Genre: Simulation
Publisher: Atlus
Developer: Atlus
Release Date: July 1, 2008

Trauma Center: Under the Knife was one of those games that really showed off the uniqueness of the Nintendo DS system. There wasn't another console, handheld or home-based, that could allow a title like Trauma Center to exist — at least until the Nintendo Wii came out. One of the launch titles for the Wii was the excellent port of Trauma Center: Under the Knife called Trauma Center: Second Opinion. That title was ported perfectly, with extra features and Wii controls that arguably made the game even better than its handheld counterpart. For some, this led to the worrying idea that Trauma Center would forever remain a Wii exclusive, especially in the wake of the Wii sequel, Trauma Center: New Blood. Luckily, Atlus hasn't forgotten the hard-working Nintendo DS, and now, a little less than three years after the original title's release, DS gamers finally get to take on the role of Dr. Derek Stiles in a new adventure.

Trauma Center 2: Under the Knife opens up a short while after the events of the original Trauma Center. As far as TC2 is concerned, neither of the Wii games ever happened. There are no mentions of Dr. Naomi Weaver, and certainly nothing that references the events in New Blood, so DS-only gamers, don't worry about missing out.

The story begins with Dr. Stiles and his nurse, Angie, training overseas in Africa and helping out the victims of a civil war between two warring tribes. However, their overseas "vacation" is quickly interrupted by the appearance of Post-Guilt Syndrome, or PGS, new illnesses appearing in the former victims of the tragic man-made virus, GUILT. Before long, Derek and Angie are caught up in a new adventure involving the remains of the medical terrorist organization Delphi, a new strain of extremely deadly modified GUILT, and a rival medical organization named the Hands of Asclepius, who seek the seemingly harmless goal of mass-producing doctors with Derek's Healing Touch ability. The result is a fairly interesting story line that has the advantage of being far more coherent than the one introduced in New Blood.

To figure out why TC2 is a more coherent game than New Blood, one only has to compare two very similar situations from both games. In both titles, the protagonists are captured by a medical terrorist group and locked in a cell. In Trauma Center 2, Derek and Angie escape by picking the locks with smuggled medical tools while trying to avoid setting off an alarm. The New Blood heroes are, inexplicably, locked in a cell with a child's video game that they have to complete in order to escape. They're both fantastical situations that would, of course, never occur in real life, but one has the aura of believability to it, while the other simply assumes that your captors are hilarious idiots. Most of TC2 is superior in this way, with plots that are over the top while still being believable, as compared to mind-numbing silliness, such as "compete on a surgery-themed game show," as seen in New Blood.

While most of Trauma Center 2's gameplay is unchanged, it does introduce some of the previously Wii-exclusive operations to the DS. Operations like fixing fractured bones, using skin grafts to heal burns, and even performing an operation in pitch darkness while using a penlight to see are all new to gamers who've yet to try to the Wii adaptations. The one downside is that the DS's more simplistic controls also render a lot of these operations far easier than they were on their console counterparts. For example, piecing together a shattered bone is now super-easy. Instead of twisting and adjusting it, you simply have to move the piece into its correct slot, with no guessing necessary. Other operations, like the aforementioned skin grafts, are more forgiving and less precise than their Wii counterparts, so correctly completing them requires far less effort. Still, these new missions add a lot of refreshing changes to the Trauma Center formula, although it does come with a cost.

Trauma Center 2 is far easier than the original. This isn't necessarily a bad change, as the original was up there with Ninja Gaiden for sending players into DS-breaking fits of rage. The problem is that Trauma Center 2 goes a bit too far in the opposite direction. A lot of the missions feel flat-out toothless now, with very few surprises or shocks waiting for you; they now feel less dangerous and are easier to complete. What that said, Trauma Center 2 does a very welcome thing by ensuring that GUILT doesn't overrun the game's operations like it did in the first title, even if that means that you get simpler operations instead.

GUILT does return in TC2, although it is far less prevalent than it was in the original Trauma Center. Even though Derek and Angie are now facing not one, but two exclusive evolutions of GUILT, you'll only have each strain of GUILT or Neo-GUILT maybe two or three times in the entire game, and that includes missions where you face multiple strains in a row. The first evolution, Mutated GUILT, is the return of three of the strains found in the first Trauma Center, although they're not coming back without surprises. The mutated Pempti strain, for example, now has two cores instead of one for double the danger. Sadly, not all of the Mutated GUILT is a good change. The Mutant Tetarti, for example, just involves adding more colors to the Tetarti, which is such a lame "improvement" that it actually made it feel like less of a threat than most of the non-GUILT operations.

Neo-GUILT is the second major threat you'll encounter in Trauma Center 2, and is the only thing really new in the title. Neo-GUILT, which shows up toward the end of the game, is a series of new strains that are supposed to be even deadlier than the main GUILT, although in actual gameplay terms, they end up much weaker. Take, for example, the Nous, an extremely weak virus that simply has to be drained and cut out, and whose primary method of attack involves creating easily drained and extracted tumors. Compared to the threat offered by the Mutated Pempti and its barrage of constantly changing attacks from two sides, it's just sort of insignificant. Most of the Neo-GUILT suffers from this problem: It just doesn't feel like a threat. They don't do a lot of damage, they don't have particularly difficult weaknesses, and they seem weak when compared to the nasty GUILT from the first title. Even the final boss feels rather lackluster compared to the Savato from Trauma Center, or even the Cardia STIGMA from New Blood. The only really aggravating member of the Neo-GUILT is Sige, and that's just because it has a gimmick that requires blowing into the DS' microphone, which is a poor replacement for challenge.

Graphically, not much has changed from the original Trauma Center. Things look a little brighter, and all of the characters use their Second Opinion redesigns, but other than that, you'll be in for few surprises. Unfortunately, there isn't much to say about Trauma Center 2 over the original, since it's mostly identical. The soundtrack is excellent, made up of a few new tracks combined with returning music from the original title, and it does a fantastic job of adding to the tension of a tight operation. Perhaps the only bad part about the audio aspect of Trauma Center 2 is the choice to have characters randomly shout out one-word snippets after every other line they speak, which grows deeply annoying when it occurs in surgery. Luckily, you can turn this off in the game's option menu, so if you find it as aggravating as I did, it won't be a concern for long.

As far as quality goes, Trauma Center 2 falls somewhere between Trauma Center: Under the Knife and Trauma Center: New Blood. The story line and characters are significantly better than those introduced in the silly New Blood, but the actual levels bring little innovation or excitement. As a whole, Trauma Center 2 is possibly even easier than New Blood, with shorter and easier operations and a number of returning operation types that are made far easier by not being on the Wii. The result is a fun game, but one that still falls short of what made the original Trauma Center so great. If you're looking for most portable doctor action, or simply something less hair-tearingly difficult than the first Trauma Center game, you'll find Trauma Center 2: Under the Knife to be quite worth playing.

Score: 8.0/10