Let's Play... Surgeon Simulator 2013

Surgeon Simulator
2013, Bossa Studios

originally played on PC

So I always wanted to be a surgeon. Along with astronaut it was one of the job boxes I ticked off every year in that big blue book parents in Ontario used to track their kids' progress through school in the 1980s. Another consumer memory brought to us by the fine folks at Jostens. Of course, this ambition disappeared as I grew older and came to realise that I wanted to memorise songs and books instead of physiology and stress-relief methodology. So the humanities and a long life of poverty for me, then. Both my parents worked in health care, and my brother and I spent a lot of time after school wandering around the hospital waiting for the age of ten so we could stay home alone as latchkey kids. You see a lot of things wandering around a hospital unsupervised. Patients in various states of recovery are obviously interesting to a young kid raised on horror films, but so are the small dramas traced into hospital waiting rooms and hallways along with family members, worry for loved ones made supine like a struggling dog by the rules of the institution. Parents annoyed by their loss of control to institutional processes, fighting with doctors and nurses for tiny scraps of hopeful good news and just a quick glimpse and please maybe let me hold their hand. Friends visiting the infirm and the elderly who only wish them to leave if they didn’t want them there in the first place. Spouses hiding their frustration and loneliness as their love for each other strains and sometimes breaks in front of a quiet public. Sublime horrors of bodies objectified, flesh drawn and quartered to find out what’s wrong, what needs fixing, a painful and necessary violence fundamental to understanding. Like Councillor Krespel in Hoffman’stales, medicine must often destroy its object of study in order for understanding. A poisonous cure, to be sure. Walking through the hallways and backrooms of the hospital alone or with my brother, sometimes we would see something very graphic indeed. Seeing a few fingers in plastic wrap abandoned teaches a person that medicine is an abstraction as much as it is an abjection. Distanciation and humour are the only recourse for sanity.

Of course, to deal with all of the domestic trauma, heartbreaking grief and loss, as well as the mountains of gore, many people who work in medicine adopt a form of gravedigger’s humour in order to compartmentalise the abject and the horrific in order to maintain their capabilities on the job. Ankle-deep in blood and crying loved ones, you smile and enjoy the smells as you wipe blood across your forehead. Metaphorically, of course, as hygiene must be maintained, in Canadian hospitals at least. I’ve noticed this attitude in friends who are cops as well – humour used to paint over otherwise horrible experiences. A friend of mine who drives ambulances spent the first day in his job cleaning up brain matter from the highway to Toronto before coming over for a birthday party for my brother and revolting every single one of the guests by not having changed his uniform first. I’m covered in brains. You’d think I would have had the bright idea to change, he said before forgetting his Asian alcohol allergies and passing out in a closet upstairs after drinking the neck of a Molson Canadian. Similarly, my father edited film and video for medical procedures, sometimes while we ate supper in the living room. The likeness of my mother’s lasagna to the fleshy subdermal parts of the inner leg was a constant source of amusement for him.

don't tell me you don't want to shake his head around, because you do

Surgeon Simulator 2013 (2013) brings this laisez-faire attitude to home medicine games. While most games dealing with health care are managerial simulations – SimHealth (1994) and Theme Hospital (1997) being the most obvious examples – or cheap licensing entries in film and television-based transmedia franchises, such as ER (2005), Grey’s Anatomy: The Video Game (2009), and House M.D. (2010), there are some examples of games which try, realistically or otherwise, to depict actual medical procedures. Life & Death (1988) and Life & Death II: The Brain (1990) are perhaps the most well-known iterations, having been compiled on numerous shovelware releases in the early CD-ROM years. This was in fact the manner in which I came to play both games, for as a farewell present when our family moved to Southern Ontario my father’s co-workers at the hospital gave him a CD-ROM drive for our fancy new 386. A collective effort in financing, as these drives were very expensive back in the day (starting around $1,000) and quite the gift. Within computer geek circles, our machine was the envy of everyone around for almost a year. Except for libraries and universities, nobody had a CD-ROM drive in 1991. The technology was so new that in order to fully experience what it had to offer, sound routed from the drive had to be sent to a mixer along with the output from the computer's sound card. Likewise, publishers had little understanding of how to properly use the medium, either filling titles with uselessly small (75x75 or sometimes 130x100) video clips often repurposed from extant video media such as television and home video, or compiling as many non-related games as they could get their copyright licenses on. A database medium, then, and unless dictionaries and encyclopaedias are of particular interest to you, nothing interesting came out on CD-ROM until Sierra started releasing ‘talkie’ versions of games such as King’s Quest V: Absence Makes The Heart Go Yonder! (1990) and Space Quest IV: Roger Wilco and the Time Rippers (1991), quickly followed by Interplay titles such as Star Trek 25^th Anniversary (1992) and J.R.R. Tolkien's The Lord of the Rings, Vol. I (1990). More often than not, however, such exciting multimedia versions of popular games were marred by their decidedly non-professional voice acting, often invoking the indie DIY spirit of the time and using members of the programming team in character voice roles. It should be noted that this dynamic of economic necessity forcing the conscription of terrible voice acting from programmers is different than occurred when designers purposely put themselves into their games, as Chris Jones did when he took an increasingly prominent role as the character Tex Murphy in a series of adventure games from Mean Streets (1989) through The Pandora Detective (1996). Shudder-inducing as thespian delusions, these early non-professional multimedia experiments are often fantastic if appreciated in the right spirit. Of course, some of these releases were very well done indeed; the CD-ROM editions of Interplay's Star Trek adventures were in face the last collective effort from the cast of the original television series.

