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{{Short description|2005 video game}}
{{Infobox VG
{{Good article}}
|title = Trauma Center: Under the Knife
{{Infobox video game
|image = [[Image:Traumacenterbox.jpg|250px|]]
| title = Trauma Center: Under the Knife
|developer = [[Atlus]]
| image = Traumacenterbox.jpg
|publisher = [[Atlus]]
| alt = A group of doctors in surgical gear posed against a dark blue background.
|designer = [[Kazuya Niinou]]
| developer = [[Atlus]]
|engine =
|released = {{vgrelease|JP=[[June 30]], [[2005]]|NA=[[October 4]], [[2005]]|PAL=[[April 28]], [[2006]]}}
| publisher = {{vgrelease|JP|Atlus|NA|[[Atlus USA]]|EU|[[Nintendo]]}}
| director = Kazuya Niinou
|genre = [[Simulation game|Medical simulation]], [[visual novel]]
|modes = [[Single-player]]
| producer = [[Katsura Hashino]]
| designer = Makoto Kitano
|ratings = {{vgratings|CERO=B|ESRB=T|OFLCA=PG|PEGI=12+}}
| writer = Shogo Isogai<br />[[Katsura Hashino]]
|platforms = [[Nintendo DS]]
| artist = Maguro Ikehata
|media =
| programmer = Nobuyoshi Miwa
|requirements =
| composer = Kenichi Tsuchiya<br>[[Shoji Meguro]]<br>Kenichi Kikkawa
|input = [[Stylus]]
| series = ''[[Trauma Center (video game series)|Trauma Center]]''
| released = {{vgrelease|JP|June 16, 2005|NA|October 4, 2005|EU|April 28, 2006}}
| genre = [[Simulation video game|Simulation]], [[visual novel]]
| modes = [[Single-player]]
| platforms = [[Nintendo DS]]
}}
}}
'''''Trauma Center: Under the Knife''''', known in [[Japan]] as {{nihongo title|Chōshittō Caduceus|超執刀 カドゥケウス|Chōshittō Kadukeusu|lit. ''Super Surgical Operation: Caduceus''}}, is a [[surgery|surgical]] simulation game developed for the [[Nintendo DS]] and the first in the ''Trauma Center'' series. The game was remade for the [[Wii]], titled ''[[Trauma Center: Second Opinion]]'', and has spawned a sequel, ''[[Trauma Center: Under the Knife 2]]''.


'''''Trauma Center: Under the Knife'''''{{efn|Known in Japan as {{nihongo|'''''Chōshittō Kadukeusu'''''|超執刀 カドゥケウス||lit. ''Super Surgical Operation: Caduceus''}}}} is a [[Simulation video game|simulation]] video game developed by [[Atlus]] for the [[Nintendo DS]]. The debut entry in the ''[[Trauma Center (video game series)|Trauma Center]]'' series, it was published in Japan and North America by Atlus in 2005, and by [[Nintendo]] in Europe in 2006. Set in a near future where medical science can cure previously incurable diseases, the world's population panics when a new manmade disease called GUILT begins to spread. Doctor Derek Stiles, a surgeon possessing a mystical "Healing Touch", works with the medical research organization Caduceus to find a cure to GUILT. The gameplay combines surgery-based simulation relying on the DS's touchscreen controls with a story told as a [[visual novel]].
==Plot==


Designed to take advantage of the DS's control options after planned development for earlier consoles stalled due to inadequate hardware, development lasted just over a year. Its early inspirations included Western television series ''[[ER (TV series)|ER]]'' and ''[[Chicago Hope]]'', with [[science fiction]] elements incorporated during a later stage. Development proved challenging for the staff, who were veterans of the ''[[Megami Tensei]]'' franchise and had little experience with genres outside [[role-playing video game|role-playing]].
The story is set in the year 2018, where diseases that were previously thought to be incurable are nearly things of the past.


The game was positively reviewed by journalists, who praised the title for its use of the DS controls while criticising its difficulty spikes and repetition. While a commercial disappointment in Japan, it sold beyond expectations in both North America and Europe, boosting Atlus' profits for that year. A remake for the [[Wii]], ''[[Trauma Center: Second Opinion]]'', released the following year. A DS sequel, ''[[Trauma Center: Under the Knife 2|Under the Knife 2]]'', was released in 2008.
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 (eventually known as Kyriaki), 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 heals a young girl who has the second known strain of GUILT (Deftera). 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 (Triti) in a young boy.

Back in America, Derek encounters the next strain of GUILT (Tetarti), 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 (Pempti) that seems to be resistant everything that is thrown at it. Eventually, Victor Niguel, Caduceus USA's head researcher, 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 surgeons. Then, one night, a man breaks into Caduceus USA and ends up infecting Cybil with the sixth strain of GUILT (Paraskevi), though Derek manages to remove the parasite from Cybil's body. The man who broke in turned out to be Kenneth Blackwell, the father of Derek's assistant Angie, and they manage to trail him back to a research lab. There, they encounter the final strain of GUILT (Savato), 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. They operate on all 7 strains and rid the world of GUILT. With the threat of GUILT eliminated, Derek becomes well known as the man who saved the world.


==Gameplay==
==Gameplay==
[[File:Trauma Center screenshot.jpg|thumb|left|250px|A GUILT operation in ''Trauma Center''|alt=The display is split between two screens. The upper screen shows gameplay displays and the assistant character commenting on the operation. The lower screen shows the operation in question.]]
''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.
''Trauma Center: Under the Knife'' is a video game that combines surgical [[Simulation video game|simulation]] gameplay with storytelling using non-interactive [[visual novel]] segments using static scenes, character portraits, text boxes, and voice clips during gameplay segments.<ref name="TraumaRetro">{{cite web|url=https://www.usgamer.net/articles/its-time-we-had-a-new-trauma-center|title=It's Time We Had a New Trauma Center|author=Davison, Peter|website=[[Eurogamer|USGamer]]|date=2013-08-07|access-date=2018-11-05|archive-url=https://web.archive.org/web/20160217143140/https://www.usgamer.net/articles/its-time-we-had-a-new-trauma-center|archive-date=2016-02-17|url-status=live}}</ref><ref name="EuroReview"/><ref>{{cite web|url=https://atlus.com/atlus-titles/tcutk/|title=Trauma Center: Under the Knife|website=[[Atlus]]|access-date=2021-01-23|archive-url=https://web.archive.org/web/20201130194613/https://atlus.com/atlus-titles/tcutk/#upcp-user-tab-panel-2|archive-date=2020-11-30|url-status=live}}</ref> The top screen of the [[Nintendo DS]] is dedicated to story sequences and level statistics displayed as 2D artwork, while the bottom touch screen is dedicated to the operations themselves rendered using 3D models.<ref name="EuroReview"/><ref name="GSreview"/> Players take on the role of protagonist Derek Stiles, a young surgeon with a mystical ability called the Healing Touch. Each operation tasks players with curing the patient of one or multiple ailments within a time limit.<ref name="GSreview"/><ref name="IGNreview"/>


Operations take place from a first-person view over the affected area.<ref name="TraumaColumn"/> The ten available surgical tools are required for different operations and injuries, selected using icons along the edges of the touch screen.<ref name="GSreview"/><ref name="ONMreview"/> Each operation is prefaced by a briefing, describing the patient's condition and possible treatments. Depending on the operation, players may need to drain blood pools obstructing the operating area, use a surgical laser to treat small tumors or virus clusters, a scalpel to open incisions or excise larger tumors, a scanner for detecting hidden ailments, forceps to close wounds and introduce or extract objects, a syringe to inject a variety of medications, and sutures to sew up both wounds and incisions. The player must frequently apply antibiotic gel to treat minor injuries and prevent infection. The player may also require the "hand" option for situations such as a heart massage or placing objects such as synthetic membranes. During one operation, several of these tools will be needed. Each operation ends with the sutured wound being treated and a bandage being applied.<ref name="Trauma1Gameplay">{{cite web|url=https://www.atlus.com/tcutk/system.html|title=Trauma Center: Under the Knife - System|website=[[Atlus]]|access-date=2018-12-01|archive-url=https://web.archive.org/web/20071206221928/https://www.atlus.com/tcutk/system.html|archive-date=2007-12-06|url-status=dead}}</ref> All of these actions are accomplished using the DS stylus.<ref name="GSreview"/>
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.


