READ.ME: Traumatic Experiences


A few weeks back, we discussed console gaming, and how here in the West we didn’t see that many visual novels on non-PC platforms. To say that we don’t see any at all is inaccurate, however, as there are a number of notable (and often well-received examples). More often than not, though, these games tend to combine the visual novel medium’s characteristic style of mostly “hands-off” storytelling with some other form of gameplay, and it’s the addition of this extra component that tends to make these titles somewhat more palatable to the masses.

Recent examples we’ve discussed in this very column include Hyperdimension Neptunia, which combines visual novel-style storytelling with JRPG-style dungeon crawling and combat; the Ace Attorney series, which combines elements of point-and-click adventure game puzzling with the visual novel medium’s characteristic means of presenting a narrative; and Aselia the Eternal, which includes a deep and complex strategy game alongside its lengthy tale. (The latter never saw a console release outside of Japan, but its use of gameplay to support rather than contrast with its narrative sequences means it is worthy of mention regardless.)

Trauma Center: Second Opinion

Trauma Center: Second Opinion

Today I’d like to talk about Atlus’ Trauma Center series, which provides an excellent example of how to balance non-interactive storytelling with letting the player actually do stuff. I’d particularly like to pay attention to the most recent entry in the series – Trauma Team for the Wii — because I’ve been playing it a lot recently and think it does a lot of things that are eminently worthy of discussion.

The Trauma Center series, lest you’re unfamiliar, alternates between visual novel-style storytelling sequences and fast-paced, frantic surgery sequences in which the player’s skill and dexterity is challenged to an almost inhuman degree. These are hard games, but immensely rewarding for the tales they tell. Initially appearing to be relatively conventional medical procedural dramas, the first few games in the series (Under the Knife for Nintendo DS, its remake Second Opinion for Wii and the Wii-based follow-up New Blood) tend to go off-piste into somewhat “sci-fi” territory by partway through, with the game’s characters challenging a different “headline disease” in each game, often with at least one break for some sort of unconventional use of surgical implements such as bomb disposal.

Trauma Team

Trauma Team

Trauma Team, meanwhile, breaks with a number of conventions of the series. Rather than adopting the first few games’ standard visual novel “character bust and text box” aesthetic, Trauma Team instead presents its story sequences more like motion comics, but is still a visual novel at heart — this is a game with a story to tell first and foremost. Alongside this change in presentation is a change in focus — rather than taking on the role of a single protagonist over the course of the whole game (or most of it, anyway — Second Opinion occasionally switched protagonists, and New Blood allowed you to choose which of the two protagonists you were playing as before each operation), you instead play six different characters, each of whom have their own specialism. The mysterious prisoner CR-S01 is a surgeon, so his surgery sequences most closely resemble the previous games. The spunky and hot-tempered Maria is a first-response medic who usually has to treat several patients at the same time. Dr Hank Freebird is an orthopedic surgeon who works with bones and joints while moonlighting as the superhero “Eagle Man” — not at the same time, obviously. Dr Gabriel Cunningham is a grumpy diagnostician who is going through a tough time in his personal life and at times wonders why he’s still doing what he’s doing. Dr Tomoe Tachibana is an endoscopy specialist and also comes from a long line of ninjas. And Dr Naomi Kimishima, who was a supporting character in Second Opinion, is a forensics specialist.

Besides each of these six characters having their own specialisms in terms of gameplay, their individual narrative threads each have their own themes, too. CR-S01′s narrative is to do with regretting past actions and finding a reason to live; Maria’s is to do with learning how to accept help from others rather than relying solely on herself; Hank’s is to do with life being precious; Gabe gradually rediscovers his passion for what he does; Tomoe’s explores the “path of honor” and how the things you want to do don’t always coincide with the things you should do; and Naomi focuses on finding truth and justice, no matter what the cost.

