As you progress you unlock new towns, each in need of a new hospital and each with their own particular challenges and quirks. In each hospital you will have to build diagnosis and treatment rooms, as well as providing facilities, refreshments and entertainment for the staff and patients to keep them comfortable and happy. As you progress, you will need to add training facilities, research departments and even marketing teams to attract patients and potential employees.
The underlying gameplay, as in its spiritual predecessor and similar titles, is space-management. Each mission map is limited in space and usually can't comfortably fit everything, so you need to make sure to skimp on space as much as possible while keeping rooms roomy enough — otherwise everyone (including your employees) will get moody and leave. Narrow corridors and rooms without windows are likely to end up bankrupting you. On some levels you can also spend money to purchase extra adjacent buildings to expand your hospital. Of course, distance between the various facilities is very important: staff need to reach the toilets and staff rooms quickly so they can get back to their jobs more often, and patients don't want to spend forever walking the hallways between the various diagnosis and treatment rooms. Not to mention the fact that emergency situations occur often, in which you'll need to provide treatment to a lot of patients within a very short period of time, including the time it takes for them to disembark from a medical helicopter or ambulance and WALK to the treatment room, and wait in line for the nurse!
Two Point Hospital was released on the 30th of August 2018 for PC on Steam. A free DLC, The Golden Toilet, was made available on launch day, all you need to do to get it was to sign up for the Two Point Studios newsletter. The first proper DLC, Bigfoot, was launched on December 5th, 2018, and introduced three more hospitals and 34 new illnesses, as well as a plethora of deco items. Workshop support was introduced on February 7th, 2019. A second paid DLC, Pebberley Island, launched on March 18th, adding three more hospitals. The alien-themed Close Encounters DLC was released on August 29th, 2019 along with the first paid-for stuff pack- the Retro Items Pack, and the eco-themed Off the Grid DLC was released on March 25th, 2020. The game was released on consoles with the first two level DLC packs on February, 2020. The game has also seen a few optional stuff items and costume pack appeared for it in the meantime. The fifth themed DLC, Culture Shock, was released on October 20th, 2020, along with the first costume packs- the paid Fancy dress pack and a sampler Zombie costume pack that is free to download. The sixth DLC themed around time travel, A Stitch in Time was released on February 23rd, 2021. A seventh themed around ambulances, Speedy Recovery was announced for release on March 15th, 2022.
A sequel, Two Point Campus, using similar mechanics but with the central theme of operating a university, was announced during the beginning of the 2021 Summer Games Fest and released on August 9, 2022.
List of DLCs
Stuff packs
- Golden Toilet (August 30th, 2018) *
- Retro Items Pack (August 29th, 2019)
- Exhibition Items Pack (March 25th, 2020)
- Sega 60th Items Pack (October 14th, 2020) *
- Sonic the Hedgehog Items Pack (July 30, 2021)
Level packs
- Bigfoot (December 5th, 2018) ^
- Pebberly Island (March 18th, 2019) ^
- Close Encounters (August 29th, 2019) ^^
- Off the Grid (March 25th, 2020) ^^
- Culture Shock (October 20th, 2020)
- A Stitch in Time (February 23rd, 2021)
- Speedy Recovery (March 15th, 2022)
Costume packs
- Free Zombie costume (October 20th, 2020) *
- Fancy dress pack (October 20th, 2020)
- Sonic the Hedgehog Costume Pack (July 30, 2021)
* Denotes free item
^ Denotes DLCs shipped free with the console ports
^^ Denotes DLCs shipped free with Jumbo Edition of the console ports
The game provides examples of:
- Aliens Steal Cattle: If a patient with Bowhine (a delusion that the patient believes they're a cow) dies, rather than fading out and maybe coming back as a Bedsheet Ghost, a UFO zips overhead and beams them up.
- Announcer Chatter: As in Theme Hospital, the receptionist will frequently announce the need for staff in a particular area of the hospital, as well as providing a few snarky comments from time to time. Two Point Hospital also adds a trio of radio DJs who burble away about various things between songs, and advertise various products.
- Artificial Stupidity: The AI is terrible when it comes to putting out fires. When a machine catches fire, the janitor assigned to put it out is purely random, meaning it might be assigned to a janitor all the way across the map rather than one outside the room. If you pick the janitor up and place him in the room, sometimes he will perform other tasks, such as cleaning up debris or watering plants, rather then putting the fire out.
