History NightmareFuel / TraumaCenterAtlus

* The effects of GUILT and Stigma are more reminiscent of bio-engineered diseases than natural infections. Most pathogens want to keep their host alive: [[ThePlague Plagues]] are usually deadly because they've jumped species from their usual host and have effects that are very dangerous for other infected hosts. GUILT and Stigma don't observe this rule - As [[SyntheticPlague genetically engineered diseases]], ''they don't care about their own survival'', simply doing everything in their power to make sure their victim is dead good and fast. If they sense that they're being threatened, they resolve to do ''as much damage as possible'' before they can be removed.
** Triti attempts to [[TakenForGranite petrify]] the victim's organs, and if its segments aren't extracted in the correct manner, it will keep [[AsteroidsMonster spreading and spreading]].
** Paraskevi in particular doesn't just try to hurt the patient - it tries to burrow its way deeper and deeper, until it's at the victim's heart. If it goes inside ''that'', [[OneHitKill it's an immediate game over]].
** Savato is essentially an ''acidic spider'' that neutralizes its victim's heartbeat and drains the energy spent by the heart to sustain itself. And when it's close to defeat, it goes ''absolutely berserk'' and needs [[TimeStandsStill the double Healing Touch]] to stop it from tearing the heart to shreds; if you've already used your manual Healing Touch (and you probably will the first time), [[UnwinnableByDesign the victim is as good as dead]] and you can only watch helplessly as it dodges your tools and makes fine paste of the patient's heart. [[{{Leitmotif}} Its theme]] ([[https://www.youtube.com/watch?v=qNTihYo5OSY Under the Knife ver.]], [[https://www.youtube.com/watch?v=bcmkrMtnkt0 Second Opinion ver.]]) features OrchestralBombing backed by an ominous choir, adding to the tense atmosphere of fighting a malevolent, literally-heart-stopping toxin.

* The [[BrutalBonusLevel X missions]] in Under the Knife 1, 2, and Second Opinion not only took all the [[NintendoHard already complicated and stressful]] [[BossBattle GUILT/Neo-GUILT surgeries]] up to an entirely new level in terms of difficulty. You will be performing them without the by-now-familiar (and perhaps comforting) assistance of Angie or any other ally - only the BigBad taunting you in the background about the futility of your struggle against them the entire time. The feeling of isolation can be quite chilling to some. ''Under The Knife'' and ''Second Opinion'' also have the ominous choir-backed FinalBoss theme playing for each of these operations, for good measure.

* There is one operation where your "patient" is a ''time bomb''. Fail to defuse it in time, or [[ParanoiaFuel fail to keep up with its triggering mechanisms/make too many mistakes]], and Derek gets a front-row seat to the bomb's explosion.

** Conversely, imagine being in Angie's shoes, having to live with the knowledge that the only reason you were spared from this atrocity is that your own father helped to inflict that very same atrocity on several other children.
** What's to say that [[FridgeHorror there are other children who have also been kidnapped for the same purpose but didn't manage to survive this long?]]

* The villain reveals after you defeat the final operation that he's suffering from diencephalic sclerosis, which he was using Stigma to counteract. Translated from medical jargon, that means that ''his brain is petrifying''. That's a horrible thing to imagine, though it does explain why he dies so quickly after Stigma is removed.
* At the end of the FinalBoss, if all 20 of the Final Desperation tumors explode, it takes 750 off the vitals. It literally kills the patient '''[[TheresNoKillLikeOverkill seven and a half times.]]'''

* At the end of one of Naomi's missions, a bomb (inside a teddy bear) that is supposed to kill Naomi is taken by Alyssa and ''explodes while she's holding it'', killing Alyssa's parents and almost killing Alyssa herself, and leaving her orphaned. [[TheBadGuyWins The Raging Bomber wins]] by killing even more people then she wanted, though you do get the satisfaction of finally catching her and witnessing her similar and grisly fate [[HoistByHisOwnPetard at the hands of her own weapon]].
** Not only that, but the bombings examined by Naomi had the bombs explode at practically point-blank range. The third and fourth victims never had a chance to see their deaths coming.

