Game Description

You've just caught your breath after about six hours of breakneck activity (excuse the reference) since you came on duty in the Emergency Room at Legacy Memorial Hospital. Before you have a chance to relax, the triage nurse bursts into your cubbyhole office bearing bad news about an accident the EMS squad has just called in. They'll be here in minutes! No time to rest, finish that donut or study up on severe trauma treatment -- you've got to move, examine, diagnose, treat -- in fact, you've got only minutes, maybe seconds, to make life and death decisions and the clock is ticking.

But, no need to get in a panic yet. In Legacy Interactive's Emergency Room 2, it'll be awhile before you get to the really tough cases. The road to the top of the doctor chain in fictional Legacy Memorial is filled with decision-making, analysis, diagnostic prowess, correct treatments and essential knowledge as you work your way up from medical student to Chief of Staff. Should the road be littered with bodies instead, you can count on being out the door, stat!

There are five major levels in Emergency Room 2, each dealing with specific rank and case difficulty. You'll begin your ER career at the lowest rank, medical student, and be responsible for ear and eye problems, abrasions and contusions -- simple stuff. The level of difficulty you'll face is determined by your success or failure rate of treating patients on a case-by-case basis. For each patient successfully treated, a new one appears in the waiting room with a problem from the next higher difficulty rating. All patients reflect their specific level of difficulty through a number (1 through 5) next to their names.

Conversely, if you fail to handle patients properly for two consecutive cases, the person added to the waiting room will be at the next lower level of difficulty, effectively forcing you to treat lesser ailments. As your successes accumulate, so does your point total and, subsequently, your rank. The minimum number of successfully treated patients by rank that leads to promotion is five to become an intern, 18 for resident, 40 for attending physician and 65 to become Chief of Staff.

Case difficulty beyond the aforementioned medical student level includes burns, dislocations, sprains and lacerations at level two and nose and throat problems, fractures and abdominal pain at level three. Tougher cases are encountered with level four trauma which includes breathing problems, chest pain and concussion. Finally, level five puts the player to the real test with gun shot or knife wounds and code blue (accident) victims.

A full work-up is required for each case as you prepare your Subjective, Objective, Assessment and Plan (SOAP) "paperwork." Each element plays an important role in how the patient will be treated and runs the gamut from patient complaints in the waiting room (if lucid) to final treatment and patient discharge.

Other features of Emergency Room 2 include 100 cases from which to choose (some with varying degrees of difficulty), a wide range of patient symptoms, live video clips and more than 40 medical tools. Cyber-doctors must become familiar with several locations within the hospital such as waiting, exam, imaging and treatment rooms as well as a laboratory, lounge and library. ~ Michael L. House, All Game Guide

Roots & Influences

Emergency Room 2 is the sequel to the original game Emergency Room. More than 230,000 copies of the original game were sold serving the basis for this follow-up title. ~ Michael L. House, All Game Guide

Review: Enjoyment

Novelty wears off very quickly. I wouldn't really rather have a root canal procedure but it's close. Repetitive and lack of anything approaching exciting gameplay. ~ Michael L. House, All Game Guide

Production Credits

DEVELOPMENT TEAM

Executive Producer: Ariella Lehrer, Ph.D.

Producer: Sam Elkholy

Medical Writer & Consultant: Elizabeth Nolan, M.D., Ph.D

Programmers: Sam Elkholy, Rob Collins

Art Designer & Director: Ross Buck

Assistant Producer: Douglas Sun, Ph.D.

Illustrator: Daniel E. Oen

3D Artist: Chris Bowers

Production Artists: Dan Haas, Bill Zullo

Design Consultant: Craig Brannon, Ph.D.

Photographer: Anthony Nelson

Composer: Peter Davison

Video Director & Producer: Andre Guttfreund

Casting Director: Andrea Stone, Laurel Smith

Video Cast: Terrence Knox, Walter Olkewicz, Ellen Bry, Steve Park, Joey Adams, Matthew Flint, Pat Skipper, B. J. Jefferson, Shannon Nelson, Jami Fox, David Brisbin, Perry King

Patient Models: Alex Elkholy, Dean Elkholy, James Howard, Stephanie Jansen, Barbara Jennings, Jesse Lee, Hilda Lopez, Anthony Nelson, Bryce Nickell, Douglas Sun, Maria Thayer, Andrew Wolfson