the most realistic four-colour surgery simulator ever released

The most popular use of the medium, however, was as a shovelware platform on which to dump a variety of unpopular titles along with a marginally-popular one. And so Life & Death came into my possession along with Beyond the Black Hole (1989), Bruce Lee Lives (1989), The Chessmaster 2000 (1986), and Cribbage King / Gin King (1989). By far the best part of Life & Death – and in likelihood actual medicine – is the screaming. Patients scream when you poke their sore spots during observations and when you perform surgery without administering an anaesthetic. Rendered in monophonic 8-bit sampled bliss and reproduced to everyone’s amazement using the famously crappy and useless pc speaker, the screaming in Life & Death is alone worth an hour of your drunken time at a party with friends. Life & Death is a fairly realistic simulation of these procedures. Players are expected to be very meticulous in performing the steps necessary to complete these operations. Ultimately, while enjoyable, the game presents players an often frustrating experience of the OCD required by modern health care practitioners as players slowly learn how to do things properly through trial and error, as well as reference to the game’s manual and in-game commentary on player performance.

surgery is definitely for the OCD set

Of course, the screaming stops should you ever choose to perform an operation properly. The game offers two surgical procedures, appendicitis and aneuritic aorta, in a small attempt at educational gameplay. Despite  the use of four-colour CGA mode for the game’s original DOS release,the presentation and simulation aspects of the game are remarkably realistic for the time and have yet to be matched in any other commercial release.

Surgeon Simulator 2013 is frustrating for quite the opposite reason. Basically a cartoon exercise in fun with physics, Surgeon Simulator tasks players with performing a variety of challenging and totally unrealistic surgical procedures. Players are in direct control of the virtual surgeon’s hands, thus providing a level of haptic complexity to the interface which guarantees that players will fuck up even the simplest of gestures, such as grabbing and maintaining a hold of an object. Don’t be turned off by the fact that the game doesn’t include a tutorial, as the fun of playing the game isn’t really about completing the challenges offered to players, but rather about enjoying the comic mayhem inherent to amateur surgery.

drunk interface. drunkterface?

The game drops players right into the matter with heart surgery as the first mission with little warning and a gleeful disregard for patient safety. Indeed, black humour runs throughout the game, evidenced not only by the playful main menu, which allows players not only to answer the phone and write on a notepad but also to play computer games (I should note here my own history with physicians who were early enthusiasts in digital gaming) and most importantly launch everything off the doctor’s desk in a flailing attempt to learn the game’s interface. Fun involves the comic mischief caused by the juxtaposition of the seriousness of surgical medicine and the autistic inability of the surgeon to control his or her own limbs, and also by the impossibility of the game to operate as a simulation of anything approaching actual medical procedures. Bones are sawed off and organs are removed and placed wherever there is room, all with no regard whatsoever for how these pieces would ever be put back together again ‘in real life’. Unlike in Life & Death, play is only concerned with opening patients up; the sawed-off bones and scooped-out organs don’t need to be reconnected after the procedure. While the game offers a variety of scenarios, such as performing heart surgery in the back of an ambulance while the doors flail open and elements of the surgery theatre continually fall out, or completing an alien autopsy / transplant in zero gravity on a space station. Of course, I have only been able to complete a few of the game’s surgeries and have not unlocked the full game.

careful... careful...

Fundamentally, Surgeon Simulator 2013 is a game of frustration, as controlling two human hands by means of the mouse and five keys on the keyboard is much more difficult than would initially appear. Simple movements are made exceedingly difficult as in a sense players relearn or recalibrate their hand-eye coordination. Of course, this leads to a variety of fun achievements on Steam, such as flashing metal horns or flipping off the patient before abusing his face like he’s in a Three Stooges routine, or successfully completing surgery after stabbing yourself in the arm with enough drugs to start hallucinating. This kind of fun only improves when playing with multiple intoxicated friends.

great, now you've hopped yourself up on goofballs

Sadly, the PC version has yet to be updated with the hilariously oppositional co-op mode from the PS4 version, in which each player operates one of the surgeon’s hands. Also sadly missing is the screaming. But the fact that as a surgeon I can inject myself with drugs and go to space while smacking the patient’s head around like Curley before telling him to fuck off and pulling out all of his organs with a hammer and replacing them with empty plastic water bottles and my watch makes me a very happy person indeed.