* The effects of GUILT and Stigma are more reminiscent of bio-engineered diseases than natural infections. Most pathogens want to keep their host alive: [[ThePlague Plagues]] usually are only so deadly because they've jumped species and do things that would be nothing too dangerous in their usual host, but very bad for other infected hosts. GUILT and Stigma don't observe this rule. As [[SyntheticPlague genetically engineered diseases]], ''they don't care about their own survival'' - they simply do everything in their power to make sure their victim is dead as fast as possible, and if they sense that they're being threatened, they resolve to do ''as much damage as possible'' before they can be removed.

* Just take a moment to think about what GUILT and Stigma do to those they infect. That is what could happen if someone bio-engineers a disease.
** Triti attempts to [[TakenForGranite petrify]] the victim's organs, and if its segments aren't extracted in the correct manner, it will keep [[AsteroidsMonster spreading and spreading]].
** Paraskevi in particular doesn't just try to damage the patient, it tries to burrow its way deeper and deeper, until it's at the victim's heart. If it goes inside ''that'', [[OneHitKill it's an immediate game over]].

** Most pathogens want to keep their host alive. [[ThePlague Plagues]] usually are only so deadly because they've jumped species and do things that would be nothing too dangerous in their usual host, but very bad for their actual one. GUILT and Stigma don't observe this rule. As [[SyntheticPlague genetically engineered diseases]], they do everything in their power to make sure their victim is dead as fast as possible. ''They don't care about their own survival.'' What's worse, when they sense that they're being threatened, they resolve to do ''as much damage as they possibly can,'' with the singular goal of killing the person they're in before they can be removed.
** At least GUILT and all its horror-inducing injuries are fictional, right? Turns out the various strains are inspired by other real-life deadly pathogens or diseases. They may not be as lethal as GUILT, but being subject to those diseases is not pleasant.
* The [[BrutalBonusLevel X missions]] in Under the Knife 1, 2, and Second Opinion not only took all the [[NintendoHard already complicated and stressful]] [[BossBattle GUILT/Neo-GUILT surgeries]] up to an entirely new level in terms of difficulty. You will be performing them without the by now familiar and perhaps comforting assistance of Angie or any other ally by your side, with only the BigBad taunting you the entire time in the background on futility of your struggle against them. The feeling of isolation can be quite chilling to some. ''Under The Knife'' and ''Second Opinion'' also have the ominous choir-backed FinalBoss theme playing for each of these operations, for good measure.

* There is one operation where your "patient" is a ''time bomb''. Fail to defuse it in time, or [[ParanoiaFuel fail to keep up with its triggering mechanisms/make too many mistakes]], and to nobody's surprise, Derek gets a front-row seat of the bomb's explosion.
* The final Episode of ''Under the Knife'' (not ''Second Opinion'') reveals that GUILT is cultivated inside seven different children, all of which are labeled as "Sinners".

* Chapter 6 of ''Second Opinion'' goes past where ''Under the Knife'' ends, with Caduceus going deeper in GUILT research, working with a particularly contagious strain of Tetarti. After clearing the infection, things take a sudden swerve as '''Derek Stiles, our protagonist''', ends up contracting GUILT. While he is established as a renowned surgeon, he's still just as human as everyone else is. Making matters worse is that his diagnosis of GUILT contained two strains: Kyriaki and Paraskevi, right in his heart. Paraskevi is particularly alarming as if it gets a chance to burrow, it's ''fatal''. This operation is one big dance to dodge a PlayerPunch, as not only would failure break Angie's heart, Langston Miller will solemnly tell Naomi to contact Caduceus USA to break the bad news.