- Ascended Fanboy: A number of the junior staff that worked on Two Point Hospital were big fans of Theme Hospital back in the day
. Now they get to work on a spiritual successor with the creators of the original game. - Bedsheet Ghost: If a patient dies, they might come back as one of these. They spook staff and other patients and drop ectoplasm on the ground. A trained Janitor removes these with a giant Dustbuster.
- Black Comedy: The entire game, thanks to its rampant jokes about medical incompetence, deaths resulting from that, and cynical jokes about medical practices.
- Boring, but Practical: The Christmas update added fairy lights to the game; an extremely cheap decor item that can easily be placed behind a number of items most other decor items can't and clings to walls thus not taking up valuable walking space. There's no reason not to line your Hospital walls with them.
- Bottomless Bladder: Averted. You have to build toilets for your patients and employees.
- Brainwashed: Occasionally the CEO of a rival hospital organisation, The Orb Foundation, will show up at your hospitals and walk around, hypnotising patients and staff (by doing a silly dance). Brainwashed staff will quickly grow miserable, and brainwashed patients will either storm out or refuse to pay.
- Church of Happyology: The Orb Foundation.
- Classically-Trained Extra: Sir Nigel Bickleworth, one of the radio DJs, is portrayed as a jobbing classically-trained actor reduced to hosting local radio. He sounds like a cross between Rex Harrison in My Fair Lady, and Frasier's Gil Chesterton. He shows open contempt for both the listeners and his job as a radio host, regularly complaining about the music he is forced to play, the advertisements he has to read, and casting aspersions on the intelligence of his audience for liking anything he doesn't like.
- Colour-Coded for Your Convenience: Hospitals and their staff are colour-coded. Doctors wear white labcoats; nurses wear dark blue scrubs; assistants wear light blue vests; janitors wear brown dust coats. Diagnostic rooms have green-trimmed walls; treatment rooms have blue trim; hybrid rooms have purple; utilities have yellow.
- Comically Inept Healing: Holistix, one of the rival hospital companies, is staffed with outright quacks shelling out holistic medicine that is both useless and extremely overpriced. Inverted if you manage to piss off their CEO - he sends you a vial of "homeopathic poison" that's just as ineffectual as their medicines, and is actually very tasty to boot.
- Corrupt Corporate Executive: Jumbo McNally, the head of one of the rival hospital companies.
- Country Switch: The game is officially localized for nine languages and actually detects the locale of your PC and choose the language accordingly. However, even if you use the English locale, there are actually subtle differences between the North American English locale and UK/International English locale- one of the differences being in the North American English locale, the announcer would sometimes announce that a blue car is being taken for crushing, while in the UK/International English locale, the announcer would sometimes announce that the blue car is taken for cubing instead.
- Deadpan Snarker: Tarquin Foxbridge, the Minister of Health, has a very snarky tone in several of the letters he sends you, even the ones where he's congratulating you for creating a three-star hospital.
- Early Game Hell: The earliest parts of each level are by far the hardest. Money is extremely tight, making it very difficult to afford the rooms you need and training for your staff. Often you'll have to barely scrape by and run deficits for months while you scrimp and save to get the rooms necessary to diagnose and treat every illness, along with getting your staff trained up to competent levels so they don't bloat the queues with multiple diagnostic sessions for each patient. Once your staff is properly trained and you have all the rooms you need, the money situation generally becomes far more stable.
- An Entrepreneur Is You: The game revolves around setting up a profitable hospital. While not as numbers-driven as some business sims (you can easily breeze through the first few towns without having to pay attention to anything besides how much money you have left), you will still need to juggle staff wages, loans, prices and operating costs to some extent.
- Erudite Stoner: Harrison Wolff, one of the radio DJs, is this one, with his slow speech and random ramblings.
- Everyone Hates Mimes: The medical condition "Mime Crisis" gives patients the classic white face and stripey jumper, and they stagger around the corridors miming as if walking into a strong wind. A trip to the psychiatrist fixes them right up (or rather hopefully that'll be the case).
- Explosive Instrumentation: Poorly-maintained medical equipment in the game will explode when shaken. The hospital itself, however, is largely earthquake-proof, though earthquakes do cause plaster debris to rain from the ceiling.
