It’s been two
hours since you entered the trauma room. What seemed like simple
injury is turning out to be a challenging case. It will take
all your medical skills to save the patient. Attending doctor
Daniel VanDeer stops to inform you of a major fire near the hospital.
A large number of patients with mild to severe burns are expected
to start arriving any minute. You cannot seem to remember the
last time you ate or slept. A small trip to the cafeteria and
a nap at the doctors’ lounge sounds like a distant dream.
This is going to be a very long day. Across from you, nurse Jenny
Scott gives you an encouraging smile. “Hang in there Doc,” she
says, “we’ll make it through.” You turn your
attention back on your patient. You cannot afford any delays,
you cannot afford to make any mistakes. Lives are depending on
you. Do you have what it takes?

ER is
without a doubt among the most successful shows in television history.
Currently in its 11th season, the show boasts 21 Emmy awards and
a stunning 112 nominations. It would have been a daunting task
for any developer to take this critically acclaimed show and convert
it into a game. However, Legacy Interactive has managed to put
together a solid game that should have appeal to the fans of the
show and sim enthusiasts alike.

The game allows players
to join the County General Hospital staff as an intern doctor.
Fresh out of medical school, this will be your character’s
first chance to out his or her skills into professional use. The
game starts with a simple and straightforward character generation
process. Players can customize physical attributes such as eye
color and hair color. In addition, 12 personality stars can be
distributed across four character traits. The number of points
spent towards the different attributes determines your character’s
aptitude in various medical areas. For instance, increasing your
character’s intelligence greatly benefits his or her aptitude
towards neurosurgery and toxicology. On the other hand, spending
points on dexterity has the most direct influence on cardiology
and general surgery.

Upon completing the character
creation process, players can immediately start playing the game
or go through a tutorial to learn the core game mechanics. The
story mode of ER consists
of six 48 hour shifts at the Country General Hospital. Patients
will continue arriving at the hospital throughout the shift and
it will be up to your character, along with other doctors to ensure
everyone receives the treatment they need. The treatment process
in the game is greatly simplified. Patients coming into the hospital
will wait for doctors in the triage area. First, doctors have to
diagnose patients to determine what the kind and severity of their
medical emergencies. Diagnosing a patient is as simple as clicking
on them. Your character will do the rest of the work and determine
which of the 6 medical disciplines your patient’s case falls
under. Especially in the later episodes of the game, some patients
will have cases that fall under more than one discipline. Occasionally,
the doctor’s initial analysis will not be sufficient to determine
what is wrong with the patient. Thus, doctors will have to send
patients to the lab for additional tests.

After diagnosing their
patients, doctors have to choose a bed before treatment can begin.
County General has three types of beds for its patients. The Main
Exam area is for patients with mild cases. The exam rooms are designed
for more serious ailments. Finally, patients with the most severe
cases belong in the trauma rooms. The rooms differ in terms of
the medical equipment available in them. If the bed you choose
does not have sophisticated enough equipment for the patient you
are dealing with, the nurse helping you with the case will frequently
have to run to other rooms to get the required medical supplies.
Since time is crucial in treating your patients, you will have
to try and make sure your patients are sent to the proper beds.

Once you select a bed
for your patient, he or she will automatically go to it. If the
patient is incapable of walking due to the nature of her medical
emergency, technicians will automatically transfer him or her to
the appropriate bed. For the most trivial cases, your character
will be able to carry out the treatment alone. Other cases will
require a nurse to be present during the treatment process. If
a nurse is not available when you get to your patient, you may
need to wait until one arrives.

Actually carrying out
the treatment requires no medical knowledge on the players part.
A simple click on the patient starts the process. The game uses
a rank from 1 to 10 to measure the seriousness of a patient’s
ailment. If the treatment is going successfully, the level of the
patient’s injury will decrease until it reaches 0 and the
patient is cured. If the patient is not positively responding to
the treatment, his or her level will gradually decrease. Sometimes
as you perform the treatment a new diagnosis will be necessary.
The new diagnosis may require additional lab testing or reveal
that the patient’s case really falls under a completely different
medical area than what the original diagnosis indicated.

