Trauma Center: Under the Knife, released in Japan as Super Surgical Operation: Caduceus (超執刀 カドゥケウス), is the first game of the Trauma Center series, developed by Atlus for the Nintendo DS. An enhanced remake for the Nintendo Wii was released, called Trauma Center: Second Opinion, featuring new characters, mechanics, and a continuation of the storyline.
The story is set in the year 2018, where diseases that were previously thought to be incurable (HIV, cancer, TFTA, etc.) have gone nearly extinct due to the help of Caduceus.
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(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 eventually 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 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 mutated strains 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 P, 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 Angie's father, Kenneth Blackwell, and they manage to trail him back to a Eidoth Pharmaceuticals research lab. There, they encounter the final strain of GUILT(Savato), first an immature form within Ludwig Milan, a researcher and a survivor, and then the mature 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 and mutate the seven, non-mutated, prototype 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. Derek and Angie pass out while in the chamber. The soldiers outside radio that the two of them were exposed to an airborne hallucinogen, and launch a rescue. With the threat of GUILT eliminated, Derek becomes well known as the man who saved the world.
- Derek Stiles: The playable surgeon of the game who possesses the Healing Touch. He was eventually transferred to Caduceus after saving a victim from GUILT.
- Angela "Angie" Thompson: A forceful and passionate nurse who serves as the main assistant of the game. Alongside Derek, she transferred to Caduceus.
The game's story progresses in chapters and episodes, but unlike the subsequent games where the player is taken back to an episode selection menu, the game utilizes a save game system during the storyline, with opportunities to save after each episode. High scores and re-attempts on missions can be done on a Challenge mode, where the X missions are also unlocked.
Operations are played mainly using the stylus and touch screen, with a few differences with subsequent games. While there is no chain system, there exists a Miss Limit, and hitting that limit will, like letting vitals drop below 0, cause an immediate operation failure. Scoring consists of the usual Time, Vital, and Special Bonuses, but Special Bonuses are not elaborated on, and the highest rank attainable in this game is S. There is also only one difficulty level available.
- Antibiotic gel
- Surgical laser
- Main article: /Soundtrack
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