The interesting thing about Trauma Team is the way these narratives are presented. When you start the game, you can pick from any of the six available characters and play their set of episodes as a standalone story. Alternatively, you can jump back and forth between them at will. An on-screen timeline in the game’s main menu shows the rough chronology of when the various characters’ episodes unfold relative to one another, and if you play them in a certain order you’ll quickly notice that there is a coherent narrative going on. Even Naomi’s forensic investigation episodes, which initially seem to be complete self-contained mini-adventures that are totally separate from the doctors’ storylines, gradually start to show a few common themes, characters and concepts with her compatriots.

Trauma Team

Trauma Team

Then, once you’ve finished what appears to be each of the six doctors’ individual narrative arcs, the game’s “true” storyline begins. Here, you’re presented with a linear sequence of missions rather than jumping back and forth between characters, and a few little hints that have been dropped over the course of the earlier episodes begin to get some explanations. The intensity and the seriousness of the story continually ratchets up until… well, you’ll have to find out for yourself. It’s a really nice example of pacing — the first part of the game is used to let you get to know all of the individual characters very well on an individual basis, then the latter portion of the game brings them all together so you can see how they interact with one another and cooperate for the greater good. This is actually the inverse of a typical visual novel’s structure — it’s much more common for a visual novel to start with all the characters together and then branch off in one of several different character-centric “paths” before the end.

Alongside the interesting narrative techniques the game uses, the actual gameplay side of things has a significant degree of importance, too — but not in the way you might be thinking. No, despite being presented using stylized, abstract visuals rather than a more realistic aesthetic, the parts where you’re performing surgery on various patients have a function besides just giving the player something to do: they provide hooks for emotional engagement. Because many of the missions are frantic races against time and the patient’s plummeting vitals, Trauma Team regularly succeeds in instilling a genuine sense of panic and anxiety in the player, which keeps the heart racing and the adrenaline pumping. The game’s narrative is a series of emotional peaks and troughs, with what may initially appear to be a relatively calm story scene gradually building in intensity to the point where the player is in full-on “fight or flight” mode by the time they have to pick up their tools and begin the operation.

Trauma Team

Trauma Team

The sense of release after succeeding in a particularly difficult operation is intoxicating, but so too is the feeling of tension during the operation itself. On a number of occasions, particularly when it comes to Hank’s orthopedics episodes, surgery sequences are clearly designed to be slightly too long to be comfortable, leading to actual genuine physical discomfort and a feeling of exhaustion if you remain tense throughout. I can’t help feeling that this is entirely deliberate — regardless of whether or not it is, it is immensely effective in engaging you and making you feel involved in the unfolding plot.

Trauma Team may not be the most conventional visual novel you’ll ever play, and the challenging nature of the gameplay sequences may stymie your progress more than once, but as an emotionally (and physically!) engaging interactive story in which you play not one but six important roles, it’s most definitely worth your time and attention.


READ.ME is Games Are Evil’s weekly delve into the world of visual novels, a genre of interactive entertainment primarily developed in Japan which has carved out a small but dedicated niche in the West.


  1. llirium /

    I agree, Trauma Team is likely to be an 'alternative' game because it gives FAR less instant gratification. But this tendency to want a quick pay-off doesn't seem fair to the amount of effort put into this game.

    Trauma Team really wants you to feel like you have some kind of relationship with it, not just to slice, laser and puzzle your way out of things. Heck, involving yourself in the actual dialogue is a part of the puzzle in the Diagnostic and Forensics path/sections.

    The only fault I see with Atlus is that they sometimes rely too hard on people *wanting* a relationship with their story or characters so badly that it can put a casual gamer off. Fortunately, I can't seem to get enough of it. ^_^

    • Yeah. I think they're catering to a niche who happily lap up that sort of relationship-heavy stuff. I know I'm certainly part of that niche (and proud, dammit!), and it's a big part of why I like Atlus titles so much in general, not just the Trauma Center series.

      I really hope we see more of this Team in the future!

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