Your character’s
ability to treat the patient is also determined by the game’s
ranking system. If your doctor’s skill level in the medical
discipline associated with the patient’s injury is greater
than or equal to the severity of the case, you will almost certainly
carry out the treatment successfully. Your character will also
be able to successfully respond to cases that slightly surpass
his or her medical expertise. For instance, if a patient has a
level 4 orthopedics injury and your character has a 2 in that medical
discipline, you have a good chance of successfully treating the
patient. However, if the severity of the case greatly exceeds your
skill level, you may want to turn the patient over to a more experienced
doctor. Unfortunately, more experienced doctors will not always
be available. Furthermore, even with a perfect score in a medical
area, you will not always be able to treat the most serious cases.
The game is realistic in acknowledging that all patients cannot
be helped. Sometimes, despite your best efforts, patients will
die and you will simply have to move on to another case.

Your doctor will gain
experience as you successfully treat patients. The experience earned
can be used to improve your medical skills. There are two kinds
of experience in ER.
General experience is earned through treating all your patients
and successfully completing special tasks that will be assigned
to you from time to time. Your doctor will also earn specialized
experience by working on a medical discipline based on his or her
medical aptitude in the corresponding area. For instance, a doctor
with an excellent neurosurgical aptitude will be able to quickly
increase his or her neurosurgery skill by treating patients suffering
from ailments related to this medical discipline. The general experience
earned is measured with stars. You can view the Experience Spender
screen at any time to distribute the stars you earned across the
six medical areas. The areas in which you have greater medical
aptitude will require fewer stars before you can attain the next
skill level. As your character’s experience grows and skill
levels increase, you will be able to take on more and more serious
cases.

The game also requires
players to pay attention to your character’s personal needs.
As you go through the shift and treat your patients, you will have
to keep an eye on three stats. These are your hygiene, energy,
and composure levels. The cleanliness of your character’s
hands and body make up the two components of your hygiene. Since
bad hygiene decreases your medical skills, you will want to keep
your hands and body clean at all times. The medical rooms feature
sinks where you can wash your hands. The hospital also features
a number of showers. Like hygiene, energy consists of two components.
You will have to make sure your character gets enough food and
rest. There are many vending machines distributed around the hospital
if you need a quick boost to your energy. You can also go to the
hospital cafeteria to get a proper meal. The hospital also has
a doctors’ lounge where you can use one of the beds to take
a nap. Rest makes up 75% of your overall energy level, so you will
have to make sure your character takes some breaks in the long
48 hour shift. Your medical skills will start to degrade and your
character might even pass out if you ignore energy levels. The
last stat you will need to watch is your composure. If your composure
gets low, your character’s relationship with other staff
members and your patients may suffer greatly. You can regain lost
composure by working out, taking a shower, successfully treating
a patient, or carrying out successful conversations with your staff
members.

Building relationships
with other staff members is yet another feature of ER.
You can initiate conversations with other staff members as long
as they are not treating a patient. The game uses a ranking system
to measure staff members’ disposition towards you. Conversations
are carried out by selecting a general topic from a list. If a
staff member does not regard you as a friend, you can start by
making neutral comments about the weather or expressing your likes
and dislikes. Once you select a topic, the other character will
respond positively or negatively with a topic of their choosing.
As the conversation continues, you may be able to find out more
about the other character’s likes and dislikes. You can use
this information and bring up those topics to get positive responses.
Soon enough, you will be able to move on to more personal topics
such as confiding in the other character. After a number of conversations,
if the staff member’s disposition towards you is positive
enough, you can even kiss him or her. While there is no real obligation
to build relationships in the game, it is nice to have something
to do besides the regular hospital routine. Furthermore, your relationship
with the hospital personnel has a small impact on your medical
skills. Your will receive a boost to your medical skills when you
are close to a staff member who likes you. However, your skill
levels will drop when you are close to a person who dislikes you.

The game does feature
a number of characters from the show. Noah Wyle, Mekhi Phifer,
and Sherry Stringfield are voice actors in the game. Fans of the
show will also notice supporting characters Abraham Benrubi and
Yvette Freeman. Being able to work with actual characters from
the show greatly helps the game’s atmosphere. However, players
who are not familiar with the show will still be able to enjoy
the game since no knowledge about the show is required to follow
the events taking place in the game.

Besides the regular activities
involving treating patients taking care of your personal needs,
each 48 hour shift in ER contains
a number of scripted events that require you to perform special
tasks. These tasks can range from meeting a staff member to special
patients that you will be asked to handle personally. The special
cases often feature colorful patients such as a circus clown or
a boxer. Some of these tasks are mandatory and failure to complete
them successfully may get your character fired. While the special
tasks do not dramatically alter gameplay for long periods of time,
they do offer a chance to break from the routine hospital work
you will be performing throughout the game.

