Trauma Center: Under the Knife

Trauma Center: Under the Knife (超執刀 カドゥケウス) is a surgical simulation game developed for the Nintendo DS and the first in the Trauma Center series. The game was remade for Wii under the title Trauma Center: Second Opinion.

Plot
The story is set in the year 2018, where diseases that were previously thought to be incurable (HIV, cancer, etc.) are nearly things of the past.

The player assumes the role of Derek Stiles, a doctor at Hope Hospital. After the near-death of a patient due to his negligence, he encounters the scene of a car crash and ends up working on a patient with incredibly severe injuries to the heart. Just as it seems like the patient is done for, a power within Derek is unlocked, and miraculously saves the patient. The power emerges once more, and Derek saves another patient when a seemingly routine operation gets dangerously out of hand. His superiors recognize the ability. They tell him that his power is said to be that of a descendant of the Greek god of medicine, Asclepius, and his gift is known by the same name, though is more frequently referred to as the Healing Touch. He practices his use of the ability, though is left weakened after forcing the power to activate under his own will. After performing another operation, Derek blacks out for a short period of time. Dr. Kasal advises Derek to avoid using the ability due to the toll it takes on his body, and Director Hoffman tells him to outright turn his back on the ability, saying that the responsibility is too great for him to handle. After saving Linda Reid, a teen with a strange parasite, he learns of a new man made disease known as GUILT, which is distributed by a medical-terrorist organization known as Delphi.

It is at this point that Derek decides to embrace his ability and use it to end the threat of GUILT. He then begins working for Caduceus USA as their main surgeon, where he eventually heals a young girl who has the second known strain of GUILT. During a conference, Delphi sets a bomb with the intent of killing the doctors attending. However, with the help of Cybil Myers, he successfully defuses the bomb. After this, he flies to Africa to aid Caduceus Europe, and encounters the third strain of GUILT in a young boy.

Back in America, Derek encounters the next strain of GUILT, which is only manageable after finding samples and using them to produce a few serums that are used to counteract the GUILT. Greg Kasal ends up being among those infected with the new strain, and is saved by Derek. Afterwards, Richard Anderson, the Head of Caduceus USA, becomes infected with a strain of GUILT that seems to be resistant everything that is thrown at it. Eventually, Victor Niguel manages to come up with measures to defeat the GUILT and after much resistance, the strain is finally removed from Anderson's body. However, Anderson succumbs to the toll taken on his body and dies soon afterwards, leaving Hoffman as the new director of Caduceus USA.

Not long after this, outbreaks of Kyriaki, Triti, and Tetarti emerge and are thwarted by Derek and the other surgeon. Then, one night, a man breaks into Caduceus USA and ends up infecting Cybil with the sixth strain of GUILT, though Derek manages to remove the parasite from Cybil's body. The man who broke in turned out to be Angie's father, Kenneth Blackwell, and they manage to trail him back to a research lab. There, they encounter the final strain of GUILT, first an immature form within one survivor, and then the main form within Blackwell himself. Practically being death incarnate, Savato proves to be a difficult challenge for Derek, being so swift that not even his normal Healing Touch is able to let Derek deliver the final blow. Using the Healing Touch twice in succession, the Healing Touch intensifies to the point where time seems to stop, and Derek finally manages to destroy Savato.

Blackwell offers his full cooperation for saving his life and rejects Caduceus's offer of amnesty, wishing to serve out his term in prison to atone for his actions. Blackwell's information leads to a great wealth of knowledge about Delphi's operation and eventually the location of Delphi's headquarters. When Derek and Angie assist with a raid in cooperation with Caduceus Europe, they find that Delphi has been using children to incubate the seven strains of GUILT, and after curing the patients, Derek and Angie encounter Delphi's leader, Adam. What they also find is that Adam is practically a corpse, heavily infected with GUILT himself. Derek and Angie pass out while in the chamber. The soldiers outside radio that the two of them were exposed to an airborne hallucinogen, and launch a rescue. With the threat of GUILT eliminated, Derek becomes well known as the man who saved the world.

Gameplay
Trauma Center is divided into several chapters and operations within each chapter. Each operation must be completed in order to access the next one and progress through the game.

The lower screen on the DS is used to display the patient, the patient's vitals, the instruments available, and is where the operation is carried out. The top screen is used to display instructions, the time remaining, the player's miss limit and score.

A typical mission requires the player to operate on a patient. During each operation, the player must keep the number of errors committed below a set limit, ensure that the patient's vitals remain above zero and keep within the time limit. If the player runs out of time, reaches the miss limit, or the patient's vitals reach zero, the patient will die.

Upon successful completion of an operation, the player is ranked based on the time remaining, the health level of the patient, and a net score based on the accuracy of the operation. The total score is then ranked, with special score rankings for each operation. Rankings for these are graded:

The player may repeat any operation in Challenge Mode and attempt to earn a better grade. Three save slots are available, but only the best score is recorded for each operation.

Instruments
There are a number of instruments available for surgery.


 * Surgical Laser - Used to cauterize objects that are too small to remove from the body otherwise.
 * Antibiotic Gel - Used to disinfect areas and treat small cuts.
 * Drain - Used to remove excess fluids, primarily blood.
 * Forceps - Used for removal of foreign objects and tumors.
 * Hands - Used to massage and for the Healing Touch.
 * Ultrasound - Used for finding objects, such as tumors, that are hidden inside organs.
 * Magnifier - Used for zooming in on parts of the body.
 * Scalpel - Used for making incisions.
 * Needle - Used for suturing incisions.
 * Syringe - Used for administering liquids.
 * Bandage - Used to bandage sutured incisions.