* In the final operation, part of the BigBadDuumvirate has rigged the room to [[TakingYouWithMe infect everyone inside with Neo-GUILT if she dies]]. Oh, and she has to be operated on, because she is infected with [[FinalExamBoss Aletheia]] which the other half of said duumvirate has unwittingly activated. ''And'' the operation has several ways of knocking out a large fraction of her vitals or outright killing her if you make certain mistakes. Good luck.
** Aletheia itself is rather creepy, manifesting as a [[VideoGame/{{Kirby}} Dark Matter]]-esque [[EyesDoNotBelongThere eye]] on the patient's heart, which has turned lavender from Aletheia's mess enveloping it.
* Remember in the previous ''Under the Knife'', the virus was cultivated within children? We find out that such biological atrocities run in the family: Heinrich does the same with his own children.
** While Angie and Derek were kidnapped by Delphi, Heinrich openly boast about his plans to use Angie to cultivate a new strain of GUILT, and use Derek as it's first test subject as a punishment for Blackwell's 'betrayal', and the duo for foiling the organization's plans time and again. Now you know the consequences of what will happen to the two protagonists should you fail the 'surgery' to disable the lock to the cell they were held in...
* When they are not Tearjerker describing Derek abandoning medicine forever, the GameOver screen for ''Under the Knife 2'' can be quite the NightmareFuel implying the death of Derek and Angie at best, or a FateWorseThanDeath at worst.

* This game has a pretty scary one in terms of the main threat, which almost puts GUILT and Stigma to shame. The Rosalia Virus causes WAY too many people to die. And when Rosalia is in its active state, they bleed to DEATH through anything with a hole, including their EYES. Sandra Lieberman (The Raging Bomber) demonstrates this as the game gives the player a good close-up of her face as she succumbs to the disease before dying in an explosion.
** Rosalia is filoviridae (Ebola-type virus) that is spread by butterflies, or more accurately, the wing scales they shed during their migration period. While giving you a touch of AxCrazy provided it spreads to the brain. It also just happens to leave its trademark black bruises in the shape of a freaking CLAW on the organs of most victims, most evidently on the liver, as the virus spreads across the body.

** The most startling thing about Rosalia? It's not some artificial parasite or bioweapon designed for mass-murder. It's just a regular virus whose existence was not by the hands of madmen but by the random evolutions of nature. It manages to be ''even more dangerous'' and complicated to treat than GUILT and Stigma.
** The first episode of Patient Zero starts quietly before the player is forced to see the bleeding face of a woman dying by the Rosalia Virus before it starts spreading out to the people gathering around her.
* Tomoe's mission ''Resolution'' is rather creepy: you guide her endoscope through a shifting maze of collapsed rubble with only the desperate cries for help from those trapped within to guide you. The appearance of some of the victims you can find are pretty jarring and are somewhat of a JumpScare since they're in 3D, in which you can see their full face and hands. Pretty frickin' unsettling.
* Imagine being a perfectly normal, friendly and law-abiding person until one day you unknowingly become infected with a disease that causes damage to your brain that turns you into a violent, delusional psychopath. That's the root cause behind all but one of Naomi's cases -- completely normal people going insane as a result of an infection. And it can happen in real life too, particularly if one develops a brain tumor.
* The ending of Naomi's second level: Veronica suffers a seizure while she is locked in her room. She desperately calls for help, clawing her hands at the door until they bleed, which the game shows in gory detail. Her calls are unanswered, and she dies in horrible agony.
** The ''reason'' she was locked in her room - her condition caused her to go into violent fits that resulted in her ''permanently injuring her mother's vision''. There are no heroes or villains in this case, just desperate people with no real answers.
* At the end of one of Naomi's missions a bomb (inside a teddy bear) that is supposed to kill Naomi is taken by Alyssa and EXPLODES WHILE SHE'S HOLDING IT. Even though it was supposed to kill Naomi, it killed Alyssa's parents and almost killed Alyssa herself, leaving her orphaned. So in a really bad way, the [[TheBadGuyWins Raging Bomber still wins]], by killing even more people then she wanted. Although it makes it more satisfying once you finally catch her and she soon meets a somewhat similar fate [[HoistByHisOwnPetard by her own weapon]].