Operations range from treating surface wounds and extraction operations, to special operations where Stiles must confront strains of a man-made parasitic infection dubbed GUILT. These strains can be highly mobile, complicating the operation.<ref name="GSreview"/> Some operations are affected by environmental hazards, such as turbulence on a plane.<ref name="ONMreview"/> A key story-based ability is Stiles's Healing Touch, triggered by drawing a five-pointed star on the touch screen. The Healing Touch slows down time for a limited period, allowing the player to perform operation actions without the patient dying.<ref name="EuroReview"/><ref name="IGNreview"/> Points are awarded with how fast and efficiently an action is performed, and graded from "Bad" to "Cool".<ref name="IGNreview"/> After each operation, the player is graded on their performances, with rankings going from "C" (the lowest) to "S" (the highest).<ref name="IGNreview"/><ref name="ONMreview"/> After an operation is completed in the story mode, players can attempt it again in the Challenge mode for a higher score.<ref name="IGNreview"/> The player can save their game after each story chapter.<ref name="ONMreview"/><ref name="Trauma1Gameplay"/> If the patient dies or the timer runs out, the game ends and the player must restart from their last save.<ref name="Trauma1Gameplay"/>
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, another surgeon will take over the operation, which will always seem to fail.


==Synopsis==
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
''Trauma Center'' is set in a near future Earth of 2018, where medical science has advanced to the point that previously major diseases such as AIDS and cancer are easily cured. The world's pioneering medical foundation is Caduceus, a multinational, semi-covert organization dedicated to researching and curing intractable diseases.<ref>{{cite web|title=Behind the Scalpel - The Story of Trauma Center|website=[[Atlus]]|access-date=2011-09-06|url=http://www.atlus.com/tcutk/story.html|archive-url=https://web.archive.org/web/20071119124930/http://www.atlus.com/tcutk/story.html|archive-date=2007-11-19|url-status=live}}</ref> The story follows Derek Stiles, a young doctor who discovers his mystical Healing Touch during a difficult operation on an emergency patient from a car crash. After treating another patient infected with an unknown parasitic disease, Stiles is offered a position at Caduceus, which he accepts. The parasite is known as the Ganglia Utrophin Immuno Latency Toxin (GUILT for short), a manmade disease being distributed by the medical terrorist cell, Delphi. Along with his companion and assistant, nurse Angela "Angie" Thompson, Stiles begins confronting new strains of GUILT in different patients, along with surviving attempts on his life by Delphi. During their work, several Caduceus staff members are infected, including the director, Richard Anderson. While the strain is eventually removed, Anderson ultimately succumbs to the stress on his body from multiple operations and gives his position to Stiles's former superior, Robert Hoffman.
graded:


During an attempted raid by Delphi on Caduceus, the intruder is identified as Angie's father Kenneth Blackwell. Trailing him to a Delphi laboratory, Stiles and Angie successfully treat a highly-virulent GUILT strain, first in a nascent form in a test subject, and then in Blackwell himself. Once cured, Blackwell offers his full cooperation 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 the location of Delphi's headquarters, which consisted of an ocean vessel. When Stiles and Angie assist with a raid in cooperation with Caduceus Europe, they find that Delphi has been using children to incubate GUILT, and after curing the patients, they encounter Delphi's leader, Adam, now a vegetable host for all seven strains of GUILT, as well as a unique, eighth strain known as "Bliss." Caduceus Europe impound Adam's remains, and Stiles is hailed for his actions.
Rank S- Master Surgeon


==Development==
Rank A- Senior Surgeon
The original plan for ''Trauma Center'' was created by the game's producer [[Katsura Hashino]]. During this early stage, many staff compared the game to similar surgery simulations for Windows.<ref name="TraumaColumn">{{cite web|url=http://www.atlus.co.jp/cs/game/ds/kad/column/column001.html|script-title=ja: :::超執刀 カドゥケウス:::|language=ja|website=[[Atlus]]|access-date=2018-12-01|archive-url=https://web.archive.org/web/20060824062232/http://www.atlus.co.jp/cs/game/ds/kad/column/column001.html|archive-date=2006-08-24|url-status=dead}}</ref> The concept behind ''Trauma Center'' originated several years before development started. While Atlus had explored the possibilities of a surgical simulation game, gaming hardware at the time was not able to realize their vision. This changed with internal previewing of the DS, which had the controls and functions to make the simulation elements work as intended. Planning for the game began in the summer of 2004.<ref name="InsideTrauma">{{cite web|url=http://nintendo-inside.jp/special/caduceus/interview.html|script-title=ja:Nintendo Inside Special - 超執刀 カドゥケウス|language=ja|website=Nintendo Inside|date=2005-04-16|access-date=2018-12-01|archive-url=https://web.archive.org/web/20060708212635/http://nintendo-inside.jp/special/caduceus/interview.html|archive-date=2006-07-08|url-status=dead}} {{usurped|1=[https://web.archive.org/web/20190215011756/http://www.atlusatlas.com/post/149697071673/trauma-center-under-the-knife-director-kazuya Translation]}}</ref> Most of the staff were veterans of Atlus's ''[[Megami Tensei]]'' [[role-playing video game]] (RPG) franchise, making the development a difficult one due to its thematic and gameplay differences. Production proved a challenge due to the new gaming hardware and its deviation from the RPG mechanics Atlus was known for. One of the more difficult elements was getting the gameplay to function, which they finally achieved after settling on a first-person perspective for surgery.<ref name="TraumaColumn"/>


According to director Kazuya Niinou, the team drew inspiration from Western television series including ''[[ER (TV series)|ER]]'' and ''[[Chicago Hope]]'', and unspecified Japanese television series and comics during their early work.<ref name="InsideTrauma"/> The scenario was written by Shogo Isogai, who faced problems when creating a narrative that would be respectful towards the medical profession while being fun, and confront very different themes to his work on the ''Megami Tensei'' series. While keeping in line with creating a medical drama, Isogai was told to add [[science fiction]] elements, which was a relief for him as he did not need to be accurate to a field he knew little about. The team needed to think carefully about the naming of GUILT strains, which were all derived from Greek words, which sharply contrasted their free borrowing of demon names for the ''Megami Tensei'' series. They also strove to push away from the common video game motif of seemingly glorifying death.<ref name="TraumaColumn"/> The characters were designed by Maguro Ikehata.<ref>{{cite video game|title=Trauma Center: Under the Knife|developer=[[Atlus]]|publisher=[[Atlus USA]]|date=2005-10-04|platform=[[Nintendo DS]]|scene=Credits}}</ref><ref>{{cite web|url=http://www.atlus.co.jp/cs/game/ds/kad/4koma/4koma001.html|script-title=ja: :::超執刀 カドゥケウス::: 4コマ漫画 - 「貫禄」作・画 池端 まぐろ|language=ja|website=[[Atlus]]|date=2005|access-date=2018-12-01|archive-url=https://web.archive.org/web/20070224210958/http://www.atlus.co.jp/cs/game/ds/kad/4koma/4koma001.html|archive-date=2007-02-24|url-status=dead}}</ref> The art style was described as "very anime-styled".<ref name="SlicedInterview"/> The operation graphics were originally very stylised, but Hashino disapproved. While they decided against being too realistic, they managed to strike an aesthetic balance between realistic and cartoon graphics.<ref name="TraumaColumn"/>
Rank B- Specialist


The music was composed by Kenichi Tsuchiya, [[Shoji Meguro]] and Kenichi Kikkawa. Meguro and Tsuchiya were both veterans of the ''Megami Tensei'' franchise, particularly its ''[[Persona (series)|Persona]]'' and ''[[Shin Megami Tensei: Devil Summoner|Devil Summoner]]'' subseries.<ref name="TraumaOST"/> The opening was one of the themes created by Meguro, who acted as sound director for the project. He found the limited sound environment even more of a challenge than earlier consoles he had composed for. Tsuchiya's work focused on environmental themes and general sound design, while Kikkawa's scores focused on orchestral tracks.<ref name="TraumaColumn"/> While Meguro and Kikkawa composed standard-definition music and reduced it to fit into the DS sound environment, Tsuchiya composed his tracks within the sound environment. At the time, Atlus did not have a [[MIDI]] interface for DS composition, so the composers had to guess what the sound would be like when transplanted into the game.<ref name="TraumaOST">{{cite web|url=http://sweeprecord.com/srin-1088/|script-title=ja:超執刀カドゥケウス サウンドトラック|language=ja|website=Sweep Record|date=22 September 2011 |access-date=2018-11-05|archive-url=https://web.archive.org/web/20170608113254/http://sweeprecord.com/srin-1088/|archive-date=2017-06-08|url-status=live}}</ref>
Rank C- Rookie Doctor