Voice Engineering: Synchronized Soundworks

Voiceover Artists: Hilary Black, Angela Francis, Josh Gerhardt, Dan Lemshaw

Packaging: Mark Wasserman

Documentation: Beverly Werber

Customer Service: Dave Jezierski

Data Entry: Gabriela Jezierski

Game Testers: Ari Gordon, Don Lee, William Ngin, John Truong, Jason Ngen, Kevin Hogue

Special Thanks to: Ronald L. Kaufman, M.D., MBA, Ben Carlson, Wilma Bonner, R.N., and the Los Angeles County and University of Southern California Medical Center, Brian Wong, M.D. ~ Michael L. House, All Game Guide

Review: Overall

Unfortunately, I've spent enough time in emergency rooms to last a life time. So, then, why would I want to play a title that professes to immerse me in the atmosphere of an ER up to my elbows (sometimes literally)? I suppose it's part morbid curiosity and part wanting to see the operation from another perspective -- doling out care instead of needing it.

One of the first things you notice after you've read the manual and begun to screen patients is the similarity to the national obsession of people trotting to the emergency room with what are best described as non-emergency wounds or illnesses. Perhaps this is a good barometer (or should I say thermometer?) of what's basically wrong with the emergency care costs in this society -- but enough of philosophizing. Suffice it to say that the day of the general practitioner seems to be fading away along with the 20th century, if it hasn't already and I just didn't notice (too busy going to the ER).

As much as I hate to admit it, after trying to diagnose my first five patients or so in my role as a medical student stuck with the ER rotation, I failed miserably each time. The problem wasn't so much that I couldn't figure out what was wrong with the patients but that I wasn't competent enough to focus exclusively on the exact, and I mean exact, procedures that must be followed in the most restrictive sense.

Emergency Room 2 is, in the most descriptive and kind term I can use, too sterile. After playing for several hours one gets a deep appreciation for the boredom that most medical students must be faced with during their eight or 12 year studies. No wonder the general perception is that doctors seem overpaid -- I'm convinced it's not an altruistic reward at all but a payoff for the massive bouts of boredom they've had to endure while passing up on the block pizza parties and weekend beach excursions. Perhaps, though, it does show the player how difficult it must be for medical personnel to develop a decent bedside manner and demeanor and show enthusiasm or warmth toward the 22nd patient of the day.

Many of the 100 patient cases presented in Emergency Room 2 are mundane and less than exciting, unless a bruised knee rocks your world. Yes, the cases do get more difficult and intense as the game wears on but that's exactly what the game does in the long run -- wears on...you. One of the biggest faults inherent to the game is the lack of action in any room of the hospital whatsoever. Rarely (read never) do you see the scurrying about of interns, nurses and doctors -- no gurney movements, no harried looking response teams racing to the "code blue!!" call we've all come to expect from medically-based television shows and definitely no heart-pounding grab for the paddles on the latest heart attack victim.

This isn't to say that some of the cases aren't frightening in their intensity but even the most wretched of injuries is still met with a sort of plodding requirement to make sure all the t's are crossed and the i's dotted. It may well be and probably is the way medical personnel are taught -- using a strict procedure down to the "nth" degree covers a lot of, er, bases in regards to heading off later malpractice suits as well as being inherently advantageous to the patient in the long run.

I suppose ER2 functions best as a learning tool rather than in-your-face entertainment. A lengthy session or two with the game will most assuredly teach you about what medical instruments are to be used when, procedures for making diagnoses and taking full notations to fill the patient's folder, when not to order X-rays or scans, both pre-op and post-op necessities and the importance of keeping tabs on your patient's progress (duh). The game can't really be faulted for a lack of procedural and intelligent approach to instilling some level of understanding to the player on what constitutes cognitive patient care.

Speaking of the patients, this is one of the several areas where the game limps badly. Kudos for the efforts of all the patient and colleague actors but in most cases it seems as if they've missed too many episodes of Emergency Room or Chicago Hope to be remotely believable. My favorite, sadly to say, is the wise-cracking lab technician who consistently spouts bad puns or inane comments regarding some part of your general ineptitude. There is no lack of spontaneous reprimands by the in-charge chief of staff who is always ready to surgically remove your head from your body because of the numerous mistakes you're bound to make.

One of the options available to help sort out the morass of procedures, instruments and treatments needed to keep your patients from the morgue is the simple expedient of asking the nurse about what tests you've missed, which instruments need to be used in the room you happen to be in or, basically, what to do next. I don't know about you but I'd be leaping off my stretcher and heading for the nearest bar if I saw my physician ask his or her nurse for help of that nature. In that case, an ounce of "prevention" would certainly worth a pound of cure.