- Failed a Spot Check: It's possible for a doctor to not be able to diagnose a patient, even if said patient has a giant lightbulb for a head in a world where having a giant lightbulb for a head is a known medical condition, or realizing their patient is a clown suffering from a clown-based medical condition, among many other obvious medical conditions.
- Formula-Breaking Episode: Several levels shake up the standard build-profit-expand gameplay cycle in minor ways:
- The town of Duckworth-Upon-Bilge challenges you not to build a private hospital from scratch, but to expand and maintain a public hospital. This means you don't get money from diagnosis and treatments, or even vending machines, and instead have to fund your hospital by completing challenges.
- The Underlook Hotel level in the "Bigfoot" DLC has a similar mechanic; patients do not pay for diagnosis or treatments, but the resort hotel covers a percentage of your operating costs, based on your cure rate over three (in-game) months, and you get bonuses for completing additional challenges.
- Overgrowth in the "Pebberley Island" DLC gives you the challenge of building an outdoor hospital. The same basic rules apply, and the room building mechanics are identical, but patients and staff are freer to move around between areas of the hospital with no walls to constrain them. Rather than purchasing new plots of land, new areas to build on are instead unlocked by completing challenges (curing a certain number of patients, promoting and training staff, etc.), and you advance through the star ratings by unlocking more plots of land.
- Topless Mountain in the "Pebberley Island" DLC, Camouflage Falls in the "Close Encounters" DLC and Mudbury Festival in the "Culture Shock" DLC all have patients arrive in waves instead of continuously, normally with each wave bigger than the last (though occasionally you'll get a smaller wave of patients who all have just one or two ailments, instead of a broad mix, requiring you to scramble and build more treatment rooms for just those illnesses). This places a greater emphasis on staff and queue management, as you'll need to clear the wave as quickly as possible to avoid operating at a loss for too long.
- Goldpan, the first map from Close Encounters, has owning plots as a requirement for advancement. Unlike every other map, Goldpan's plots require accepting and meeting their challenges instead of just buying them.
- All of the REMIX versions of hospitals have some kind of unusual initial setup with a single, difficult goal. Examples include requiring research to unlock hospital space, and starting with a large amount of cash and staff but no training and several hundred fracture-ward patients coming.
- Future Spandex: The symptom of the illness "Science Friction", introduced in the "Close Encounters" DLC - patients are stuck in skin-tight silver jumpsuits, suffering with terrible chafing!
- Freudian Couch: Used in all psychiatric therapies.
- Friendly Rivalry: Sophie Nova of Bungle Tech is the only one of the rival CEOs to not directly harm anything in the hospital during her visits. She clearly states that her intentions are to see the tech you're using before her visits, and if she likes what she sees, offers free research points when she leaves.
- Gender-Blender Name: The game's name generation engine is not tied down to the NPC generation engine. This results in characters with feminine looks but a male-sounding name and vice-versa.
- The Greys: The "Close Encounters" DLC adds alien visitors who sneak into your hospitals (in Holographic Disguise) and drop litter, rummage through your bins, and - gasp! - queue-jump! Their appearance, once unmasked, is the stereotypical grey alien.
- Hammerspace: It's where janitors keep their brooms, vending machine supplies, trash bags, and ghost-fighting Dustbusters.
- Healing Hands: One of the random perks doctors and nurses can have, which causes patients' health status to increase.
- High-Tech Hexagons: The DNA Lab's Healixir is made up of a bunch of hexagons, as is the room's decor.
- His Name Really Is "Barkeep": Sir Nigel Bickleworth is not a knight. "Sir" is his first name.
- Holiday Mode: Starting late October 2018, Halloween mode was implemented, with new spooky songs and effects like bats flying overhead and Jack-o-lanterns on the hospital premises.
- The December 2018 update implements Christmas mode, with new Christmas-sy tunes. It also drops with the first paid DLC in the gamenote , which unlocks several new hospitals further north in the game map as well as new illnesses to cure.
- Incompetence, Inc.: Bungle Tech are an extreme example of this. Pretty much anything they make is defective or blows up. The hospital you run in Melt Downs is one previously owned by them which they had to abandon due to an incident in research that's never fully explained. Whatever happened there had to have been spectacular, since it's full of rubble and broken treatment machines. Their CEO has the same walking animation as the Fracture patients, presumably to reflect the injuries she's sustained due to the company's negligence.
- Instant Bandages: Patients with various broken bones come in already wearing bandages and casts. The treatment is a stretch in traction, followed by removal of the bandages using a silly machine.