==Release==
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.
The game was first announced in July 2004 alongside five other Atlus titles for the DS.<ref>{{cite web|url=https://www.gamespot.com/articles/atlus-reveals-ds-surgery-game/1100-6104218/|title=Atlus reveals DS surgery game|author=Niizumi, Hirohiko|website=[[GameSpot]]|date=2004-08-05|access-date=2018-12-01|archive-url=https://web.archive.org/web/20181129225813/https://www.gamespot.com/articles/atlus-reveals-ds-surgery-game/1100-6104218/|archive-date=2018-11-29|url-status=live}}</ref> The game was released in Japan on June 16, 2005.<ref>{{cite web|url=http://www.atlusnet.jp/catalog_nw/d1_det_172.html|script-title=ja:[DS] 超執刀 カドゥケウス|language=ja|website=[[Atlus]]|access-date=2018-12-01|archive-url=https://web.archive.org/web/20131024030254/http://www.atlusnet.jp/catalog_nw/d1_det_172.html|archive-date=2013-10-24|url-status=dead}}</ref> A commercial demo was released through Nintendo's online store on May 29.<ref>{{cite web|url=http://dengekionline.com/data/news/2005/5/19/ac92a0800d533247770dbddf2f38c8ac.html|script-title=ja:店頭体験会で『超執刀カドゥケウス』の魅力“タッチパネル手術”に挑戦！|language=ja|website=[[ASCII Media Works|Dengeki Online]]|date=2005-05-19|access-date=2018-12-01|archive-url=https://web.archive.org/web/20181130114924/http://dengekionline.com/data/news/2005/5/19/ac92a0800d533247770dbddf2f38c8ac.html|archive-date=2018-11-30|url-status=live}}</ref> While it lacked the high amount of blood and gore that would have earned it a mature rating, its content still merited a CERO rating of "B", indicating an age range of early teens and up.<ref name="TraumaColumn"/><ref name="InsideTrauma"/> Its release was supported by a guidebook published by [[Enterbrain]] in July of that same year.<ref>{{cite web|url=http://www.enterbrain.co.jp/jp/p_catalog/book/2007/978-4-7577-3392-3.html|script-title=ja:超執刀カドゥケウス 公式ガイドブック|language=ja|website=[[Enterbrain]]|access-date=2020-12-06|archive-url=https://web.archive.org/web/20060627195533/http://enterbrain.co.jp/jp/p_catalog/book/2005/4-7577-2380-6.html|archive-date=2006-06-27|url-status=dead}}</ref> A soundtrack album was released by Sweep Records in October 2011.<ref name="TraumaOST"/>


The game was first revealed under its English name at the 2005 [[Electronic Entertainment Expo]].<ref>{{cite web|url=https://www.ign.com/articles/2005/05/13/pre-e3-2005-atlus-announces-lineup|title=Pre-E3 2005: Atlus Announces Lineup|author=Adams, David|website=[[IGN]]|date=2005-05-13|access-date=2018-12-01|archive-url=https://web.archive.org/web/20121221205403/https://www.ign.com/articles/2005/05/13/pre-e3-2005-atlus-announces-lineup|archive-date=2012-12-21|url-status=live}}</ref> It released in North America on October 4.<ref>{{cite web|url=http://www.ign.com/articles/2005/10/04/trauma-center-opens-its-practice|title=Trauma Center Opens Its Practice|author=Adams, David|website=[[IGN]]|date=2005-10-04|access-date=2019-03-10|archive-url=https://web.archive.org/web/20121227171413/http://www.ign.com/articles/2005/10/04/trauma-center-opens-its-practice|archive-date=2012-12-27|url-status=live}}</ref> The game was localized for the West by [[Atlus USA]].<ref name="SlicedInterview">{{cite web|url=https://www.slicedgaming.com/features.php?action=display&content_id=158|title=Sliced Gaming Feature: Trauma Centre Interview|author=Schaedel, Nick|website=Sliced Gaming|date=2006-09-02|access-date=2018-11-05|archive-url=https://web.archive.org/web/20181104162311/https://www.slicedgaming.com/features.php?action=display&content_id=158|archive-date=2018-11-04|url-status=live}}</ref> For the game's English version, the game's setting was changed from Japan to North America. Derek Stiles's English name was written as a pun on the word "stylus", referencing the DS stylus.<ref>{{cite web|url=http://www.siliconera.com/2006/11/20/nintendo-la-wii-event-chat-with-atlus/|title=Nintendo LA Wii Event: Chat with Atlus|author=Yip, Spencer|website=Siliconera|date=2006-11-20|access-date=2018-11-05|archive-url=https://web.archive.org/web/20091212043136/http://www.siliconera.com/2006/11/20/nintendo-la-wii-event-chat-with-atlus/|archive-date=2009-12-12|url-status=live}}</ref> The English dub was handled by PCP Productions, who had previously worked with Atlus on ''[[Shin Megami Tensei: Digital Devil Saga]]''.<ref>{{cite web|url=https://www.pcb.cc/credit-list|title=PCB - Credits|website=PCB Productions|access-date=2019-07-16|archive-url=https://web.archive.org/web/20190216142300/https://www.pcb.cc/credit-list|archive-date=2019-02-16|url-status=dead}}</ref> Voice acting was restricted to shoutouts during operations, while Stiles himself did not have a voice actor.<ref>{{cite web|url=http://www.ign.com/articles/2006/09/07/interview-trauma-center-second-opinion|title=Interview: Trauma Center: Second Opinion|author=Casamassina, Matt|website=[[IGN]]|date=2006-09-07|access-date=2018-11-05|archive-url=https://web.archive.org/web/20140617145103/http://www.ign.com/articles/2006/09/07/interview-trauma-center-second-opinion|archive-date=2014-06-17|url-status=live}}</ref> Due to their lack of a European branch, Atlus USA did not publish the game in the region. The game was instead published by Nintendo of Europe on April 28, 2006.<ref name="SlicedInterview"/><ref>{{cite web|url=http://www.nintendoworldreport.com/news/10949/noe-to-publish-trauma-center-in-europe|title=NoE To Publish Trauma Center In Europe|author=Graves, Robert|website=Nintendo World Report|date=2005-11-16|access-date=2018-12-01|archive-url=https://web.archive.org/web/20170906165103/http://www.nintendoworldreport.com/news/10949/noe-to-publish-trauma-center-in-europe|archive-date=2017-09-06|url-status=live}}</ref><ref>{{cite web|url=http://www.nintendoworldreport.com/news/11111/trauma-centre-under-the-knife-coming-to-europe-this-april|title=Trauma Centre: Under the Knife Coming to Europe this April|author=Pallesen, Lasse|website=Nintendo World Report|date=2006-02-20|access-date=2018-12-01|archive-url=https://web.archive.org/web/20181130121107/http://www.nintendoworldreport.com/news/11111/trauma-centre-under-the-knife-coming-to-europe-this-april|archive-date=2018-11-30|url-status=live}}</ref>
In addition to normal operations, there are operations known as "X-missions". The X-missions are seven operations, each one containing an ultrahard version of a strain of GUILT. However, the game does not note the player about the X-missions, unlike the other games in the series. As with every game in the series, the X-missions are unlocked after beating the game once, and are found in the challenge mode, with fake records used to fill the time/score/rank slots (such as exactly 30 seconds remaing on the clock). As with every game in the series, the player is not required to complete these operations.


