"Beneficence, nonmaleficence, autonomy, and justice constitute the 4 principles of ethics. The first 2 can be traced back to the time of Hippocrates “to help and do no harm,” while the latter 2 evolved later".

This is taken form a medical research paper on the principles of clinical ethics. Why would I cite this, would you ask? Well, in the chapter 3 when Stiles is getting ready to operate Tyler's sister, he goes against the oldest principles of to help and do no harm.

Our prestige doctor protagonist simply insists on doing a surgery on a pacient with an incurable disease, while everyone advised against it, as the pacient would only suffer from this treatment. I know it's only a game, but this is one of the, if not, the most important aspects of being a doctor (something I am). If Stiles was not a god with healing and time stopping powers, he would not be able to operate this girl, she would die on the table, and he would have to live with this forever, but this is not real life, and lucky Stiles will just be the hero this time.

The game goes out of it's way to always hammer the point of doing good by your patients but I think it mixes feelings with something that should not have sentimental value attached, decisions are always hard to make but if we apply our morals above everything then we have no code to abide.

Queria começar dizendo que infelizmente não consegui zerar e tive que ver o resto no youtube, porque o jogo já é difícil e ainda ocorre pulo de dificuldade do capitulo 5 pro 6 que é DESUMANO, então botando isso de lado, achei a estória bem maluca, tipo, os caras (cirurgiões) desarmam uma BOMBA com a maior naturalidade do mundo e isso é insano, os personagens são carismáticos mas são meio genéricos e o final é satisfatório. O jogo quase é bom, mas a sua "jankiness" impede ele de ser algo melhor. Resumindo, foi uma experiência agradável ao todo, espero que na continuação (que ainda não joguei) tenham arrumado os problemas principais na gameplay e ainda mantenham a estória insana e não propositalmente engraçada.

6/10

EDIT: também não gostei muito do artstyle

while it has its charm using the ds' touch screen abilities to its potential by making a surgery game, it's extremely hard and at times gets aggravating.

i know difficult games are a thing that many of us love, but its bad when you go on youtube for help because the stages fuck you over continuously and people are talking about how they quit the game because it was too hard. some of those people have resorted to using action replay, which i also ended up doing because of the original game's difficulty. some of the levels feel impossible for human beings to do unless they have extremely fast reflexes or strong wrists. like, i can not inject 5 aneurysms at once when i'm at the age where my wrists are far more frail. i'm not risking carpal tunnel to beat a difficult stage.

you'd think that with action replay this will be 'enjoyable'. no, you for some reason, this game makes you DIFFUSE A BOMB when you're a doctor, which takes many losses to actually understand how to diffuse it (yes, even with ign's walkthrough). you also can't use action replay for this stage either, it's literally 'do things as fast as humanly possible or everyone dies'. what's even worse is that the lady that helps you diffuse it has experience diffusing bombs. so why throw this all on the rookie? why does she have to force you to do it? (for gameplay reasons, but i digress)

which brings us to the plot. you play as derek styles, a 26 year old 'rookie' doctor who gets a barrage of insults even if you do the surgery right when he's improving his skill and you're beating every stage with no problem. however, this finally stops when its revealed he gets a 'healing touch' that slows down time to save patients. only then do his co-workers actually start being nice to him... for some reason.

like yes, he has done numerous surgeries beforehand. but it was only when his ability showed up that his coworkers suddenly saw him in a positive light. someone on here basically mentioned that derek suddenly upgrading from a rookie surgeon to working at caduceus was unrealistic and i have to agree. actually, why did the doctors suddenly force him from minor arm surgery to doing surgeries that can actually threaten peoples lives if not done proper. WTF?

then theres the reveal of GUILT, the man-made viruses and one of the more fascinating parts of the plot. for the most part, they're pretty easy to take down. but the one with the triangles is the worst one out of all of them. it took me forever to figure out how to kill those.

perhaps atlus wanted to make this game painfully tricky to emphasize to the normal every day crowd on just how hard surgeons have it. though i highly doubt this was the case with the inaccuracies of the career itself in the game with derek. i wanted to like this game, especially with the creative surgery concept. i really did. especially since i love how ds games experimented with the touch screen capabilities. the music in the game is amazing and i love the 2000s campy anime art this game has. maybe sometimes these surgeries can be fun, but for the most part they're too tricky. the game is really hard to enjoy or recommend.

i was actually introduced to this game with the wii version my mom had gotten the family when i was really young, though i mainly watched my brothers play it and don't know the difficulty. hopefully it's a lot better than the original ds version.

my mom gave me this game when I was 9 years old because after playing animal crossing she wanted to try a game where she could pretend to be a doctor and found it too hard (i.e. didn't finish the first mission)

the reveal of GUILT imprinted on me so hard that I still think about this franchise

there are legitimate complaints about this game but I simply don't care. if I'd played even a few years later I probably wouldn't have even cared, but this game means a lot to me.

