Genre: Simulation
Developer: Atlus
Publisher: Atlus
Release Date: November 20, 2007

Atlus may be famous for translating Japanese games for the American audience, but it's actually a well-known Japanese developer as well, being the originators of the Shin Megami Tensei series (Digital Devil Saga, Persona, etc.). However, at least in raw uniqueness, it's difficult to think of any that really highlight as well as Trauma Center: Under The Knife, a famously difficult surgery simulator for the Nintendo DS. A first-of-its-kind game, Trauma Center cast you as Derek Styles. With 10 surgical tools and one cute nurse, you had to save lives, ultimately facing off against the mysterious genetically engineered disease, GUILT.

The Wii version, Trauma Center: Second Opinion (a port, not a sequel in spite of the name), then added a second doctor, more context to the storyline, and the ability to select the difficulty level — a godsend for those of us who found the DS iteration a little too difficult. When this version ended, Atlus could easily have left well enough alone, for the game was, at worst, in the top three launch titles of the Wii.

Fortunately for us, Atlus decided to give the series another go, this time with a full-fledged sequel. Taking place several years after the previous version, Trauma Center: New Blood casts you as Markus Vaughn and Valerie Blaylock, two fairly experienced doctors who have been spending time at Montgomery Memorial Hospital, hidden in a remote village not too far from Fairbanks, Alaska. Blaylock has been hoping to learn the legendary Healing Touch from Vaughn, but has met with no success thus far. Fortunately, plenty of dramatic, tough and occasionally rather humorous situations are going to give her a chance to learn, all the while facing off against the new genetically engineered disease, Stigma, which Vaughn seems to know more about than he's willing to let on.

The basic gameplay of New Blood is not especially changed from the previous Wii version. You have the same eight basic tools, and the same basic array of options, all used toward the same goal: Follow the instructions provided and save the patient's life within the five-minute time limit. Mistakes are typically penalized by dropping a patient's vitals, as well as wasting time. If either runs out, the game's over, although the only loss penalty is restarting the operation. This might sound easy enough, but even on the Easy difficulty level, it will be exceptionally difficult; you often have to juggle two or three tasks to survive, and those tasks, while clearly explained, can be fairly complex.

The new features of the Wii version, however, offer a nice mix of ways to make things easier as well as new challenges. Challenge scenarios are written into the game at various points. These missions compare in difficulty to the X scenarios of the previous iterations, but show up across the storyline. Being fully skippable, their primary purpose is to take full advantage of the online high-score system, which uses the game's detailed scoring system to determine who's the best surgeon on each operation. Notably, all six combinations of difficulty and doctor for each operation share one scoreboard, however this balances out by making higher difficulties offer significantly higher potential scores.

On top of these, however, is New Blood's largest new feature: cooperative play. The two doctors consistently work together, and while you can select single doctors and complete most scenarios, the title is clearly balanced toward cooperative play, to the point of the higher difficulty levels being practically impossible for all but the most skilled of gamers to complete solo as play advances, while it is much easier and more fun to play with a friend. The game also allows you to replay any scenario you have completed in any order, which makes breezing through on the Easy difficulty level and then replaying the levels with a friend on Hard in whichever order you wish, a perfectly viable and game-extending option.

New Blood's presentation is truly top-tier in nature; the graphics stick to the same styles as the original, albeit with significantly more detailed and high-quality drawings to tell the cut scenes. Just like its predecessor, surgery does not look next-gen at all, with plenty of almost flash-like effects and very simple, representative graphics. This may, however, be a game that truly benefits from this, as even very squeamish individuals will be able to handle surgeries that, when seen in real life, could result in severe nausea. On top of that, the frame rate is as smooth as glass, no matter how harried things get during play.

Sound effects have been improved with well-acted full voice acting for the entire game, altogether higher-quality music, and the same effective, but not nausea-inducing, sound effects of the prior titles. There's a fair bit more of music this time around, though repetitions inevitably occur.

About the only complaint I have about the presentation is one rather odd oversight: The game explicitly discusses taking place near Fairbanks, Alaska (and even manages to remind an actual Alaskan of what parts of Fairbanks look like), along with Los Angeles and Maryland. It also includes American flags and futuristic ideas of what the latter two cities might look like, but the only time you should see a state flag outside the Alaskan hospital, it's inexplicably blacked out. Alaska's flag is not exactly difficult to draw, which leads to the conclusion shown in the image below. Being an Alaskan through and through, this reviewer is probably one of the only people who will ever be offended by this. Nonetheless, in a game that otherwise seems to do a pretty good job of researching itself, it seems highly unusual.

Two more substantial flaws prevent New Blood from fully outshining the original game, though both are comparatively minor. First, every episode involves a surgery, which means that the numerous long sequences of text that seem endemic to the storyline are not always exceptionally compartmentalized. Several different skip functions prevent this from being too severe, but it can be rather jarring at times. Secondly, the interface outside of the menus follows with the same problem from the previous Wii version: a rather unwieldy pointer-based system that requires both hands to select stages if you want to play anything other than the stage that you've most recently unlocked. Neither is exactly a game-killer, but both do annoy, and along with writing that isn't quite as novel as it was the first time around, prevent the title from being quite as great as the original.

Trauma Center: New Blood does not outshine the original, but it really does not need to do so to be a solid, exceptional work. Between writing that generally holds up beautifully and excellent use of all the major Wii features, the game's a perfectly worthy sequel, and it's a worthwhile title for any Wii owner who wants a bit of a challenge (or a lot of one, for that matter!). While I might recommend playing the original first, this remains one of the kinds of experiences that only the Wii can provide, making it one of the best third-party efforts the system has seen thus far.

Score: 8.4/10