The Healing Touch
The Healing Touch is an ability that, according to the ancient Greeks, descended from Asclepius, the Greek god of medicine. It allows a surgeon to focus his concentration to superhuman levels in order to move extremely quickly and precisely for a limited amount of time. In the surgeon's mind, this appears to slow time.

GUILT
Gangliated Utrophin Immuno Latency Toxin is a group of deadly man-made parasites (virus) that start to infect patients later in the game. There are seven strains that the player encounters in the game, each one representing a sin:

Invisible Blades: Kyriaki- A parasite that makes lacerations to the organs. Comes in mature and immature types.

Creeping Tumors: Deftera- A mobile tumor that comes in two types (Type A and Type B). Often comes in two pairs and often attack two different parts of the body.

Contagious Nightmare: Triti- A mass membrane with thorns on each corner that slowly petrifies the organs. As the thorns are removed, the membrane will spread according to the placement of the thorns.

Synchronized Venom: Tetarti- A virus that comes in three types that affects the liver. Creates poisonous abscesses.

Armored Bacteria: Pempti- A virus that makes a gelatinous fluid in the lungs. Sends in multiple spawns to attack the victim.

Arrow to the Heart: Paraskevi- A fibrous virus that makes lacerations as it moves. It first starts out in the intestines. Then, it moves through the body until it reaches the heart, where it will kill the victim.

Faceoff with Death: Savato- A parasite that wraps a web around the heart and drains of its energy. Sends in multiple spawns to attack the heart

Main characters
Derek Stiles (月森孝介 Tsukimori Kōsuke) (age 26) - The main character and a surgeon at Hope Hospital. He is just beginning to realize his potential.

Angela "Angie" Thompson /Ange Tonegawa (利根川アンジュ Tonegawa Anju) (age 21) - A young nurse that works as Derek's assistant. She is part German and was raised by a very well-educated family.

Hope Hospital staff
Mary Fulton / Momoe Furumura (古村百恵 Furumura Momoe) (age 39) - The senior surgical assistant for Hope Hospital. She is a nurse who helped Derek learn the basics of surgery. She moved away from Hope Hospital, where Angie took her place.

Greg Kasal / Shinichi Kutsukake (沓掛真一 Kutsukake Shin'ichi) (age 35) - The senior surgeon at Hope Hospital.

Robert Hoffman / Iichiro Kitazaki (北崎威一郎 Kitazaki Iichirō) (age 62) - Dr. Hoffman was an exceptional surgeon who stopped practicing in his 40's. He's now the director of Hope Hospital.

Caduceus USA staff
Sidney Kasal (Age 35) - Greg's younger brother and director of Caduceus USA, who dedicated his life to the study of clinical medicine after his wife died of illness.

Stephen Clarks (Age 42) - Caduceus's head surgeon.

Cybil Myers (Age 34) Sayaka Myoujin (明神さやか Myōjin Sayaka) - The leading anesthesiologist at Caduceus. She was previously a policewoman.

Victor Niguel / Shuya Aragaki (新垣修也 Aragaki Shūya) (Age 26) - Head of research and development. He focuses mainly on his work and its uses. He is considered a recluse and can't stand the thought of "idiots" being near him.

Tyler Chase / Tohgo Sakura (佐倉東吾 Sakura Tōgo) - A former schoolmate of Derek's. He tries to keep everyone in a good mood. He is known as the "death doctor" of Cadaceus until Derek talks him out of it.

Leslie Sears (Age 26) - One of the many nurses on staff at Caduceus. She looks after many GUILT patients, including Tyler's sister, Amy.

Richard Anderson - The head director of Caduceus USA and Secretary of Health. Died after three treatments in a short period of time from Pempti.

Members of Delphi
Adam (Age 121) - Born Erich von Raitenau in Austria in 1897, he was the head of the Delphi organization. He has been sustaining his life deep within the Delphi Headquarters situated on a boat in the Pacific Ocean, and has been the main culprit in helping to create the GUILT outbreak. As the leader of Delphi he believes that humans deserve the "blessing" of disease as it is what God's will and it is his quest to rid the world of doctors using GUILT. He claimed that the GUILT virus originally came from his body before being modified by Delphi's scientists and then released into the world. However, the details of the origin of the GUILT and "Bliss" viruses and how he came to be in his current disease-ridden state, and how he can seem to communicate through the voice of others are not described within the game.

Professor Blackwell (Age Unknown) - The father of Angie who left his family when Angie was only 8 years old. After discovering that Delphi wanted to use his own daughter in their GUILT experiments, he made a deal to join them and in return they let his daughter stay with his family.

Reception

 * In the January 2006 issue of Nintendo Power, Steven Grimm placed Trauma Center and its 9.0 score in the magazine’s review archive, describing the game as “fiendishly addictive”.
 * IGN gave Trauma Center an "impressive" 8.0
 * Official Nintendo Magazine gave Trauma Center 80%.
 * GameSpot gave Trauma Center a 7.8 out of 10, saying that it "succeeds because it strikes such a good balance between its medical theme and its puzzler roots."
 * Trauma Center has an average review ratio of 80% on Game Rankings.
 * Metacritic currently ranks Trauma Center at 81%.
 * X-Play reviewed this game and its remake and gave them both 4/5.

Music
Shoji Meguro is responsible for the game music. Despite lack of information toward any soundtracks release, there are two music tracks offered in the official site.