When I first heard of the game Trauma Center: Under the Knife, I was curious to its true nature. Previously 'Doctor' games like ER were on the market, which were just not entertaining. Another doctor game that has been out on the market for years has been Doctor Mario, but even then the game had its limits. In a way, it is an advanced version of Operation, an old board game, where you used tweezers to perform surgery. While I had not heard many things about TC, it sounded like a great and innovative game. For those whom still have no idea, this is a game where you perform surgery on patients in a virtual world. While that sounds rather limiting, they put this together with so many combinations of injuries that it proves to be quite entertaining.

No one ever said that being a doctor would be an easy job, and that is exactly what I like. In a game, I love challenge and change, and this is chalk full of it. You are graded on every single move that you make, so pointing that laser on a wound could cost you greatly. You have ten tools to help you reach your goal, some of them being a laser, antibiotic gel, forceps, scalpel, and stitches. Eventually you discover a skill that will greatly compliment all of them, and that is the “Healing Touch”. All of these tools are triggered by using the stylus, and it is much more accurate than a mouse could ever be. This gives you the feel like you are actually operating on people, and the controls are extraordinarily respondent.

The games starts off at Hope Hospital, located in the city of Angeles Bay. Since its inception, Hope Hospital has continuously serviced 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. This doctor will soon realize his full potential. You play as Dr. Derek Stiles, a doctor whom has just completed his residency, and have accepted a position in the hospital.

Dr. Greg Kasel -- the head of the surgical department -- guides you through the first section, showing you the ropes of performing surgery. Hardened by countless operations, he has become strict, and expects perfection from others that he performs on his own patients. Thankfully in this game it will be hard to perform perfection, as it would be in real life. This is something I love and hate in this game, as there is no tutorial about what you have done wrong, which leaves you guessing on how to improve.

Now having only recently made the transition, Dr. Derek Stiles still feels like an intern at heart, and in the beginning is not taking his job terribly seriously. This attitude goes as far as putting a patient's life in danger. During an operation a new nurse tells you that you should continue to look around inside the body a bit longer, the young doctor declares the operation successful, and as such there is no need to. He leaves the hospital to go to another appointment saying that if need be, he will give them a check up tomorrow.

The nurse ends up being right as the patient's condition deteriorates, so much so that they almost end up dying because of it. Thankfully you return to save the day, and your own behind. Luckily there was no malpractice suit system in this game, so the game can continue on its long journey. This early piece of storyline sows the seeds for you getting your ultimate tool, the "Healing Touch". This ability allows you to slow down time, allowing you to complete the most difficult operations with the time you need. This is when the real game begins.

At the beginning of every operation, you have a nurse prep you on the problems. These issues may range from accidents, from a motor vehicle, to dealing with cancer patients, and removing their tumours. One moment you may be removing glass shards from a heart, and the next you could end up sucking the juices out of a boil. As gross as it sounds, it feels great doing so. Then the levels progress, and you deal with several of these problems at a time.

Visually the game has its plusses. Outside of surgery you will have cells/sprites of people, so it is rather manga like, or quite like playing a Super Nintendo. Inside of surgery, it ends up being quite bloody and graphic. The shards of glass, the pus filled wounds, and the deep lacerations could cause a weak stomach to have trouble dealing with this game. In addition to this, the game's difficulty spikes constantly, which will keep you on your toes and ready for more challenges. This could be too difficult for some people to retain their enjoyment, but if you press through you will feel overwhelmed with success when it arrives after the long struggle.

The game attempts to have an anti-suicide portion, as in the second chapter you must operate on a woman whom has tried to end her own life. After the operation ends, you and the nurse -- Angie -- talk to the woman. The woman admits to trying to kill herself, and Angie ends up saying, "Maybe you should die, as there are patients here who have to fight just to breath properly. Every day, someone dies after a long and futile struggle to live." Finishing it up with "I'm sorry we saved you. Go end your life, for all I care."

In the end the doctor sits the woman down, and explains to her that there are people in this world that care about her, like her mother and friends at school. He asks her if she could ever look into their eyes, and tell them that she wanted to die. She says "No", so he gives her a mirror, and tells her to tell that to herself. She then breaks down, cries, and thanks the doctor for showing her the light. This game is filled with these types of stories, and it is a treat to go through them.