Legacy Interactive has
also included a perk and special ability system that adds a level
of depth to the game. Perks are special bonuses you can earn by
treating patients or completing special tasks. Occasionally, after
you successfully complete a treatment, an icon will appear on over
the patient’s head, indicating that they wish to give you
a perk. You can carry up to 4 perks at any given time. Perks can
be used to temporarily increase the amount of experience earned,
give you a bonus on the next patient you will treat, or increase
your levels of hygiene, energy, or composure. Some perks will even
make staff members like you better for a period of time. If you
are not satisfied with the perks you receive from patients, you
can try trading perks with other staff members. The strength of
your relationship with the staff member will determine their likelihood
of trading with you.

Special abilities give
you more permanent bonuses. You can unlock special abilities by
attaining certain skill levels in medical areas. Once unlocked,
special abilities can be activated to give your character their
bonuses. However, some special abilities give their bonuses at
a cost. For instance, the special ability Total Book Worm increases
toxicology and neurosurgery skill of you and everybody around you
at the cost of decreasing your orthopedics, pediatrics, and general
surgery skills. Only three special abilities can be active at the
same time, but players are allowed to change which special abilities
are active at any time. Thus, players have the liberty of activating
the particular set of abilities that might be most helpful in treating
particular patients.

ER has
a wide variety of elements that can make it an entertaining sim
game. However, the game does suffer from a problematic interface
that might frustrate many players. There are a number of ways to
navigate the hospital in ER.
Players can click on an area on the screen to move their characters
there. Players can also click on rooms on the minimap to quickly
order their characters to go to a specific room. By default, the
minimap shows the floor your character is currently on. You can
either click on a room on that floor or select a different floor
and click on a room there to direct your character. Once you diagnose
a patient and choose a bed, the patient’s image appears at
the top of your screen. You can click on this image to take your
character directly to the corresponding bed. This prevents you
from having to remember which bed you selected. The biggest problem
with the entire interface is that sometimes your commands will
simply not register. For instance, diagnosing a patient and opening
the bed selection panel, clicking on an available bed will sometimes
do nothing. You will have to click away from the patient and access
the bed selection screen all over again before the command will
go through. Other commands like clicking on a room on the minimap
or an area on the gameplay screen will also sometimes fail to register
even if your character is not engaged in any other activity. To
make things worse, other patients and staff members will frequently
get in your character’s way, making it unnecessarily difficult
to navigate the hospital.

The game also uses an
Area of Influence system that can be frustrating. Your doctor can
only interact with patients or staff members that are currently
in his or her Area of Influence, designated by a white circle centered
around your character. Thus, you have to be within a few feet of
a patient before you can click on them to diagnose them. This is
not a great problem with patients since they do not move around
the triage area. Staff members going about their duties however,
can become difficult to interact with since they may leave your
Area of Influence before you can click on them. To make matters
worse, since your overall view area is not very large either, staff
members can even leave the screen and make it harder to relocate
them.

Locating fellow staff
members can be another problem. The game does feature a screen
where you can see the current location of each staff member on
duty. However, since you can only see one staff member at a time,
you will have to scroll down the long list before you can see the
information about the person you want to locate. Of course, since
staff members constantly go from one location to another, by the
time you get to the room they were supposed to be in, they may
be at a completely different spot, causing you to go through the
list to locate them again. A function to page staff members to
arrange meetings could have made this process a lot easier.

ER is
not without its share of problems. The buggy interface design can
significantly detract from the gaming experience. The treatment
process may be too simplistic for some players. While the game
requires no medical knowledge, making it accessible to a wide variety
of gamers, curing patients does boil down to watching a dial go
back and forth as his or her condition gets better or worse. Players
that expect a more in depth treatment process will not be satisfied
with this system. The game could have also used a free-form mode
with no scripted events so players can enjoy the simulation at
their own pace without having to worry about special tasks. Yet,
despite its problems, ER can
be a very entertaining and addictive game to play. There are plenty
of activities at County General Hospital that will keep players
busy. ER does manage to capture the spirit
of the TV show. If you are looking for a casual sim game or if
you are a fan of the show, consider giving ER a
chance. There is plenty of material here to interest you.

Final Grade: B-
(find out more about our
grading system)

System Requirements:

• Windows® 2000/XP
• DirectX® compatible
  sound
• Keyboard, mouse, speakers
• 1.2 GHz Pentium 4/Pentium M/AMD equivalent
  or better
• 256 MB RAM
• 2 GB available hard disk space
• T&L capable video
  card with 64 MB of video RAM (ATI Radeon 7500 or greater; Nvidia
  Geforce 2 or greater)