procedure perfectly it’s very satisfying. Drilling in just deep enough and then affixing a plate with screws takes precision and patience, and placing pins with gentle strokes of a hammer is more of an art than a science. While first response is chaotic surgery, orthopedics is very much a Zen experience. There is no time limit, no dropping vitals and delicate accuracy is paramount—just don’t make too many mistakes.

Resurgam’s chief endoscopist is Tomoe Tachibana, a young medical prodigy and Japanese heiress. She used her money to pay her way through med school and commissioned a custom set of gold-plated endoscopic tools. Endoscopy is the biggest variation on the standard surgery model because it’s basically surgery in 3D. You use a lot of the same tools but the controls have significant differences. You navigate with the Wii remote, pointing it to shine your light, and push it forward to advance through a patient’s viscera; yes, the regular old Wiimote can recognize depth and Atlus has done possibly the best job of using that feature and making it work accurately. It really feels like you’re threading a cable through some guy’s esophagus.


The added depth can throw experienced players for a loop and makes old procedures feel fresh, but I had a few issues with tool use. The game auto-locks onto affected areas—tumors, polyps, blood pools and the like—and you can’t work on them until you’re locked on. It was cool that being too close or far away affected your ability to work, but the lock on problems made fast-paced operations harder than they needed to be.

The biggest departures from the series are the diagnostic and forensics tracks. You can tell that diagnostics was modeled after “House MD”—the similarities between Greg House and the sardonic, heavy-smoking Gabriel Cunningham are undeniable—but Trauma Team’s diagnostician and his missions have their own distinct personality. For starters, Gabe is partnered with an overly-helpful AI computer called RONI. The bickering between the two is highly amusing but RONI turns out to be a helpful tool. Gabe can do the old fashioned stuff, like checking charts, observing abnormalities and using the trusty stethoscope, but RONI is basically his version of House’s diagnostic team, recording all the symptoms and putting them in order. Diagnosis takes keen attention to detail. You have to examine everything the patient says, their appearance and medical scans like CTs, X-rays and MRIs. Narrowing down the candidates and hunting for symptoms becomes addictive quickly; diagnostics is the most pleasant surprise of the game because it takes the compelling puzzle aspect of a House episode and adds its own unique style. Trauma Team manages to make something as mundane as analyzing a blood panel an entertaining part of the gameplay.


If you’re a fan of the Ace Attorney games then you’ll love forensics. Naomi Kimishima, the surgeon with a shady past from Trauma Center Second Opinion, retired in the intervening decade after being diagnosed with a terminal disease. Now she’s a medical examiner for the FBI. You’ll be doing a lot of the things Phoenix Wright does—examining crime scenes for clues, listening to recorded testimony—but the theme is much more serious. One of the biggest sources for info is the victim’s corpse and personal effects; they’re presented in standard Trauma Center abstraction but it’s still a little morbid. As you find evidence it is arranged in a series of cards. You can then make connections between different items or send them off to Naomi’s FBI contact Little Guy for analysis. As your investigation progresses you have to answer multiple choice questions about the case, using deductive reasoning.Even with five new disciplines the controls still work almost seamlessly, aside from a few issues with endoscopy. Atlus was smart in designing Trauma Team—they added to the controls by building on the familiarity established in previous games. There are several new tools to use and new ways to use old ones, but with some helpful tutorials they become second nature in no time. Atlus said there was still a lot of potential in the Wii remote and that they wouldn’t be using WiiMotion Plus for this game; now I know what they meant. By working smart and adapting the existing control scheme to new operation types, they’ve kept the gesture controls simple and intuitive.

I could understand if one of Trauma Team medical fields was the odd one out but it really is six well-built games in one. It’s certainly the biggest game in the Trauma series—easily 25 hours long—and this broad scope applies to the story as well. The plot arcs are split up among the six characters and overlap quite often; sometimes a patient even moves from one doctor to the next. You’ll have to play through each track to get the full story and this has some curious side effects. In some cutscenes a character will talk to another and say some pretty vague stuff or just trail off, and you won’t understand it until you play the mission from their perspective and see what they were thinking. It can make some of the cutscenes seem a little flat or confusing—at first I thought I was getting some translation decay—but when you finish out the whole story it’s a lot more satisfying.


Trauma Team’s plot conforms to the more realistic direction Atlus took with the operations. The story still retains the series’ characteristic anime melodrama but despite happening further in the chronology than the previous games, it is far more grounded with less mysticism, miraculous scifi technology and philosophical musings. There are no bio-terrorists with obscure religious motivations and no magical healing touch. A pandemic threat is the common theme throughout the game and the big focus of the last act, but it is much more of a turbo-charged H1N1 than the creepy crawly GUILT parasites.

The game has a wider active cast but their respective problems are more down-to-earth, making them more relatable characters. Instead of wrestling with navel-gazing existential or moral questions, they deal with personal problems—family issues, lack of confidence, feelings of powerlessness. Instead of bombastic medical heroics and sinister plots worthy of Cobra Commander, the game touches on issues like depression, doubt, suicide, drug use, divorce and responsibility. The delivery is about as hammed-up as you’d expect from a typical anime or medical drama but the dialogue is more serious overall and touches on more human issues. Trauma Team walks a fine line between camp and adult drama. It has the same dramatic feel of previous games in the series but has a more serious, grounded edge. Naomi’s entire campaign is about getting there too late—realistic depictions of death and the search for hard answers in its wake.

The doctors all have their larger than life quirks, but more often than not they work through their own issues by coming face to face with their patients’ emotional struggles. Trauma Team never strays from the bounds of its Teen rating but it isn’t a whitewashed party game collection by a long shot, so longtime fans finally have a more poignant, evocative story to sink their teeth into. Conversely, if you’re a parent this could be a great game to play with your kids. The whole Trauma Center series earns marks for rewarding the player for saving people rather than killing them, but in particular Trauma Team’s insightful tackling of difficult subjects could be a great springboard for discussing these issues with an uncertain teenager.It’s also easier to play together this time. The cooperative mode from New Blood is back and vastly improved. The balance issues are gone—the game isn’t hard unless you want it to be really hard—and the division of tasks is handled much better. In New Blood it was common for both players to run into each other doing the same thing or fight over who did what (humorously demonstrated in this Awkward Zombie comic), but Trauma Team handles that problem differently in each field. In surgery you choose the tools before starting, while first response has you split up the patients. Orthopedics has you tag-team between each action, and in endoscopy you take turns on a timer. Diagnostic and forensics don’t have co-op, but their visual novel gameplay wouldn’t exactly work with two players.


Trauma Team only has minor improvements in graphics and sound over New Blood, but the amount of voice work is substantially greater. The music is just as addictive, but has a more somber flavor this time around. You can tell the graphics engine has been reworked for better fluidity and speed, and with endoscopy the series has its first foray into 3D gameplay. The art style has a stronger manga influence and is presented in comic panels, lending a graphic novel quality to the story. The art itself has a more vibrant color palette compared to the sterile appearance of the other games, which is a welcome change.

To be honest the game didn’t need a huge visual overhaul, but what it did need was a lot of new gameplay ideas and that’s exactly what Atlus gave us. Trauma Team is a remarkably well balanced experience for an “ensemble” game, even with the drastically different diagnostics and forensics tracks. It’s deep on content and has a good story tying it all together, and at the budget price of $40 it’s one of the year’s best deals on Wii. As a longtime fan I can safely say that Trauma Center enthusiasts will love it, and it’s a great place for newcomers to start. Atlus has built one of the best series reboots I’ve seen in a long time.