The sound is mostly drab and the constant sound of the intercom system calling out needs or messages does nothing to enhance the atmosphere, mainly because you never see anyone respond to anything. I suppose the lack of music is just as well since the most appropriate tune in this ER would be Taps. The interface has its own problems at times. In far too many cases you can actually get "stuck" in a particular room and no amount of clicking on another room in the drop down menu will allow you to backtrack to, say, the exam room from the treatment room. There also appears to be a small problem when the patient utters one of a wide selection of inane comments while laying on the examination table (such as, "My dad says if you screw up he's gonna sue you" or the ubiquitous "Can I stay home from work tomorrow?" and they get worse) -- it causes delay and hesitation in carrying out a clicked-on command.

I would be remiss if I didn't at least touch on the purpose of the entire exercise. By carefully and repeatedly, I might add, correctly curing your patients' multiple ills through all five levels of difficulty, you will eventually take over the hospital as chief of staff. Along the way you'll need to learn everything there is to know about what instruments are used for what ailment and the proper treatment for a vast mixing bowl of injuries and illnesses. On one positive note for the players who can't get enough of patient misery from the 100 cases contained in the game, the developers offer more cases just a download away on the Internet at www.emergencyroom2.com.

As you work your way up the ladder of success, you'll be ranked as medical student (the lowest of the low), intern, resident, attending physician and finally chief of staff. You earn points by successfully treating each patient and through accumulation of these points move up in rank. There are five levels of difficulty in terms of medical emergencies. Level 1 deals with ear and eye problems as well as cuts and contusions. Dislocations, sprains, deeper cuts and burns are treated as Level 2 maladies. All nose and throat problems, bone breaks and abdominal pain come in at Level 3. Level 4 begins to get really serious with chest pain, concussed patients and those with respiratory or breathing problems. The real action occurs with Level 5 problems of gun shot or knife wounds and all "code blue" cases.

Actually winning the game requires a steady series of successful diagnoses using all the tools provided by the Legacy Memorial Hospital in the various treatment rooms. You are responsible for your patients from the time of admission to the discharge phase. As an example, take a male patient who has turned an ankle. You'll find out about his problem first by listening to him in the Waiting Room. You'll need to find out about current immunization shots or any general information that may help your diagnosis later.

From there you study the Continuing Medical Education (CME) data available in the very same Waiting Room and Treatment Room. Then it's on to a complete hands-on (literally) medical exam -- just looking at the injury isn't enough, you've got to poke and prod to test for tenderness and discomfort. Meanwhile, one of the most important aspects on which you are judged is your completeness in filling out a SOAP -- that's a Subjective, Objective, Assessment and Plan for you non-medical folks and it is where you enter every single bit of data you learn about the patient. Ah, paperwork, paperwork!

As you dispense your valuable advice and exhibit your fledgling skills, you'll eventually need to visit all locations within the hospital: Waiting Room, Exam Room, Imaging Room, Laboratory, Treatment Room and Discharge Room. Be sure to check in at the Doctor's Lounge and Library to bone up on current medical news or treatments as well as sneaking another look at the CME.

All of this sounds like a busy and fun experience but in reality it becomes drudgery. The "last straw" status, though, is reserved for a completely unnecessary and puzzling artificial restriction -- the dreaded time limit. If you take too long in your diagnosis the patient may (will) die or, at the very least, have to be seen again and re-examined from scratch. For me, after investing considerable time getting the proverbial ball to go through the right hoops only to be "cut off" because I didn't do it fast enough made me want to file a malpractice suit of my own against the developers.

Whatever good qualities the game may have (and there are some) are easily outdistanced by the overall phoniness of the environment. The sheets covering the patients always look the same, patients begin to look the same (maybe that is reality after all), the blood always looks the same (when there is any) and, of course, the rooms never change. Oh, yes, one last thing -- never, ever hit the Escape key while playing this game. Unlike any other game that comes to mind, you are thrown directly back to the Windows desktop without so much as a confirmation "yes" or "no" option -- very annoying. Call me picky, call me choosy, call me dumb and color me purple -- just don't call me Doctor because I'll never get through this course. ~ Michael L. House, All Game Guide

Review: Graphics

The sameness begins to overwhelm you. ~ Michael L. House, All Game Guide

Review: Sound

Dismal and adds little to the experience. Annoying patient comments. The only bright spot is the Lab Technician. ~ Michael L. House, All Game Guide

Review: Replay Value

Can't imagine going through it twice. ~ Michael L. House, All Game Guide

Review: Documentation

Covers the basics well. ~ Michael L. House, All Game Guide