Nightmare Fuel / Trauma Center (Atlus)

This is in the first chapter, by the way. You get even worse operations later.

Trauma Center revolves around performing surgeries, so frightening moments are to be expected, ESPECIALLY of the medical variety. It might help to take a few breaths before taking care of some of these patients.

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Shared Examples

• In earlier operations, if you fail an operation, another doctor will simply take over for you, securing the patient's life. However, in later operations, whoever you're playing as is often the only doctor capable of dealing with whatever is inside the patient, which means if your patient's vitals hit 0 (or you run out of time), your patient will outright die.
• The effects of GUILT and Stigma are more reminiscent of bio-engineered diseases than natural infections. Most pathogens want to keep their host alive: 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 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 petrify the victim's organs, and if its segments aren't extracted in the correct manner, it will keep 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, 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 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), 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. Its theme (Under the Knife ver., Second Opinion ver.) features Orchestral Bombing backed by an ominous choir, adding to the tense atmosphere of fighting a malevolent, literally-heart-stopping toxin.
  • Though GUILT and all its horror-inducing injuries are fictional, the various strains are inspired by other real-life deadly pathogens or diseases that are nowhere as lethal as GUILT, but still horrific to contend with.
• The X missions in Under the Knife 1, 2, and Second Opinion not only took all the already complicated and stressful 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 Big Bad 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 Final Boss theme playing for each of these operations, for good measure.

Under the Knife and Second Opinion

• 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 the end of the first chapter is a Wham Episode, giving you the first life-or-death operation in the game. Defibrillator, done. Remove glass shards from patient's chest area, done. Open up the patient and... oh god there are shards of glass in his heart too!
• Linda Reid, a patient with suicidal tendencies, can hit a little too close to home for those who have attempted suicide or have a close friend who has. Luckily, Stiles patches up her wounds, and gives her a talk that manages to give her new perspective on life, and she gives up on her suicidal tendencies. Then her wounds re-open on their own before your very eyes, and we get our first encounter with GUILT and its effects. Also, just consider: how long were those strains of Kyriaki inside her, cutting her up from the inside?
• There is one operation where your "patient" is a time bomb. Fail to defuse it in time, or fail to keep up with its triggering mechanisms/make too many mistakes, and Derek gets a front-row seat to the bomb's explosion.
• The final Episode of Under the Knife reveals that GUILT is cultivated inside seven different children, all of which are labeled as "Sinners".
  • Imagine being in the shoes of a parent who discovers their child is a suitable subject for this nefarious purpose. No wonder why Blackwell joined Delphi to save his daughter.
  • 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 there are other children who have also been kidnapped for the same purpose but didn't manage to survive this long?
• 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 Player Punch, as not only would failure break Angie's heart, Langston Miller will solemnly tell Naomi to contact Caduceus USA to break the bad news.
• Before the final operation of Second Opinion, Owen reveals himself to be one of Delphi's agents and flashes a downright DEMONIC looking Slasher Smile before being taken into custody. While his true nature is likely unsurprising, considering his default portrait, that smile is more than enough to send shivers down your spine.

New Blood

• 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 Final Boss, if all 20 of the Final Desperation tumors explode, it takes 750 off the vitals. It literally kills the patient seven and a half times.

Under the Knife 2

• In Under the Knife 2, Neo-GUILT (particularly Sige) causes its victims to become Ax-Crazy.
  • Call it Narm if you must, but Sige-infected Adel demonstrates a rather cruel use for the Healing Touch: Using its Bullet Time properties to kill people.
    "Dr. Stiiiiiiiiiiiiiiles...do you know what else the "Healing" Touch is good for? It's also good for...KILLING◊!"
• In the final operation, part of the Big Bad Duumvirate has rigged the room to infect everyone inside with Neo-GUILT if she dies. Oh, and she has to be operated on, because she is infected with 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 Dark Matter-esque eye on the patient's heart, which has turned lavender from Aletheia's mass enveloping it.
• Remember the reveal in the previous Under the Knife that 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 boasts about his plans to use Angie to cultivate a new strain of GUILT and use Derek as its first test subject, as a punishment for Blackwell's 'betrayal' and the duo foiling the organization's plans time and again. Now you know the consequences should you fail the 'surgery' to disable the lock to the cell they were held in...
• When they are not describing Derek abandoning medicine forever, the Game Over screen for Under the Knife 2 can be quite the Nightmare Fuel implying the death of Derek and Angie at best, or even a Fate Worse than Death.
  Chapter 6-4, 6-6: Six months passed after the abduction of Derek Stiles and Angie Thompson. All leads were exhausted; no one even knew if they were alive or dead. The battle against Delphi's bioterrorism worsened day by day... And before long, Derek and Angie faded from memory.
  Chapter 7-5, 7-6, 7-7: The mission to contain the threat posed by Neo-GUILT ended in failure; modern medicine was powerless against what was beyond human understanding. Derek Stiles was never found, and his illustrious reputation faded into obscurity. To this day, it is uncertain whether or not humanity was freed from the cursed legacy of GUILT.

Trauma Team

• 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 any and all orifices, including their EYES. Sandra Lieberman (The Raging Bomber) demonstrates this, as the game gives the player a good close-up of her face while she succumbs to the disease before dying in an explosion.
  • Rosalia is a filoviridae (Ebola-type virus) that is spread by butterflies - or more accurately, the wing scales they shed during their migration period - and causes violent insanity in victims if it spreads to the brain. It also just happens to leave its trademark black bruises in the shape of a CLAW on the organs of most victims, most evidently on the liver, as the virus spreads across the body.
  • It gets worse when Naomi contracts it. Twisted Rosalia is essentially a giant caterpillar in her heart. The implications that it's the result of Rosalia and the remnants of GUILT mixing together only make it more disturbing.
  • 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 came about by the random evolutions of nature, and 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 from the Rosalia Virus, which 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 since they're in 3D, giving you the full unsettling sight of their face and hands.
• 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 and 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, killing Alyssa's parents and almost killing Alyssa herself, and leaving her orphaned. 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 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.
• Once the Rosalia virus is 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 shadowy tumor on an x-ray chart. The colony itself shows up as a black scale-like texture inside the body, which can cause unnatural bruising on the outside, and grows and swells as the viruses inside multiplies... until it ruptures and spreads the virus throughout the body, causing the victim to bleed from every orifice. At that point, the victim has no chance to survive unless they get immediate medical attention.

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