===Instruments===
==Reception==
{{Video game reviews
There are a number of instruments available for [[surgery]].
|MC = 81/100 (45 reviews)<ref>{{cite web|url=https://www.metacritic.com/game/trauma-center-under-the-knife/critic-reviews/?platform=ds|title=Trauma Center: Under the Knife for Nintendo DS|website=[[Metacritic]]|access-date=2009-02-22|archive-url=https://web.archive.org/web/20120419052645/http://www.metacritic.com/game/ds/trauma-center-under-the-knife|archive-date=2012-04-19|url-status=live}}</ref>
|1UP = B<ref name="1UPreview">{{cite web|url=http://www.1up.com/do/reviewPage?cId=3144529&did=1|archive-url=https://web.archive.org/web/20100105125708/http://www.1up.com/do/reviewPage?cId=3144529&did=1|url-status=dead|archive-date=2010-01-05|title=Trauma Center: Under the Knife|author=Nutt, Christian|date=2005-10-10|website=[[1UP.com]]|access-date=2009-02-25}}</ref>
|EuroG = 7/10<ref name="EuroReview">{{cite web|url=http://www.eurogamer.net/articles/r_traumacenter_ds|title=Trauma Center: Under the Knife Review|author=Bramwell, Tom|date=2005-11-01|website=[[Eurogamer]]|access-date=2009-02-25|archive-url=https://web.archive.org/web/20160303173536/http://www.eurogamer.net/articles/r_traumacenter_ds|archive-date=2016-03-03|url-status=live}}</ref>
|Fam = 31/40<ref name="FamReview">{{cite magazine|url=https://www.famitsu.com/cominy/?m=pc&a=page_h_title&title_id=3660|script-title=ja:(DS) 超執刀 カドゥケウス|language=ja|magazine=[[Famitsu]]|access-date=2018-11-05|archive-url=https://web.archive.org/web/20160704081043/https://www.famitsu.com/cominy/?m=pc&a=page_h_title&title_id=3660|archive-date=2016-07-04|url-status=live}}</ref>
|GamePro = {{Rating|4.5|5}}<ref name="GProReview">{{cite magazine|url=http://www.gamepro.com/article/reviews/49062/trauma-center-under-the-knife/|title=Review: Trauma Center: Under the Knife|date=2005-10-12|magazine=[[GamePro]]|access-date=2009-02-25|archive-url=https://web.archive.org/web/20090624081313/http://www.gamepro.com/article/reviews/49062/trauma-center-under-the-knife/|archive-date=2009-06-24}}</ref>
|GSpot = 7.8/10<ref name="GSreview">{{cite web|url=https://www.gamespot.com/reviews/trauma-center-under-the-knife-review/1900-6135233/|title=Trauma Center: Under the Knife Review|author=Navarro, Alex|date=2005-10-06|website=[[GameSpot]]|access-date=2009-02-22|archive-url=https://web.archive.org/web/20070224001826/http://www.gamespot.com/ds/adventure/traumacenter/review.html|archive-date=2007-02-24|url-status=live}}</ref>
|GSpy = {{Rating|4.5|5}}<ref name="GSpyReview">{{cite web|url=http://ds.gamespy.com/nintendo-ds/caduceus/655513p1.html|title=GameSpy: Trauma Center: Under the Knife Review|author=Leeper, Justin|website=[[GameSpy]]|access-date=2009-02-25|archive-url=https://web.archive.org/web/20170114053000/http://ds.gamespy.com/nintendo-ds/caduceus/655513p1.html|archive-date=2017-01-14|url-status=live}}</ref>
|IGN = 8/10<ref name="IGNreview">{{cite web|url=https://www.ign.com/articles/2005/10/08/trauma-center-under-the-knife|title=Trauma Center: Under the Knife Review|author=Harris, Craig|date=2005-10-07|website=[[IGN]]|access-date=2009-02-22|archive-url=https://web.archive.org/web/20070223052656/http://ds.ign.com/articles/657/657045p1.html|archive-date=2007-02-23|url-status=live}}</ref>
|ONM = 80%<ref name="ONMreview">{{cite magazine|url=http://www.officialnintendomagazine.co.uk/article.php?id=2466|title=Review: Trauma Center: Under the Knife|date=2008-01-10|author=East, Tom|magazine=[[Official Nintendo Magazine]]|access-date=2009-02-22|archive-url=https://web.archive.org/web/20090601042950/http://www.officialnintendomagazine.co.uk/article.php?id=2466|archive-date=2009-06-01|url-status=dead}}</ref>
|PALGN = 7/10<ref name="PALGNreview">{{cite web|url=http://palgn.com.au/article.php?id=3930|title=Trauma Center: Under the Knife Review|author=Keller, Matt|website=PALGN|date=2006-04-29|access-date=2018-11-05|archive-url=https://web.archive.org/web/20060901054627/http://palgn.com.au/article.php?id=3930|archive-date=2006-09-01|url-status=dead}}</ref>
}}
In Japan, ''Trauma Center'' did not appear in Japanese gaming magazine ''[[Famitsu]]''{{'}}s top 500 best-selling titles for 2005, indicating sales of less than 15,000 units.<ref>{{cite web|url=http://geimin.net/da/db/2005_ne_fa/|script-title=ja:2005年テレビゲームソフト売り上げTOP500|website=Geimin.net|access-date=2016-04-15|archive-url=https://web.archive.org/web/20160415125007/http://geimin.net/da/db/2005_ne_fa/|archive-date=2016-04-15|url-status=dead}}</ref> In contrast, the North American release was described by Atlus staff as "absolutely fabulous", with sales going "off the charts".<ref>{{cite web|url=http://www.gamasutra.com/view/feature/130949/mapping_the_world_with_atlus_jim_.php|title=Mapping The World With Atlus: Jim Ireton on Atlus' Import Aspirations|last=Anderson|first=John|website=[[Gamasutra]]|date=2006-02-06|access-date=2015-08-20|archive-url=https://web.archive.org/web/20141111034728/http://www.gamasutra.com/view/feature/130949/mapping_the_world_with_atlus_jim_.php|archive-date=2014-11-11|url-status=live}}</ref> The game's popularity prompted Atlus to issue further print runs of the game.<ref>{{cite web|url=https://www.ign.com/articles/2006/06/27/trauma-center-resuscitated|title=Trauma Center Resuscitated|website=[[IGN]]|date=2006-06-27|access-date=2018-11-05|archive-url=https://web.archive.org/web/20121228080718/https://www.ign.com/articles/2006/06/27/trauma-center-resuscitated|archive-date=2012-12-28|url-status=live}}</ref> The game also met with strong sales in Europe.<ref>{{cite web|url=https://www.eurogamer.net/articles/news090806traumacenterwii|title=Trauma Center for Wii launch|author=Gibson, Ellie|website=[[Eurogamer]]|date=2006-08-09|access-date=2018-11-05|archive-url=https://web.archive.org/web/20160714062055/https://www.eurogamer.net/articles/news090806traumacenterwii|archive-date=2016-07-14|url-status=live}}</ref> While Atlus had seen financial losses prior to 2006, the international success of ''Trauma Center'' contributed to the company making a profit.<ref>{{cite web|url=http://www.rpgfan.com/news/2006/1572.html|title=Index Becomes Atlus' New Parent Company|author=Winkler, Chris|website=RPGFan|date=2006-11-27|access-date=2018-11-05|archive-url=https://web.archive.org/web/20070510162152/http://www.rpgfan.com/news/2006/1572.html|archive-date=2007-05-10|url-status=live}}</ref>


''Famitsu'' praised the game's innovative use of the touch screen,<ref name="FamReview"/> while Christian Nutt of ''[[1UP.com]]'' called the game a standout title for the DS due to its polished controls and unconventional premise.<ref name="1UPreview"/> ''[[Eurogamer]]''{{'}}s Tom Bramwell praised the gameplay and{{Specify|date=August 2021}}, although he found faults in the game's presentation and confusing or arbitrary mechanics.<ref name="EuroReview"/> ''[[GamePro]]'' called the game "a cure for what has been a spell of mediocrity on the DS".<ref name="GProReview"/> ''[[GameSpot]]''{{'}}s Alex Navarro praised the game's balancing of narrative and arcade-style gameplay.<ref name="GSreview"/>
*'''[[Laser|Surgical Laser]]''' - Used to cauterize objects that are too small to remove from the body otherwise.
*'''[[Antibiotic|Antibiotic Gel]]''' - Used to disinfect areas and treat small cuts.
*'''[[Drain (surgery)|Drain]]''' - Used to remove excess fluids, such as blood.
*'''[[Forceps]]''' - Used for removal of foreign objects and tumors.
*'''[[Hands]]''' - Used for heart massage if the patient goes into cardiac arrest, and for the Healing Touch.
*'''[[Ultrasound]]''' - Used for finding objects, such as tumors, that are hidden inside organs.
*'''[[Magnifier]]''' - Used for zooming in and out on parts of the body.
*'''[[Scalpel]]''' - Used for making incisions.
*'''[[Sutures]]''' - Used for closing or tightning incisions.
*'''[[Hypodermic needle|Syringe]]''' - Used for administering medications.
*'''[[Surgical tape|Bandage]]''' - Used to [[bandage]] sutured incisions.


