From the Archives: You Must Be This Awesome to Succeed

When I beat Lifesigns: Hospital Affairs (aka Lifesigns: Surgical Unit, aka Resident Doctor Tendo 2) I was ultimately very satisfied with the whole game.

But the fact that I didn’t get the “best” endings to each chapter throughout very much made me think of a now-famous video clip from popular Irish comedian Dara O’Briain, which you may have seen do the rounds on the Internet in the past.

It concerns the concept of how video games, in many cases — though there are exceptions, particularly in more recent years — demand a certain level of competence in order for you to be able to see everything they have to offer.

This article was originally published on Games Are Evil in 2013 as part of the site’s regular READ.ME column on visual novels. It has been edited and republished here due to Games Are Evil no longer existing in its original form.

Allow me to quote the most pertinent point he makes for those of you too lazy to sit and watch the full eight minutes:

“I love videogames for this reason over all other art forms; they do a thing which no other art form does.

“You cannot be bad at watching a movie; you cannot be bad at listening to an album; but you can be bad at playing a video game, and the video game will punish you and deny you access to the rest of the video game.

“No other art form does this; you’ve never read a book, and three chapters in the book has gone ‘what are the major themes of the book so far?’ You’ve never been listening to an album and after three songs the album has gone ‘dance for me! Show me how good your dancing is!’

“You’re dancing, and you’re going ‘is this good enough?’ and the album has gone ‘no!’ and stopped. Games do this all the time.”

This is actually an issue which, for the most part, visual novels tend to sidestep due to their focus on narrative over gameplay rather than, as is more typically the case, the other way around. In the case of most visual novels, it is absolutely impossible to screech to a halt and be denied access to the rest of the game; the choices you make might lead to a bad ending, but the story is always moving forwards; there’s never a stage at which you have to reload and do the same bit over and over again.

There are, however, exceptions to the rule. Aselia the Eternal, which we last talked about quite some time ago, demanded that the player get their head around the challenging strategic metagame in order to progress through the story, but dealt with the sense of “dissonance” between the two parts by blurring the lines between “story” and “game” moments rather than segregating them.

Meanwhile, Corpse Party on PSP is, for the most part, a linear run to the finish, but there are occasional points where your progress is dependent on making the correct choice and, even more rarely, successfully navigating a simple “action” sequence that usually involves ensuring you don’t have a genuinely horrendous death inflicted on you by a ghost.


Both of these games deal with “failure” in different ways: Aselia simply gives you a “game over” if one of the main cast dies, while Corpse Party “rewards” you for failure with one of its many “wrong ends” and actually, in many ways, encourages the player to seek out these unpleasant early conclusions before moving on with the plot. They both have one thing in common, though: they end the game.

Lifesigns (as we will refer to it from hereon for simplicity’s sake) handles things a little differently. While making a hash of one of the game’s relatively infrequent surgery sequences and causing the patient to die through your own cack-handedness does usually result in a “game over,” there are a number of situations throughout where the different endings are dependent on your performance in skill-based minigames ranging from the surgery sequences to cooking takoyaki at an island festival.

For example, towards the end of the game’s first chapter, two emergency patients are brought in, both in critical condition. If you save the first one within three minutes (actually relatively easy if you’ve done it once before and can remember the steps; somewhat more difficult the first time you take it on) then you can move on to the second one, save them both and be home in time for dinner. If you save the first one a little too slowly, however, the second one dies in the meantime, which adds something of a bittersweet feeling to the end of the chapter. And if, in an earlier sequence, you fail to convince your highly strung fellow doctor to calm down and handle things in a rational manner, the first patient dies, while you are able to save the second instead.


I found this really interesting, as at no point during playing the game was I aware that it was doing this; it wasn’t until I looked at some walkthroughs after progressing past that point that I discovered things could have unfolded very differently. The game handles it well; it implies strongly that things could have gone better somehow, but it doesn’t make this explicit and nor does it “punish” the player by refusing to allow them to go any further.

The effect this has in the long-term is to make the game very replayable — while the overall unfolding plot will be the same each time, as there aren’t really any “branch points” in the complete narrative, the fact that there are several endings for each episode means that you can potentially have a noticeably different experience each time you play.

I’m all for multiple endings, but I am slightly torn on how they’re implemented here — and particularly the fact that they’re so dependent on player skill rather than anything else. There’s nothing wrong with doing it this way, of course, and in the high-stakes world of emergency medicine it’s perhaps entirely appropriate that things like your ability to save both of two critical-condition patients is dependent on how quick and skilled you are with your surgical tools.


I did also find it somewhat interesting that certain things do carry across between the otherwise self-contained episodes — for example, your efficiency at performing one of the surgical procedures in the game’s second chapter determines, through a somewhat convoluted series of circumstances, which of the game’s “love interests” you’ll be able to date in the final chapter.

What I think is important, however, and the reason I’m ultimately not mad at Lifesigns for throwing me a couple of bad endings to chapters along the way, is this: never once did I feel like the game was punishing me unfairly. The few “game over” screens I did see along the way were due to my own incompetence rather than something I had no control of, and the bad endings I did get felt like perfectly valid conclusions to that part of the story rather than a sign that I had failed somehow. And, as noted above, the knowledge that yes, I actually could have done better is sufficient incentive for me to return to the game in the future and revisit it.

All this aside, Lifesigns left me with one strong feeling that far outweighed any criticisms I could otherwise level at it: I would love to see more medical drama games, as Lifesigns is absolutely proof that you don’t have to veer off into Trauma Center crazytown to make a convincingly satisfying experience. As review scores will attest, this is not something that every gamer will engage with, of course, but since when have all games had to be all things to all people?

This article was originally published on Games Are Evil in 2013 as part of the site’s regular READ.ME column on visual novels. It has been edited and republished here due to Games Are Evil no longer existing in its original form.

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