* The Rosalia virus is incredibly scary because once it's inside someone, no medical tool can detect it until it's too late. The virus itself multiplies and gathers together in a colony within the person's body, which can only show up as a shadow tumor on an x-ray chart. The colony themselves shows up as a black and scaly-like texture inside the body, which cans show up as unnatural looking bruises on the outside. Not only that, but the colony grows and swells as the viruses inside multiplies until it ruptures, which spread the virus throughout the body and the victim starts to bleed from every orifice. At that point, the victim has no chance to survive unless they get immediate medical attention.

** Savato is essentially an ''acidic spider'' that neutralizes its victim's heartbeat and drains the energy spent by the heart to sustain itself. And when it's close to defeat, it goes ''absolutely berserk'' and needs [[TimeStandsStill the double Healing Touch]] to stop it from tearing the heart to shreds; if you've already used your manual Healing Touch (and you probably will the first time), [[UnwinnableByDesign the victim is as good as dead]]. [[{{Leitmotif}} Its theme]] ([[https://www.youtube.com/watch?v=qNTihYo5OSY Under the Knife ver.]], [[https://www.youtube.com/watch?v=bcmkrMtnkt0 Second Opinion ver.]]) features OrchestralBombing backed by an ominous choir, adding to the tense atmosphere of fighting a malevolent, literally-heart-stopping toxin.

* Chapter 6 of ''Second Opinion'' goes past where ''Under the Knife'' ends, with Caduceus going deeper in GUILT research, working with a particularly contagious strain of Tetarti. After clearing the infection, things take a sudden swerve as '''Derek Stiles, our protagonist''', ends up contracting GUILT. While he is established as a renowned surgeon, he's still just as human as everyone else is. Making matters worse is that his diagnosis of GUILT contained two strains: Kyriaki and Paraskevi, right in his heart. Paraskevi is particularly alarming as if it gets a chance to burrow, it's ''fatal''. This operation is one big dance to dodge a PlayerPunch, as Angie would not take losing Derek too well if you screw up this operation.

* Just take a moment to think about what GUILT and Stigma do to those they infect. That is what could happen if someone bio-engineers a disease.
** Paraskevi in particular doesn't just try to damage the patient, it tries to burrow its way deeper and deeper, until it's at the victim's heart. If it goes inside ''that'', [[OneHitKill it's an immediate game over]].
** Savato is essentially an ''acidic spider'' that neutralizes its victim's heartbeat and drains the energy spent by the heart to sustain itself. And when it's close to defeat, it goes ''absolutely berserk'' and needs [[TimeStandsStill the double Healing Touch]] to stop it from tearing the heart to shreds; if you've already used your manual Healing Touch (and you probably will the first time), [[UnwinnableByDesign the victim is as good as dead]]. [[{{Leitmotif}} Its theme]] ([[https://www.youtube.com/watch?v=qNTihYo5OSY Under the Knife ver.]], [[https://www.youtube.com/watch?v=bcmkrMtnkt0 Second Opinion ver.]]) features OrchestralBombing backed by an ominous choir, adding to the tense atmosphere of fighting a malevolent, literally-heart-stopping toxin.
** Most pathogens want to keep their host alive. [[ThePlague Plagues]] usually are only so deadly because they've jumped species and do things that would be nothing too dangerous in their usual host, but very bad for their actual one. GUILT and Stigma don't observe this rule. As [[SyntheticPlague genetically engineered diseases]], they do everything in their power to make sure their victim is dead as fast as possible. ''They don't care about their own survival.'' What's worse, when they sense that they're being threatened, they resolve to do ''as much damage as they possibly can,'' with the singular goal of killing the person they're in before they can be removed.
** At least GUILT and all its horror-inducing injuries are fictional, right? Turns out the various strains are inspired by other real-life deadly pathogens or diseases. They may not be as lethal as GUILT, but being subject to those diseases is not pleasant.