Justin Leeper, writing for ''[[GameSpy]]'', felt that ''Trauma Center'' could succeed in appealing to a broader audience than other titles with unconventional gameplay ideas.<ref name="GSpyReview"/> Craig Harris of ''[[IGN]]'' was surprised by how much he enjoyed his time playing.<ref name="IGNreview"/> Tom East of ''[[Official Nintendo Magazine]]'' called ''Trauma Center'' "engaging, fun and highly original",<ref name="ONMreview"/> and Matt Keller of ''PALGN'' generally enjoyed the gameplay experience despite its short length and other issues with the difficulty and graphics.<ref name="PALGNreview"/>
===The Healing Touch===
The Healing Touch is an ability, 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.
Within the Trauma Center series, five of the characters posses this power. Derek Stiles and Markus Vaughn both are able to use their Healing Touches to slow down time by using superhuman concentration. In Second Opinion, Naomi Weazer has the ability to raise the patient's vitals by 10 every time she scores an OK, Good or Cool, as well as Markus Vaughn's partner Valerie Blaylock who is eager to learn the Healing Touch. When she finally does, she is able to stabilize the vitals at the amount they were when the Healing Touch was first activated. The director of Caduceus, Robert Hoffman, is also able to use the Healing Touch, but the exact nature of his powers are unknown; most likely his powers are the same as Derek's and Markus's. The final case featuring use of Healing Touch is in Trauma Center: Under the Knife 2 when Mr. Mercer finds a way to imitate the Touch from Derek's video footages, and teaches it to his employees from the Hands of Asclepius, including Derek's student Adel Tulba.


The use of the DS touch screen and stylus were generally lauded by critics;<ref name="EuroReview"/><ref name="GSreview"/><ref name="IGNreview"/><ref name="ONMreview"/><ref name="GSpyReview"/> East called it a concept only made possible by the hardware,<ref name="ONMreview"/> while Leeper had issues with stylus motions registering.<ref name="GSpyReview"/> The story was generally praised, with many calling it both silly and engaging,<ref name="EuroReview"/><ref name="GSreview"/><ref name="IGNreview"/><ref name="ONMreview"/><ref name="GProReview"/> and a few noting its handling of mature themes.<ref name="EuroReview"/><ref name="1UPreview"/> Others also negatively noted the large amount of text, which slowed the game's pace.<ref name="EuroReview"/><ref name="ONMreview"/> Difficulty spikes in later portions of the game, lack of room for improvisation, and general repetitiveness were noted by reviewers as detrimental factors.<ref name="EuroReview"/><ref name="GSreview"/><ref name="IGNreview"/><ref name="ONMreview"/><ref name="1UPreview"/><ref name="FamReview"/><ref name="PALGNreview"/>
===GUILT===
Gangliated Utrophin Immuno Latency Toxin is a group of deadly man-made parasites that start to infect patients later in the game. There are seven [[Strain (biology)|strains]] that the player encounters throughout the course of the game, each one representing a Greek day of the week:


==Legacy==
Kyriaki (Sunday) "Invisible Blades"- A parasite that causes lacerations to the organs. Comes in mature and immature types.
{{See also|Trauma Center: Second Opinion}}


During their 2005 gaming awards, ''GameSpot'' nominated ''Trauma Center'' in their "Most Innovative Game" category.<ref>{{cite web|url=https://www.gamespot.com/articles/gamespots-best-and-worst-of-2005-awards-kick-off/1100-6141367/|title=GameSpot's Best and Worst of 2005 awards kick off|website=[[GameSpot]]|date=2005-12-16|access-date=2018-12-01|archive-url=https://web.archive.org/web/20140305060000/https://www.gamespot.com/articles/gamespots-best-and-worst-of-2005-awards-kick-off/1100-6141367/|archive-date=2014-03-05|url-status=live}}</ref> In the years following its release, ''Trauma Center'' would become a notable success for Atlus, breaking into mainstream gaming when they had previously been restricted to niche success. In a feature by Jess Ragan for ''1UP.com'', ''Trauma Center: Under the Knife'' was described as having "helped pull the Nintendo DS out of a debilitating software drought and demonstrated the system's potential to both hardcore gamers and skeptical outsiders alike".<ref>{{cite web|url=http://www.1up.com/do/feature?pager.offset=4&cId=3163291|title=Filling a Niche: Bold Video Games that Bucked the Mainstream|author=Ragan, Jess|website=[[1UP.com]]|date=2007-10-10|access-date=2018-12-01|archive-url=https://web.archive.org/web/20160614223224/http://www.1up.com/do/feature?pager.offset=4&cId=3163291|archive-date=2016-06-14|url-status=dead}}</ref> Website ''[[VentureBeat]]'' listed ''Under the Knife'' as one of the most memorable games of 2005 due to breaking away from gaming trends and creating an experience focused on saving lives.<ref>{{cite news|url=https://venturebeat.com/2015/07/28/10-years-later-gamesbeats-most-memorable-games-of-2005/view-all/|title=10 years later: GamesBeat's most memorable games of 2005|author=Kleckner, Stephen|website=[[VentureBeat]]|date=2015-07-28|access-date=2018-12-01|archive-url=https://web.archive.org/web/20181201122121/https://venturebeat.com/2015/07/28/10-years-later-gamesbeats-most-memorable-games-of-2005/view-all/|archive-date=2018-12-01|url-status=live}}</ref>
Deftera (Monday) "Creeping Tumors"- A "mobile" tumor that always attacks in pairs and often attacks two different parts of the body.


Following the release of ''Under the Knife'', most of Hashino's team shifted to work on the ''[[Persona (series)|Persona]]'' series, with a small number of staff being assigned to form a new team for further development of the series.<ref>{{cite web|url=https://www.gamasutra.com/view/news/116413/Exclusive_Behind_The_Scenes_Of_Atlus_Persona_4.php|title=Exclusive: Behind The Scenes Of Atlus' Persona 4|website=[[Gamasutra]]|date=2009-10-06|access-date=2018-12-06|archive-url=https://web.archive.org/web/20180221171415/https://www.gamasutra.com/view/news/116413/Exclusive_Behind_The_Scenes_Of_Atlus_Persona_4.php|archive-date=2018-02-21|url-status=live}}</ref> This group would be known internally as "CadukeTeam".<ref>{{cite web|url=http://www.atlusnet.jp/topic/detail/227|script-title=ja:ディレクター金田のカドゥケウス日誌 Vol.01|language=ja|author=Kanada, Daisuke|website=[[Atlus]]|date=2007-10-01|access-date=2018-11-05|archive-url=https://web.archive.org/web/20170322184928/http://www.atlusnet.jp/topic/detail/227|archive-date=2017-03-22|url-status=dead}}</ref> The ''Trauma Center'' series would be continued with three subsequent games on Nintendo hardware; ''[[Trauma Center: New Blood]]'' for the [[Wii]] in 2007, the direct sequel ''[[Trauma Center: Under the Knife 2]]'', released in 2008 for the DS; and ''[[Trauma Team]]'' for the Wii in 2010.<ref name="TraumaRetro"/> A remake of ''Under the Knife'', ''[[Trauma Center: Second Opinion]]'', was released for the Wii in 2006 as a launch title for the console.<ref name="TraumaRetro"/><ref>{{cite web|url=http://www.siliconera.com/2006/05/10/surprise-titles-coming-from-atlus/|title=Surprise titles coming from Atlus|author=Yip, Spencer|website=Siliconera|date=2006-05-10|access-date=2018-11-05|archive-url=https://web.archive.org/web/20100219231811/http://www.siliconera.com/2006/05/10/surprise-titles-coming-from-atlus/|archive-date=2010-02-19|url-status=live}}</ref> In a series retrospective, Peter Davison of ''[[Eurogamer|USGamer]]'' noted both the series' notable position in Atlus's gaming library, and how the titles made use of the Nintendo console mechanics.<ref name="TraumaRetro"/>
Triti (Tuesday) "Contagious Nightmare"- A mass membrane with thorns at each corner that slowly petrifies the organs. As the pieces of the membrane are removed, it will spread according to the placement of the thorns.


== Notes ==
Tetarti (Wednesday) "Synchronized Poison"- Parasites that comes in three types. Creates poisonous abscesses.
=== Citations ===
{{Reflist|30em}}


=== Explanatory notes ===
Pempti (Thursday) "Armored Bacteria"- A virus that creates a gelatinous fluid in the lungs or liver. When threatened, it defends itself by spawning multiple smaller bodies to cause lacerations and minor tumors throughout the lungs and liver.
{{Notelist}}

Paraskevi (Friday) "Arrow to the Heart"- A fibrous centipede-like parasite that makes lacerations as it is cut to be extracted. Generally is found first in the intestines while maneuvering through the other organs on a mission to invade the heart, whereupon it will kill the victim almost instantly.

Savato (Saturday) "Faceoff with Death"- A parasite that wraps a web around the heart and drains its energy as a form of sustenance. Causes damage to the heart through lacerations, some of which spawn smaller Savato bodies that attempt to feast on the heart.

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

Angela "Angie" Thompson (age 21) - A young nurse that works as Derek's assistant. She is part [[Germans|German]] and was raised by a very well-educated family.