- An Interior Designer Is You: You are able to decorate your hospital corridors and rooms with all sorts of decorative items, including posters, potted plants, artworks, and gadgets like radios and clocks. Most have no direct effect, but they do increase the attractiveness of the environment which in turn improves the mood of patients and staff.
- Is This Thing Still On?: The trailer video ends with the doctor who was hosting the video declaring "Can I go play golf yet? I'm teeing off at 3!"
- Justified Tutorial: Of sorts in regards to Sandbox mode. When you boot up the game for the first time, Sandbox is locked and the only way to access it is to achieve a One-Star rating on the first three hospitals in Career mode (Hogsport, Lower Bullocks, and Flottering). These first three levels are essentially tutorials that teach you the bare-bones basics of the game such as: Building rooms, buying/upgrading/fixing equipment, diagnosing/curing illnesses, and hiring/training your staff. Once you get a One-Star rating on Flottering, Sandbox mode will be unlocked and yours to play.
- Kaiju: The disease "Metropolism" has patients who arrive at the hospital dressed as giant reptiles ("Reptile Metropolism") or robots ("Mechanical Metropolism"). The cure for both variants is to give the patient a big cardboard city to trample, snapping them out of their delusion.
- Losing Your Head: The treatment for Lightheadedness, although it's replaced. The patient will reach for their open larynx wondering where it went.
- Naked People Are Funny: One of the illnesses is "Emperor Complex", where patients stroll around stark naked believing themselves to be clothed. They also have a tendency to do, as the game's art director put it, "everything you wouldn’t want a naked person to do in front of you" - stretching, bending over and so on. Once cured of this delusion, they leave pretty quickly!
-
Nintendo Hard: Some of the levels require ungodly micromanagement skills in order to proceed. This is especially pronounced in the second and third Culture Shock hospitals where the payout is really low. Building one room a wave too early? It will come back and bite you in the next wave. - Only Sane Man: The Two Point Foundation is certainly quirky and some of your treatments overcharge the patients for simple cures (i.e. pulling a pot off a person's head for thousands of dollars), but in comparison to your rivals, you're downright professional.
- Ricky Hawthorn is significantly more sensible and professional than his coworkers, Conspiracy Theorist and Erudite Stoner Harrison Wolff and incredibly pretentious Classically-Trained Extra Sir Nigel Bickleworth.
- Paper People: The illness "Flat Packed" (introduced in the "Close Encounters" DLC) has patients arrive at the hospital made out of corrugated cardboard. They're thin and flat, and tend to crumple up and float around like paper.
- The Paranoiac: Harrison Wolff is just as likely to ramble about (hilariously) weird conspiracy theories as he would with non-sequiturs.
- Parody Commercial: Two Point Radio plays them every now and then between songs. Keeping to the consistency of the game, there are ads for Burp Soda, Palpitation, Cheezy Gubbins, Briney Brittle, ProbabiliTEA and more, which are sold by vending machines in your hospital. There are also ads for your rivals' hospitals as well as the banks, and if you had bought the corresponding DLC, ads for something related to the DLC (ie Underlook Hotel, a new housing estate at Goldpan, etc). Also, the game's opening cutscene is a commercial for your hospital.
- Percussive Maintenance: How the janitors repair and upgrade machines - whacking them repeatedly with a wrench.
- Pictorial Speech-Bubble: The most urgent status of your patients and staff members is communicated by a pictorial speech bubble floating above their head (hungry, thirsty, tired, bored, needing the toilet, needing a break, health level, etc.). More detail can be discovered by clicking on the person.
- The Pig-Pen: Jumbo McNally, CEO of a rival hospital, will occasionally visit and drop litter everywhere he goes.
- Pixellation: Used to censor people on the toilet, undergoing surgery, or suffering from "Emperor Complex". Also the main symptom of the disease "8-Bitten".
- Potty Emergency: Patients who cannot make it to the toilet will pee and poop on your hospital floors.
- Punny Name:
- Nearly every single disease in the game.
- The title of the game itself has a clever double meaning. Not only is it a spiritual successor to Theme Hospital, making it a kind of "Theme Hospital 2.0", but graphical advances mean that the Isometric Projection of Theme Hospital is now replaced with true 3D graphics in two-point perspective.
