Surgeon Simulator 2 review

I cannot stress this enough: Surgeon Simulator 2 is not a surgery game. The first game was goofy and weird—you were expected to navigate an intense night of open-heart surgery with a clumsy set of keybindings and mouse clicks—but even at its ridiculous heights, the anonymous doctor was still cracking ribs and replacing livers under the supposed guise of a medical institution. In the sequel, though, you will encounter those same challenges in radically different contexts. It completely obliterates Surgeon Simulator's foundational pitch, and instead filters the franchise through the lens of madcap physics games like Goat Simulator and Octodad.

Maybe your patient needs a new liver, but that liver can only be found by negotiating a rudimentary Mario-style jumping puzzle. Or he needs a new leg, and first you must pull off his old leg with your bare hands and hold it up to a scanner that, inexplicably, will only unlock its corresponding door when presented with human flesh, like the hospital is owned and operated by Sander Cohen. Maybe you're knee deep in surgery in an abandoned corridor, while an intercom regales you of a vast conspiracy that is producing all of these uncanny, identical bodies you're operating on.

At every turn, Bossa Studios fleshes out Surgery Simulator's mechanics, deepens its challenges, and colors in the margins until it resembles a genuine, honest-to-god video game. Meme no more.

The first thing you'll notice after taking control of Surgeon Simulator 2 is that your character is no longer cemented to the ground. They can run, jump, and crouch to squeeze through vents. The first game mapped the movement of your hand down to the tendon, but here some of that cruel unwieldiness has been scaled back. Left click closes your grasp, right click allows you to rotate your wrist, and the shift key pulls your elbow back and forth. Surgeon Simulator 2 is still a hard game to manage, but it's not quite as eager to throw you to the wolves as the original.

There is something very Portal-ish to Surgeon Simulator 2's revamped doctoring. To win each level, you need to replace part of your patient's body. Maybe they have a bad kidney, or a defective set of intestines, or, in some cases, require a whole head transplant. After identifying the ailments, the doctor goes on a scavenger hunt to find the body parts they need. The actual surgery mechanics—trying to cut out a heart without screwing everything up—is not really the point. Instead, the preeminent Surgeon Simulator 2 experience happens when you know you need a fresh left arm, but don't know where to find it.

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Those puzzles are generally well designed. In one case, I found myself on the third floor of the hospital, pulling a lever that caused a payload of spare legs to slam onto the operating floor with a huge, viscerally horrifying splat. Once you have your ingredients, it's all about keeping a steady hand. 

The bulk of your experience in Surgeon Simulator 2 will probably be spent in its story mode, which lasts 11 missions, and follows a playful, well-acted mystery that lays some of the foundational blocks of Bossa Studio's new extended universe. The player is a fresh recruit in a shabby, enigmatically conceived "surgery training school," which aims to democratize the art of operation from the moneyed private-school elites. The origins of the school get increasingly convoluted as the narrative is doled out like a System Shock-style radio play, through dueling voices over the intercom. There's not a ton of meat on these bones, but if nothing else, the story will make you consider if the right to conduct surgery, no matter who you are, ought to be unimpeachable natural law.

The campaign can be completed all by your lonesome, but at every turn, Surgeon Simulator 2 strongly encourages taking advantage of its up-to-four player co-op—to the point that the player is sorted into a public, matchmaking-friendly party when loading up a mission. I never took advantage of that option—this is not the sort of game you want to play with randoms—but I did complete about half the levels with a friend. The addition of a fellow doctor streamlined everything. It's always nice to have someone holding a new stomach at the ready right as I pull out the old one, you know?

But as always with Surgeon Simulator, it will be the calamities I remember most; the gristly pandemonium of a botched amputation is best experienced with friends. 

That said, I was a little disappointed that none of Surgeon Simulator 2's mainline missions fully take advantage of the mechanical potential of its multiplayer. The levels don't increase in complexity when you add more players, and I think Bossa left some of its more exotic, Portal 2-ish puzzle opportunities on the table. Give me a level where I'm trapped in a room filling up with water, while my only chance of rescue lies with one of my doofus friends who needs to replace a set of kidneys in time! It appears that Bossa has offloaded much of those responsibilities to its robust level creator, where anyone can create their own clockwork Surgeon Simulator contraptions. There, at least, someone can create a level that outright requires a party of four.

Nothing better shows how far Surgeon Simulator has moved from its original premise than in the user-generated material. In the first custom level I booted up, I was offered a brief tutorial on how to bug out the game and allow my doctor to fly. In the second, I played through an interpretation of the first act of Raiders of the Lost Ark. You know, in a video game about surgery.

That's just a fraction of what's possible. Build a bizarre game, and you reap the rewards of a bizarre community.

All of this makes me wonder if the Surgeon Simulator name needed to be attached to this game at all. Bossa could've left out the blood transfusions and stomach pumps entirely and made a ludicrous, smart puzzle game that was completely operation-free. But then again, that "Simulator" word was part of the joke. It's just never been funnier than it is now.