===Hope Hospital staff===
Mary Fulton (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 (age 35) - The senior surgeon at Hope Hospital.

Robert Hoffman (age 62) - Dr. Hoffman was an exceptional surgeon who stopped practicing in his 40s. He's now the director of Hope Hospital.

===Caduceus USA staff===
* This is known as Caduceus Japan in the Japanese version and in [[Trauma Center: New Blood]].
Sidney Kasal (Age 35) - Greg's younger brother and director of Caduceus USA, who dedicated his life to the study of [[Medicine#Clinical disciplines|clinical medicine]] after his wife died of illness.

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

Cybil Myers (Age 34) - The leading [[anesthesiologist]] at Caduceus. She was previously a policewoman.

Victor Niguel (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 - 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 [[United States Secretary of Health and Human Services|Secretary of Health]]. Died after three treatments in a short period of time from Pempti.

Robert Hoffman (age 62) - Head director of Caduceus USA after Secretary Anderson passed away.

===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 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 Kenneth Blackwell (46) - 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.Blackwell was infected with the mature form of Savato. However, he was saved by Derek.

Ludwig Milan (37) - A Delphi agent found at the medical facility where Professor Blackwell was conducting his research. He was the first victim of the immature form of Savato, which was in a developing form at that time. After he was saved by Derek, he helped create the serum that led to Savato's destruction.

==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 [http://uk.ds.ign.com/objects/695/695152.html]
*''[[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." [http://www.gamespot.com/ds/adventure/traumacenter/review.html]
*''Trauma Center'' has an average review ratio of 80% on [[Game Rankings]]. [http://www.gamerankings.com/htmlpages2/922120.asp]
*[[Metacritic]] currently ranks ''Trauma Center'' at 81%.[http://www.metacritic.com/games/platforms/ds/traumacenterundertheknife?q=trauma%20center]
*[[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.

==Sequel==
In the May 2008 issue of Nintendo Power, an article showed that a sequel, titled ''[[Trauma Center: Under the Knife 2]]'' is set to be released July 1st, 2008.<ref>[http://www.atlus.com/new_forum/viewtopic.php?p=27691#27691 Atlus USA :: View topic - Atlus announces Trauma Center: Under the Knife 2 for DS<!-- Bot generated title -->]</ref> The game is described as keeping the same gameplay, with "some of the old ones (the surgical tools) [having] improved functionality as they did in ''Trauma Center: New Blood''." Dr. Stiles and Angie will feature once more, taking place after the events of the first game. Reviews of the second game have been generally positive.

==References==
{{reflist}}


==External links==
==External links==
* [http://www.atlus.com/trauma_center/index.html North American website]
* [https://web.archive.org/web/20060330232121/http://www.atlus.com/trauma_center/index.html North American website]
* [https://web.archive.org/web/20060202085113/http://www.atlus.co.jp/cs/game/ds/kad/index.html Japanese website]
*{{moby game|id=/nintendo-ds/trauma-center-under-the-knife |name= ''Trauma Center: Under the Knife''}}
*[[Wikia]] has a wiki about: [http://traumacentergame.wikia.com/wiki/Main_Page ''Trauma Center'']


{{Trauma Center series}}
{{Trauma Center series}}


[[Category:2005 video games]]
[[Category:2005 video games]]
[[Category:Atlus games]]
[[Category:Nintendo DS games]]
[[Category:Nintendo DS games]]
[[Category:Nintendo DS-only games]]
[[Category:Nintendo DS-only games]]
[[Category:Trauma Center|Under the Knife]]
[[Category:Single-player video games]]
[[Category:Fictional nurses]]
[[Category:Video games set in 2018]]
[[Category:Trauma Center (video game series)]]

[[Category:Video games developed in Japan]]
[[de:Trauma Center]]
[[Category:Video games scored by Shoji Meguro]]
[[fr:Trauma Center: Under the Knife]]
[[ja:超執刀 カドゥケウス]]
[[pt:Trauma Center: Under The Knife]]
[[simple:Trauma Center: Under the Knife]]
[[fi:Trauma Center: Under the Knife]]
[[zh:超執刀 Caduceus]]

Latest revision as of 16:18, 16 December 2024

Trauma Center: Under the Knife
A group of doctors in surgical gear posed against a dark blue background.
Developer(s)Atlus
Publisher(s)
Director(s)Kazuya Niinou
Producer(s)Katsura Hashino
Designer(s)Makoto Kitano
Programmer(s)Nobuyoshi Miwa
Artist(s)Maguro Ikehata
Writer(s)Shogo Isogai
Katsura Hashino
Composer(s)Kenichi Tsuchiya
Shoji Meguro
Kenichi Kikkawa
SeriesTrauma Center
Platform(s)Nintendo DS
Release
  • JP: June 16, 2005
  • NA: October 4, 2005
  • EU: April 28, 2006
Genre(s)Simulation, visual novel
Mode(s)Single-player

Trauma Center: Under the Knife[a] is a simulation video game developed by Atlus for the Nintendo DS. The debut entry in the Trauma Center series, it was published in Japan and North America by Atlus in 2005, and by Nintendo in Europe in 2006. Set in a near future where medical science can cure previously incurable diseases, the world's population panics when a new manmade disease called GUILT begins to spread. Doctor Derek Stiles, a surgeon possessing a mystical "Healing Touch", works with the medical research organization Caduceus to find a cure to GUILT. The gameplay combines surgery-based simulation relying on the DS's touchscreen controls with a story told as a visual novel.

Designed to take advantage of the DS's control options after planned development for earlier consoles stalled due to inadequate hardware, development lasted just over a year. Its early inspirations included Western television series ER and Chicago Hope, with science fiction elements incorporated during a later stage. Development proved challenging for the staff, who were veterans of the Megami Tensei franchise and had little experience with genres outside role-playing.

The game was positively reviewed by journalists, who praised the title for its use of the DS controls while criticising its difficulty spikes and repetition. While a commercial disappointment in Japan, it sold beyond expectations in both North America and Europe, boosting Atlus' profits for that year. A remake for the Wii, Trauma Center: Second Opinion, released the following year. A DS sequel, Under the Knife 2, was released in 2008.

Gameplay

[edit]
The display is split between two screens. The upper screen shows gameplay displays and the assistant character commenting on the operation. The lower screen shows the operation in question.
A GUILT operation in Trauma Center

Trauma Center: Under the Knife is a video game that combines surgical simulation gameplay with storytelling using non-interactive visual novel segments using static scenes, character portraits, text boxes, and voice clips during gameplay segments.[1][2][3] The top screen of the Nintendo DS is dedicated to story sequences and level statistics displayed as 2D artwork, while the bottom touch screen is dedicated to the operations themselves rendered using 3D models.[2][4] Players take on the role of protagonist Derek Stiles, a young surgeon with a mystical ability called the Healing Touch. Each operation tasks players with curing the patient of one or multiple ailments within a time limit.[4][5]

Operations take place from a first-person view over the affected area.[6] The ten available surgical tools are required for different operations and injuries, selected using icons along the edges of the touch screen.[4][7] Each operation is prefaced by a briefing, describing the patient's condition and possible treatments. Depending on the operation, players may need to drain blood pools obstructing the operating area, use a surgical laser to treat small tumors or virus clusters, a scalpel to open incisions or excise larger tumors, a scanner for detecting hidden ailments, forceps to close wounds and introduce or extract objects, a syringe to inject a variety of medications, and sutures to sew up both wounds and incisions. The player must frequently apply antibiotic gel to treat minor injuries and prevent infection. The player may also require the "hand" option for situations such as a heart massage or placing objects such as synthetic membranes. During one operation, several of these tools will be needed. Each operation ends with the sutured wound being treated and a bandage being applied.[8] All of these actions are accomplished using the DS stylus.[4]

Operations range from treating surface wounds and extraction operations, to special operations where Stiles must confront strains of a man-made parasitic infection dubbed GUILT. These strains can be highly mobile, complicating the operation.[4] Some operations are affected by environmental hazards, such as turbulence on a plane.[7] A key story-based ability is Stiles's Healing Touch, triggered by drawing a five-pointed star on the touch screen. The Healing Touch slows down time for a limited period, allowing the player to perform operation actions without the patient dying.[2][5] Points are awarded with how fast and efficiently an action is performed, and graded from "Bad" to "Cool".[5] After each operation, the player is graded on their performances, with rankings going from "C" (the lowest) to "S" (the highest).[5][7] After an operation is completed in the story mode, players can attempt it again in the Challenge mode for a higher score.[5] The player can save their game after each story chapter.[7][8] If the patient dies or the timer runs out, the game ends and the player must restart from their last save.[8]

Synopsis

[edit]

Trauma Center is set in a near future Earth of 2018, where medical science has advanced to the point that previously major diseases such as AIDS and cancer are easily cured. The world's pioneering medical foundation is Caduceus, a multinational, semi-covert organization dedicated to researching and curing intractable diseases.[9] The story follows Derek Stiles, a young doctor who discovers his mystical Healing Touch during a difficult operation on an emergency patient from a car crash. After treating another patient infected with an unknown parasitic disease, Stiles is offered a position at Caduceus, which he accepts. The parasite is known as the Ganglia Utrophin Immuno Latency Toxin (GUILT for short), a manmade disease being distributed by the medical terrorist cell, Delphi. Along with his companion and assistant, nurse Angela "Angie" Thompson, Stiles begins confronting new strains of GUILT in different patients, along with surviving attempts on his life by Delphi. During their work, several Caduceus staff members are infected, including the director, Richard Anderson. While the strain is eventually removed, Anderson ultimately succumbs to the stress on his body from multiple operations and gives his position to Stiles's former superior, Robert Hoffman.