real left-field win here for atlus, adapting the grisly world of surgery to an arcade-like game designed by the digital devil saga staff and helmed by one of the designers of the hamtaro gba games. it's primarily a game of juggling various timers, specifically the main time limit, the drain on your patient's vitals, and the time until a new hazard spawns in that will increase the drain rate. kyriaki, the first of a set of viruses called GUILT that make up the second half of the game, best exemplifies this. it appears by creating an incision in the patient's tissue, which will bleed and thus increase the drain on the patient. locating one permanently requires using the ultrasound to locate it (preferably after creating the incision) and then cutting it out of the tissue with the scalpel, after it will which it will make another incision, leaving you with two extra cuts to deal with. to kill it, you target it with a laser for some amount of seconds, but leaving the laser in one place for too long will puncture the tissue, requiring you to drain the resulting hemorrhage and close the wound with healing gel. when multiple of these appear at once, you'll be put in uncomfortable circumstance of having to juggle your focus on each one as well as the various injuries you incur along the way, down to decisions such as "should I try to cut them out now or suture wounds while I wait for them to line up so I can cut them both out at once." choosing wrong can often mean a quick death for your patient, especially in particular scenarios where killing one on its own might lead to two more coming out from underneath and causing many extra incisions at once. reminds me of something like diner dash in an odd way.

draining vitals isn't a one-way street however, as you have two separate tools for increasing vitals in exchange for time. the primary one is your stabilization serum, which gives a quick burst of vitals in exchange for the time you take raising the plunger of the syringe to fill it; the amount you raise the vitals scales with the amount you fill into the syringe. alternatively, you can use the aforementioned healing gel, which lightly raises vitals as applied by rubbing the screen. both are limited resources that refill slowly when not being used and will refill completely after a short lockout when they deplete, and alternating between the two becomes a natural tendency in the later operations when simply fighting the virus on its own can't outpace the natural vitals drain. later levels extend these limitations to other tools as well: final boss savato repeatedly locks out your scalpel when severing the spider-virus's webs, and in its second phase managing your time remaining on the laser to both proactively deal damage to the virus itself as well as reactively dealing with mini-spiders it floods the tissue with imposes further considerations on when and where to strike. the best levels impose malleable rotations on the player, where multiple tools must be swapped between in series. these are rarely static, as the often twitchy viruses and the wounds they inflict will keep the player weaving in defensive maneuvers dynamically. learning this balance between offense and defense evokes the tension and precision of the real operating room.

the level of creativity on display with the operations is also worth applauding. the latter half of the game (especially the "boss rush" chapter six) begins to repeat itself a fair bit, but earlier on the game is more than happy to give one-off operations their own bespoke mechanics, from clots staggered in sequence traveling through winding veins to draining fluid from a man's lungs on an airplane undergoing heavy turbulence. the game even weaves in non-surgery elements just to keep things fresh, such as some hexagonal block puzzles and a mid-story bomb disposal. as with any game like this, duds rear their head as well. two of the GUILT strains become annoying for opposite reasons: triti and its rules for cell expansion (it's similar to conway's game of life) are poorly explained and tend to mandate a specific solution that will jeopardize the operation with any single mistake. conversely, deftera depends on two viruses colliding in order to vacuum out of the tissue, and while its random movement can be manipulated by using the gel as a fence of sorts, ultimately a good performance on these levels comes down to rolling lucky on getting good collisions back to back. falling back on more of a puzzle approach as in the former example or mechanics out of the player's hands as in the latter example can work when it's a singular operation or a break from the action, but given that both of these get repeated a few times apiece, it's hard to be quite as forgiving.

One of the earliest third-party games to really make the DS touch screen make sense, this remains one of the most unique, fun and intense games in the DS library.

It does have quite a lot of "first game in the series" stank, though. The game is needlessly picky and precise with certain actions like suturing wounds or bandaging up the patient, the last chapter is complete filler, there's no retry button on the pause menu so if things inevitably go south I hope you like murdering the patient to get it over with...

And, most importantly, the difficulty is completely off-the-rails and tends towards being blatantly unfair. This is one of those games where it lags and slows down constantly, but you'll be thankful for that because it really feels like the only way to deal with some of the shit the game throws at you.

So for those reasons I might recommend the much more polished Wii remake, Second Opinion, instead. But I do prefer controlling this game on DS compared to Wii. 'Tis a conundrum.

Under the Knife is a great game. The story is largely great, though I don't think the women are the best written (Atlus in 2005, yeah, checks out) in the story which at points really sticks out. Angie starts off particularly bad and has some questionable moments, but ultimately this is Derek's story, and for Derek, it's a pretty good one.

Gameplaywise, there is absolutely nothing like this series (and I'm upset it's a dead franchise). It's very fun to play through. I will say, Under the Knife (and Second Opinion, also) have the problem of stopping normal operations entirely midway through Chapter 3. You will operate entirely on GUILT and you will like it. Thankfully, these operations are still fun, but the game somewhat lacks diversity in what it has you do. For the controls, it's mostly straightforward, though I find the drain somewhat counterintuitive and oftentimes the sutures would just not accept what appeared visually to be valid stitchwork.

Ultimately, it adds up to a great time. And for the first game in the series, it's a fantastic start.