** While Angie and Derek were kidnapped by Delphi, Heinrich openly boast about his plans to use Angie to cultivate a new strain of GUILT, and use Derek as it's first test subject as a punishment for Blackwell's 'betrayal', and the duo for foiling the organisation's plans time and again. Now you know the consequences of what will happen to the two protagonists should you fail the 'surgery' to disable the lock to the cell they were held in...

* At first, the operations are relatively low-tension operations: removing glass from a patient's arm, removing tumors from another patient's stomach, burning away polyps from someone's throat. Might make some players queasy, but nothing really life-threatening happening. However, the operation at [[EstablishingSeriesMoment the end of the first chapter]] is a WhamEpisode, giving you the first life-or-death operation in the game. Defibrillator, done. Remove glass shards from patient's chest area, done. Open up patient and oh god there are shards of glass in his heart too!

** Savato is essentially an ''acidic spider'' that neutralizes its victim's heartbeat and drains the energy spent by the heart to sustain itself. And when it's close to defeat, it goes ''absolutely berserk'' and needs [[TimeStandsStill the double Healing Touch]] to stop it from tearing the heart to shreds; if you've already used your manual Healing Touch, [[UnwinnableByDesign the victim is as good as dead]]. [[{{Leitmotif}} Its theme]] ([[https://www.youtube.com/watch?v=qNTihYo5OSY Under the Knife ver.]], [[https://www.youtube.com/watch?v=bcmkrMtnkt0 Second Opinion ver.]]) features OrchestralBombing backed by an ominous choir, adding to the tense atmosphere of fighting a malevolent, literally-heart-stopping toxin.

** Savato is essentially an ''acidic spider'' that neutralizes its victim's heartbeat and drains the energy spent by the heart to sustain itself. And when it's close to defeat, it goes ''absolutely berserk'' and needs [[TimeStandsStill the double Healing Touch]] to stop it from tearing the heart to shreds. [[{{Leitmotif}} Its theme]] ([[https://www.youtube.com/watch?v=qNTihYo5OSY Under the Knife ver.]], [[https://www.youtube.com/watch?v=bcmkrMtnkt0 Second Opinion ver.]]) features OrchestralBombing backed by an ominous choir, adding to the tense atmosphere of fighting a malevolent, literally-heart-stopping toxin.

** Savato is essentially an ''acidic spider'' that neutralizes its victim's heartbeat and drains the energy spent by the heart to sustain itself. And when it's close to defeat, it goes ''absolutely berserk'' and needs [[TimeStandsStill the double Healing Touch]] to stop it from tearing the heart to shreds.

* The [[BrutalBonusLevel X missions]] in Under the Knife 1, 2, and Second Opinion not only took all the [[NintendoHard already complicated and stressful]] [[BossBattle GUILT/Neo-GUILT surgeries]] up to an entirely new level in terms of difficulty. You will be performing them without the by now familiar and perhaps comforting assistance of Angie or any other ally by your side, with only the BigBad taunting you the entire time in the background on futility of your struggle against them. The feeling of isolation can be quite chilling to some.

Dr. Stiiiiiiiiiiiles... do you know what else ''VideoGame/TraumaCenter'' is good for? It's also good for... '''[[NightmareFuel SCARING!]]'''

* The [[BrutalBonusLevel X missions]] in Under the Knife 1, 2, and Second Opinion not only took all the [[NintendoHard already complicated and stressful]] [[BossBattle GUILT/Neo-GUILT surgeries]] [[UpToEleven up to an entirely new level in terms of difficulty]]. You will be performing them without the by now familiar and perhaps comforting assistance of Angie or any other ally by your side, with only the BigBad taunting you the entire time in the background on futility of your struggle against them. The feeling of isolation can be quite chilling to some.