During an attempted raid by Delphi on Caduceus, the intruder is identified as Angie's father Kenneth Blackwell. Trailing him to a Delphi laboratory, Stiles and Angie successfully treat a highly-virulent GUILT strain, first in a nascent form in a test subject, and then in Blackwell himself. Once cured, Blackwell offers his full cooperation 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 the location of Delphi's headquarters, which consisted of an ocean vessel. When Stiles and Angie assist with a raid in cooperation with Caduceus Europe, they find that Delphi has been using children to incubate GUILT, and after curing the patients, they encounter Delphi's leader, Adam, now a vegetable host for all seven strains of GUILT, as well as a unique, eighth strain known as "Bliss." Caduceus Europe impound Adam's remains, and Stiles is hailed for his actions.

Development

[edit]

The original plan for Trauma Center was created by the game's producer Katsura Hashino. During this early stage, many staff compared the game to similar surgery simulations for Windows.[6] The concept behind Trauma Center originated several years before development started. While Atlus had explored the possibilities of a surgical simulation game, gaming hardware at the time was not able to realize their vision. This changed with internal previewing of the DS, which had the controls and functions to make the simulation elements work as intended. Planning for the game began in the summer of 2004.[10] Most of the staff were veterans of Atlus's Megami Tensei role-playing video game (RPG) franchise, making the development a difficult one due to its thematic and gameplay differences. Production proved a challenge due to the new gaming hardware and its deviation from the RPG mechanics Atlus was known for. One of the more difficult elements was getting the gameplay to function, which they finally achieved after settling on a first-person perspective for surgery.[6]

According to director Kazuya Niinou, the team drew inspiration from Western television series including ER and Chicago Hope, and unspecified Japanese television series and comics during their early work.[10] The scenario was written by Shogo Isogai, who faced problems when creating a narrative that would be respectful towards the medical profession while being fun, and confront very different themes to his work on the Megami Tensei series. While keeping in line with creating a medical drama, Isogai was told to add science fiction elements, which was a relief for him as he did not need to be accurate to a field he knew little about. The team needed to think carefully about the naming of GUILT strains, which were all derived from Greek words, which sharply contrasted their free borrowing of demon names for the Megami Tensei series. They also strove to push away from the common video game motif of seemingly glorifying death.[6] The characters were designed by Maguro Ikehata.[11][12] The art style was described as "very anime-styled".[13] The operation graphics were originally very stylised, but Hashino disapproved. While they decided against being too realistic, they managed to strike an aesthetic balance between realistic and cartoon graphics.[6]

The music was composed by Kenichi Tsuchiya, Shoji Meguro and Kenichi Kikkawa. Meguro and Tsuchiya were both veterans of the Megami Tensei franchise, particularly its Persona and Devil Summoner subseries.[14] The opening was one of the themes created by Meguro, who acted as sound director for the project. He found the limited sound environment even more of a challenge than earlier consoles he had composed for. Tsuchiya's work focused on environmental themes and general sound design, while Kikkawa's scores focused on orchestral tracks.[6] While Meguro and Kikkawa composed standard-definition music and reduced it to fit into the DS sound environment, Tsuchiya composed his tracks within the sound environment. At the time, Atlus did not have a MIDI interface for DS composition, so the composers had to guess what the sound would be like when transplanted into the game.[14]

Release

[edit]

The game was first announced in July 2004 alongside five other Atlus titles for the DS.[15] The game was released in Japan on June 16, 2005.[16] A commercial demo was released through Nintendo's online store on May 29.[17] While it lacked the high amount of blood and gore that would have earned it a mature rating, its content still merited a CERO rating of "B", indicating an age range of early teens and up.[6][10] Its release was supported by a guidebook published by Enterbrain in July of that same year.[18] A soundtrack album was released by Sweep Records in October 2011.[14]

The game was first revealed under its English name at the 2005 Electronic Entertainment Expo.[19] It released in North America on October 4.[20] The game was localized for the West by Atlus USA.[13] For the game's English version, the game's setting was changed from Japan to North America. Derek Stiles's English name was written as a pun on the word "stylus", referencing the DS stylus.[21] The English dub was handled by PCP Productions, who had previously worked with Atlus on Shin Megami Tensei: Digital Devil Saga.[22] Voice acting was restricted to shoutouts during operations, while Stiles himself did not have a voice actor.[23] Due to their lack of a European branch, Atlus USA did not publish the game in the region. The game was instead published by Nintendo of Europe on April 28, 2006.[13][24][25]

Reception

[edit]

In Japan, Trauma Center did not appear in Japanese gaming magazine Famitsu's top 500 best-selling titles for 2005, indicating sales of less than 15,000 units.[32] In contrast, the North American release was described by Atlus staff as "absolutely fabulous", with sales going "off the charts".[33] The game's popularity prompted Atlus to issue further print runs of the game.[34] The game also met with strong sales in Europe.[35] While Atlus had seen financial losses prior to 2006, the international success of Trauma Center contributed to the company making a profit.[36]

Famitsu praised the game's innovative use of the touch screen,[28] while Christian Nutt of 1UP.com called the game a standout title for the DS due to its polished controls and unconventional premise.[27] Eurogamer's Tom Bramwell praised the gameplay and[specify], although he found faults in the game's presentation and confusing or arbitrary mechanics.[2] GamePro called the game "a cure for what has been a spell of mediocrity on the DS".[29] GameSpot's Alex Navarro praised the game's balancing of narrative and arcade-style gameplay.[4]

Justin Leeper, writing for GameSpy, felt that Trauma Center could succeed in appealing to a broader audience than other titles with unconventional gameplay ideas.[30] Craig Harris of IGN was surprised by how much he enjoyed his time playing.[5] Tom East of Official Nintendo Magazine called Trauma Center "engaging, fun and highly original",[7] and Matt Keller of PALGN generally enjoyed the gameplay experience despite its short length and other issues with the difficulty and graphics.[31]

The use of the DS touch screen and stylus were generally lauded by critics;[2][4][5][7][30] East called it a concept only made possible by the hardware,[7] while Leeper had issues with stylus motions registering.[30] The story was generally praised, with many calling it both silly and engaging,[2][4][5][7][29] and a few noting its handling of mature themes.[2][27] Others also negatively noted the large amount of text, which slowed the game's pace.[2][7] Difficulty spikes in later portions of the game, lack of room for improvisation, and general repetitiveness were noted by reviewers as detrimental factors.[2][4][5][7][27][28][31]

Legacy

[edit]
See also: Trauma Center: Second Opinion

During their 2005 gaming awards, GameSpot nominated Trauma Center in their "Most Innovative Game" category.[37] In the years following its release, Trauma Center would become a notable success for Atlus, breaking into mainstream gaming when they had previously been restricted to niche success. In a feature by Jess Ragan for 1UP.com, Trauma Center: Under the Knife was described as having "helped pull the Nintendo DS out of a debilitating software drought and demonstrated the system's potential to both hardcore gamers and skeptical outsiders alike".[38] Website VentureBeat listed Under the Knife as one of the most memorable games of 2005 due to breaking away from gaming trends and creating an experience focused on saving lives.[39]