- Rage Quit: An In-Universe example that, while it doesn't completely match the trope, is accurate to the patients. Patients have their own needs, and if they reach zero, they'll leave your hospital in a very furious mood, denting your reputation as a consequence. Further lampshaded when that happens - the status text when they're doing that actually reads "Rage quitting"!
- Real-Time with Pause: Though this is a real-time strategy game, you are able to slow down and pause the game to build rooms, move around staff and perform other activities. Some actions, such as building on a new plot of land or upgrading a machine still have to take place in real-time.
- Room 101: The treatment for Jest Infection, disguised as a circus tent to make the clown patient willingly walk in. It's described as removing the patient's sense of humor entirely and permanently, by exposing them to an extremely depressing whirlwind until they snap out of being a clown.
- The Scrappy: In game example - the radio DJ Sir Nigel Bickleworth is hated by both his colleagues Harrison Wolff and Ricky Hawthorn.
- Screen Shake: During the frequent, powerful earthquakes and volcanic eruptions of England.
- Screw This, I'm Outta Here: Keep your patients waiting too long, or deprive them of food, drink, warmth and entertainment while they wait, and they'll storm out in anger, denting your reputation in the process.
- Shout-Out:
- The title of the game itself doubles as a shout-out to Twin Peaks.
- The illnesses and clinics, as well as having Punny Names, also have shout-outs to various media:
- "Mock Star" patients dress and behave like Freddie Mercury in his iconic 80s-era yellow jacket. The Flavor Text describes sufferers as "sadly ga-ga".
- "Night Fever" patients dress and behave like John Travolta in Saturday Night Fever.
- Patients coming in with a saucepan stuck on their head ("Pandemic") have it removed in the "Pans Lab".
- "Bogwarts". The Flavor Text suggests that as well as being cured by a visit to the pharmacy, it could also be cured "by witchcraft".
- "Spinal Bap" references the band "Spinal Tap", itself being a functional band in the movie This is Spın̈al Tap.
- "Mime Crisis" is very closely named to Time Crisis, although the two are vastly different.
- The illness "Mucky Feet" is named in tribute to Mucky Foot, the studio that was set up by former Bullfrog employees and which developed Startopia, another Space-Management Game.
- A disease that drains the patient entirely of colour, leaving them monochrome, is called "Grey Anatomy". The show's name itself is a shout out to the 1858 textbook "Gray's Anatomy", which is about the human anatomy. That makes the disease a shout out to a shout out.
- A special freeplay weekend introduced patients coming in with head crabs from the Half-Life series.
- The treatment for "Wanderust", a disease that makes patients crave for excitement by putting themselves in dangerous situations, is a trip through the "Counterfeat", a machine that simulates an Indiana Jones-style ancient temple full of booby traps. Naturally, these include spikes popping out of the walls, a collapsing floor, and the iconic giant rolling boulder.
- "Space Caged" is an illness caused by watching too much sci-fi, and sufferers dress up wearing an overturned garbage can with a plunger sticking out of it.
- "Reptile Dysfunction" causes sufferers to think they're dragons, complete with costumes, and one symptom is "a newfound romantic interest in donkeys".
- "Shifting Perspective", introduced in the Culture Shock DLC, is an illness where the patient is unable to tell if objects are "small or far away", in reference to the famous cows scene in Father Ted. The Flavor Text even says it's caused by "Sundays on the island", in reference to the show's setting of Craggy Island.
- "Monopolies", a disease where patients arrive dressed like Uncle Pennybags, and with a compulsion to "spend all their money on racecars, top hats and thimbles".
- "Slackbladder", introduced in the Stitch in Time DLC, is a shoutout to Blackadder (not just in sounding similar, but in an episode of Blackadder Goes Forth, Lord Flashheart insults Blackadder by continually referring to him as "Slackbladder"). Sufferers are afflicted with "an insatiable desire for political power", much like the series' protagonist.
- Staff character names include Longbottom, Lovecraft, Dynamite, Kilmister, McBoatface, Gamgee and Tobias Funkle.
- The tutorial for janitorial work is titled "Charlie Work".
- The guest trainer in diagnostic medicine is named "Dr. Gregory Mouse".
- The arcade machine, one of the unlockable items of furniture, is clearly playing a game of Sonic Mania - the title screen music plays faintly when the machine is in use, and the screen shows Sonic running through the Flying Battery Zone. Being published by Sega allowed for this little easter egg.
