'Doctors and nurses' - most of us have played it, either as children or adults. It's a subject matter that lends itself well to high drama, something borne out by the raft of medical soaps and documentaries bombarding our television screens on a daily basis. Given the right treatment there's huge scope for translating the tension of the operating theatre into a video game, especially on the Nintendo DS, with the stylus making an obvious scalpel, and the touch screen acting as human tissue to get stuck into. Trauma Centre takes this synergy between the DS hardware and the surgical profession, and then runs with the idea slap-bang into a brick wall of unimaginative narrative and poor level design.

Assuming the role of Doctor Derek Styles, who’s lazy, clumsy and unsure manner earn him the scorn of his colleagues. The story follows Derek from Hippocratic zero to 'last chance for the world' hero, all told through a seemingly endless procession of stills and text. This wouldn't be a problem if the story was even half decent, but the pedestrian plot centred on bio-terrorism and the development of a bio-weapon called GUILT (I shit you not) is barely enough to hold the player's interest. What's even worse is the ham-fisted treatment of complex and emotive issues like euthanasia, genetic engineering and death. Think Jack Klugman (Quincy, ME) eulogising about the evils of substance abuse, and you'll have some idea as to the overall tone.

Arguably the quality of the Trauma Centre's story should not be the measure of a game whose mechanic is based on manual dexterity, and there is much to praise Trauma Centre in this department. The surgical tools for each procedure are neatly arranged as a series of icons down the edges of the touch screen. Ancillary equipment like kidney dishes, for disposal of excised tissue, and vials of drugs pop up at the bottom of the screen when needed. This leaves a large area of the touch screen free as a workspace. The top screen is used to display messages from the assisting nurse, as well as remaining time for the operation. It's hard to fault the interface design, which is a joy to use, as are the individual tools, requiring a variety of different hand gestures for effective deployment.

For example, the syringe plunger must be drawn up to fill it with liquid from a vial. Large wounds have to be sutured using a zig-zag motion. The surgical laser must be aimed accurately with a pointing motion, and applied for the correct length of time to destroy growths without damaging surrounding tissue. The key to success is mastering the use of each tool at speed: once the first incision is made the patients vitals begin to drop, and clumsy handiwork will accelerate their deterioration still further.

To combat this you're given an unlimited supply of adrenalin which can be administered to bring the patients vitals back up. This in turn brings some strategy to the proceedings, as performing an injection may take a couple of seconds, time which could perhaps be better spent stemming the flow of blood and slowing the rate of deterioration. Should matters get out of hand the game offers one final lifeline with the 'Healing Touch'. Activated by drawing a five pointed star, the Healing Touch slows time for a while, allowing you to get back on top of things.

The Healing Touch can only be used once per operation, and the penalty for using it is no Special Bonus score when your performance is evaluated after closing the patient. Not that you'll really care, as the scoring system, as well as the game's difficulty, is all over the shop. Operations that seemed to go well may rank a 'C' and others that were bordering on disaster can earn an 'S' rank. It makes replaying levels for score completely pointless because the final assessment seems so arbitrary.

The game's most fundamental problem though is a complete lack of imagination in level design. Considering there must be hundreds of real world procedures that could have made the transition from operating table to touch screen it is so disappointing to see Trauma Centre run out of steam after just the first dozen levels. Pretty much the entire game is taken up with the treatment of the fictional GUILT in one of its seven forms, which means that instead of performing brain surgery you'll be mindlessly chasing alien bugs around the screen trying to zap them with the laser gun or slice them up with the knife. It gets tired really quickly as you're forced to perform the same (or similar) operation over and over again.

In some way you sense that Atlus realised this problem during development and tried to break the monotony with the inclusion of some out of context levels involving simple geometric jigsaw puzzles, and even a level where a bomb must be disarmed. This, incidentally, is one of the best in the game, and hopefully will be developed into a full title at some point. The inclusion of these levels does nothing to prevent the boredom setting in, however. This makes even less sense when a more obvious solution to injecting more variety into the bug hunt would be to let the player tackle two strains of GUILT simultaneously, a trick the game completely misses.

Trauma Centre is a game which heads off in the right direction, but quickly takes a wrong turn, and gets bogged down in a preposterous story and insipid level design. Perhaps more disturbingly it shows a lack of faith on the part of Atlus to release a title that doesn't follow the 'kill the bad guys' video game norm. What should have been an intelligent and elegant game of doctors and nurses has ended up as yet another incarnation of cowboys and Indians.