Following the release of Under the Knife, most of Hashino's team shifted to work on the Persona series, with a small number of staff being assigned to form a new team for further development of the series.[40] This group would be known internally as "CadukeTeam".[41] The Trauma Center series would be continued with three subsequent games on Nintendo hardware; Trauma Center: New Blood for the Wii in 2007, the direct sequel Trauma Center: Under the Knife 2, released in 2008 for the DS; and Trauma Team for the Wii in 2010.[1] A remake of Under the Knife, Trauma Center: Second Opinion, was released for the Wii in 2006 as a launch title for the console.[1][42] In a series retrospective, Peter Davison of USGamer noted both the series' notable position in Atlus's gaming library, and how the titles made use of the Nintendo console mechanics.[1]

Notes

[edit]

Citations

[edit]
  1. ^ a b c d Davison, Peter (2013-08-07). "It's Time We Had a New Trauma Center". USGamer. Archived from the original on 2016-02-17. Retrieved 2018-11-05.
  2. ^ a b c d e f g h i j Bramwell, Tom (2005-11-01). "Trauma Center: Under the Knife Review". Eurogamer. Archived from the original on 2016-03-03. Retrieved 2009-02-25.
  3. ^ "Trauma Center: Under the Knife". Atlus. Archived from the original on 2020-11-30. Retrieved 2021-01-23.
  4. ^ a b c d e f g h i j Navarro, Alex (2005-10-06). "Trauma Center: Under the Knife Review". GameSpot. Archived from the original on 2007-02-24. Retrieved 2009-02-22.
  5. ^ a b c d e f g h i j Harris, Craig (2005-10-07). "Trauma Center: Under the Knife Review". IGN. Archived from the original on 2007-02-23. Retrieved 2009-02-22.
  6. ^ a b c d e f g :::超執刀 カドゥケウス:::. Atlus (in Japanese). Archived from the original on 2006-08-24. Retrieved 2018-12-01.
  7. ^ a b c d e f g h i j k East, Tom (2008-01-10). "Review: Trauma Center: Under the Knife". Official Nintendo Magazine. Archived from the original on 2009-06-01. Retrieved 2009-02-22.
  8. ^ a b c "Trauma Center: Under the Knife - System". Atlus. Archived from the original on 2007-12-06. Retrieved 2018-12-01.
  9. ^ "Behind the Scalpel - The Story of Trauma Center". Atlus. Archived from the original on 2007-11-19. Retrieved 2011-09-06.
  10. ^ a b c Nintendo Inside Special - 超執刀 カドゥケウス. Nintendo Inside (in Japanese). 2005-04-16. Archived from the original on 2006-07-08. Retrieved 2018-12-01. Translation[usurped]
  11. ^ Atlus (2005-10-04). Trauma Center: Under the Knife (Nintendo DS). Atlus USA. Scene: Credits.
  12. ^ :::超執刀 カドゥケウス::: 4コマ漫画 - 「貫禄」作・画 池端 まぐろ. Atlus (in Japanese). 2005. Archived from the original on 2007-02-24. Retrieved 2018-12-01.
  13. ^ a b c Schaedel, Nick (2006-09-02). "Sliced Gaming Feature: Trauma Centre Interview". Sliced Gaming. Archived from the original on 2018-11-04. Retrieved 2018-11-05.
  14. ^ a b c 超執刀カドゥケウス サウンドトラック. Sweep Record (in Japanese). 22 September 2011. Archived from the original on 2017-06-08. Retrieved 2018-11-05.
  15. ^ Niizumi, Hirohiko (2004-08-05). "Atlus reveals DS surgery game". GameSpot. Archived from the original on 2018-11-29. Retrieved 2018-12-01.
  16. ^ [DS] 超執刀 カドゥケウス. Atlus (in Japanese). Archived from the original on 2013-10-24. Retrieved 2018-12-01.
  17. ^ 店頭体験会で『超執刀カドゥケウス』の魅力“タッチパネル手術”に挑戦！. Dengeki Online (in Japanese). 2005-05-19. Archived from the original on 2018-11-30. Retrieved 2018-12-01.
  18. ^ 超執刀カドゥケウス 公式ガイドブック. Enterbrain (in Japanese). Archived from the original on 2006-06-27. Retrieved 2020-12-06.
  19. ^ Adams, David (2005-05-13). "Pre-E3 2005: Atlus Announces Lineup". IGN. Archived from the original on 2012-12-21. Retrieved 2018-12-01.
  20. ^ Adams, David (2005-10-04). "Trauma Center Opens Its Practice". IGN. Archived from the original on 2012-12-27. Retrieved 2019-03-10.
  21. ^ Yip, Spencer (2006-11-20). "Nintendo LA Wii Event: Chat with Atlus". Siliconera. Archived from the original on 2009-12-12. Retrieved 2018-11-05.
  22. ^ "PCB - Credits". PCB Productions. Archived from the original on 2019-02-16. Retrieved 2019-07-16.
  23. ^ Casamassina, Matt (2006-09-07). "Interview: Trauma Center: Second Opinion". IGN. Archived from the original on 2014-06-17. Retrieved 2018-11-05.
  24. ^ Graves, Robert (2005-11-16). "NoE To Publish Trauma Center In Europe". Nintendo World Report. Archived from the original on 2017-09-06. Retrieved 2018-12-01.
  25. ^ Pallesen, Lasse (2006-02-20). "Trauma Centre: Under the Knife Coming to Europe this April". Nintendo World Report. Archived from the original on 2018-11-30. Retrieved 2018-12-01.
  26. ^ "Trauma Center: Under the Knife for Nintendo DS". Metacritic. Archived from the original on 2012-04-19. Retrieved 2009-02-22.
  27. ^ a b c d Nutt, Christian (2005-10-10). "Trauma Center: Under the Knife". 1UP.com. Archived from the original on 2010-01-05. Retrieved 2009-02-25.
  28. ^ a b c (DS) 超執刀 カドゥケウス. Famitsu (in Japanese). Archived from the original on 2016-07-04. Retrieved 2018-11-05.
  29. ^ a b c "Review: Trauma Center: Under the Knife". GamePro. 2005-10-12. Archived from the original on 2009-06-24. Retrieved 2009-02-25.
  30. ^ a b c d Leeper, Justin. "GameSpy: Trauma Center: Under the Knife Review". GameSpy. Archived from the original on 2017-01-14. Retrieved 2009-02-25.
  31. ^ a b c Keller, Matt (2006-04-29). "Trauma Center: Under the Knife Review". PALGN. Archived from the original on 2006-09-01. Retrieved 2018-11-05.
  32. ^ 2005年テレビゲームソフト売り上げTOP500. Geimin.net. Archived from the original on 2016-04-15. Retrieved 2016-04-15.
  33. ^ Anderson, John (2006-02-06). "Mapping The World With Atlus: Jim Ireton on Atlus' Import Aspirations". Gamasutra. Archived from the original on 2014-11-11. Retrieved 2015-08-20.
  34. ^ "Trauma Center Resuscitated". IGN. 2006-06-27. Archived from the original on 2012-12-28. Retrieved 2018-11-05.
  35. ^ Gibson, Ellie (2006-08-09). "Trauma Center for Wii launch". Eurogamer. Archived from the original on 2016-07-14. Retrieved 2018-11-05.
  36. ^ Winkler, Chris (2006-11-27). "Index Becomes Atlus' New Parent Company". RPGFan. Archived from the original on 2007-05-10. Retrieved 2018-11-05.
  37. ^ "GameSpot's Best and Worst of 2005 awards kick off". GameSpot. 2005-12-16. Archived from the original on 2014-03-05. Retrieved 2018-12-01.
  38. ^ Ragan, Jess (2007-10-10). "Filling a Niche: Bold Video Games that Bucked the Mainstream". 1UP.com. Archived from the original on 2016-06-14. Retrieved 2018-12-01.
  39. ^ Kleckner, Stephen (2015-07-28). "10 years later: GamesBeat's most memorable games of 2005". VentureBeat. Archived from the original on 2018-12-01. Retrieved 2018-12-01.
  40. ^ "Exclusive: Behind The Scenes Of Atlus' Persona 4". Gamasutra. 2009-10-06. Archived from the original on 2018-02-21. Retrieved 2018-12-06.
  41. ^ Kanada, Daisuke (2007-10-01). ディレクター金田のカドゥケウス日誌 Vol.01. Atlus (in Japanese). Archived from the original on 2017-03-22. Retrieved 2018-11-05.
  42. ^ Yip, Spencer (2006-05-10). "Surprise titles coming from Atlus". Siliconera. Archived from the original on 2010-02-19. Retrieved 2018-11-05.

Explanatory notes

[edit]
  1. ^ Known in Japan as Chōshittō Kadukeusu (超執刀 カドゥケウス, lit. Super Surgical Operation: Caduceus)
[edit]
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