Long read: The beauty and drama of video games and their clouds

"It's a little bit hard to work out without knowing the altitude of that dragon..."

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Trauma Team

Medical miracle.

The brilliantly-named Hank Freebird is the resident orthopaedist, a gentle giant who looks like a cross between Arnie and The Thing from Fantastic Four. His operations represent something of a change of pace, with the patient's vitals no longer a concern and no time limits to worry about; instead there are five hearts at the top of the screen which deplete when you make a mistake. Here there's a ‘chain' system which affects your score; whether you're cutting out a piece of synthetic bone, drilling into a patient's tibia or affixing a metal plate with screws, impeccable work will see your chain increase.

A neat touch has the music gradually fading in as you progress, with a sparse backing rising in volume and a thumping beat added. It adds a little more excitement to non-life-threatening procedure, though the use of the Wii controls here is anything but routine. Whether it's feeling a powerful buzz of rumble in your palm as you drag a drill through bone between two narrow guidelines, or executing a hammering motion to whack a new ball joint into place, the use of the remote here is exemplary.

Endoscopy is next, and probably the game's weakest link, despite an inspired use of the machine in the latter stages and the presence of a ninja butler in technician Tomoe Ichibana's storyline. Thrusting the remote towards the screen mimics the real-life motion alarmingly well (and given how often games fail to make such a movement work, Atlus' skill here is remarkable) but otherwise controls feel awkward. As the nunchuk is used to move the camera viewpoint, you need to press C to both open the tool selection wheel and the same button to confirm which you want to use.

While the stories get more realistic, diseases look ever more alien. Excised polyps resemble Dragon Quest slimes without the smiley face, while tumours are shiny, gelatinous blobs.

Couple that with a lock-on system that can be capricious when dealing with multiple wounds in a small area - pretty much every op, then - and you've got a recipe for frustration. It's a nice idea in theory and a little practice goes a long way, but you'll really need to work to get a decent rank on this. Even a Trauma Center veteran like myself struggled to get above a B.

The final two areas are something completely new for a franchise previously resistant to change. In her review of Second Opinion, Keza MacDonald spoke of the game's debt to House, but the snarky, scruffy, chain-smoking diagnostician Gabriel Cunningham is perhaps the most direct reference to date, even if he does come with a hairstyle that even David James would balk at. He's partnered with a talking computer, the RONI system, and there's some nice back-and-forth between the two as the likeably irascible Gabe finds he's more than met his match in the machine.

A successful diagnosis requires you to flit between the examination room, your office and the image analysis lab, talking to and examining the patient, checking scans and X-rays for potential abnormalities before matching up the symptoms with potential illnesses. It's fascinatingly technical at times, using authentic medical terminology throughout. Even if ultimately much of it boils down to spot-the-difference, it's an interesting insight into an unfamiliar world.