- Another arcade machine, this time featuring the game Dungeon of the Endless, was added into the game shortly after.
- And then the Sega 60th items pack adds a ton of Sega arcade machines, including a statue of the one-eyed mammoth from Space Harrier, an OutRun machine, a Sega Periscope machine, and even a Sega Dream Catcher crane machine.
- Swindles Bank (one of three banks that provide loans to cash-strapped hospitals) has a two-headed griffon in a ring of circular dots as its logo, a clear parody of the now-defunct Midland Bank. This also counts as a shout-out to Theme Park, the UK edition of which was sponsored by Midland Bank and prominently featured the logo.
- One of Sir Nigel Bickleworth's radio interludes has him complaining about the terrible writing of a frozen peas advertisement he is forced to read out, parodying the famous Orson Welles outtakes for a series of 1970 Findus frozen foods advertisements.
- Sir Nigel Bickleworth's personality itself is also a Call-Back to a particular William McDuff from The Movies, right down to his thespian background. Unsurprisingly, said game was by Lionhead Studios.
- Occasionally, the hospital announcer will call for "Doc Brown to the roof please, that's Doc Brown to the roof."
- One of the later areas you can run your hospital in is called Sweaty Palms. This is a call back to the disease in the original Theme Hospital.
- One of the punchlines in the opening blurb of the Rotting Hill hospital (which could be a shout-out to the film, Notting Hill, or simply the district of London from which the film took its name) is that the hospital "smells vaguely of cabbage", one of the random attributes that were included in staff descriptions in Theme Hospital.
- Janitors with the ghost hunting ability capture the ghosts of dead patients by sucking them up with a vacuum cleaner.
- Another shout-out to Theme Hospital comes in the Bigfoot DLC pack, which adds the illness "Bloaty Dread", a reference to the "Bloaty Head" illness in its predecessor.
- The first DLC pack, "Bigfoot", adds several new locations to build hospitals, including a snowbound mountain-top hotel called "The Underlook Hotel". You can also hear it being mentioned on Two Point Radio at times.
- When Christmas Mode is active, one of the seasonal songs the radio plays is called Aurora the Explorer. Thankfully it's really good and is not repetitive to the point of driving the player mad.
- For the 30th anniversary of the Sonic the Hedgehog series in 2021, the game added costumes of Sonic, Tails, Knuckles, and Amy as well as Sonic the Hedgehog decorations.
- The Shrink: Psychiatry is one of the specialisms that doctors can have. The patient lies on a Freudian Couch as they get diagnosed or treated by them.
- Sliding Scale of Gender Inequality: While Theme Hospital had only male doctors and handymen, and only female nurses and receptionists, Two Point Hospital redresses the balance with male and female staff members in every role.
- Spiritual Successor: To 1997's Theme Hospital; several senior members of the development team worked on the original game, while much of the junior members of the staff have confessed to be fanboys of the original. Two Point Hospital has a lot of the same mechanics, but expands and improves on them in numerous ways, such as being able to train all members of staff and not just doctors, and being able to go back to previous hospitals to continue running and expanding them.
- Stealth Pun: Janitors capture ghosts with handheld vacuums, like Dustbusters. Making them... Ghostbusters.
- Stuff Blowing Up: Earthquakes can damage your equipment, and they can explode, in which at that point, you have to replace them.
- Stylistic Suck: Cleverly done with patients suffering from "8-Bitten", a disease that causes them to appear pixellated. Far from just being a mosaic filter, patients even get downgraded walk cycles (with fewer frames than other people) and only 8 viewing angles - watch an 8-Bitten patient while turning the camera around and notice they will "snap" to a new angle every 45 degrees, exactly like in isometric games where the sprites are only drawn from a few specific angles. When treatment is unsuccessful, patients will still exhibit some of the symptoms, losing the blocky appearance but keeping the jerky walk cycle.
- Timed Mission: A couple of varieties. You will occasionally get emergency cases, where multiple patients all suffering the same malady arrive at once, and must be treated within a certain time period (thankfully they don't need to go through the diagnostic process, and you only need to cure more than half to succeed). At other times, you will receive a timed challenge from a staff member to improve something about the hospital, such as curing a certain number of patients, avoiding any deaths, or increasing the attractiveness of the hospital or a particular room. Thankfully, both emergencies and staff missions are optional.
- Toilet Humor: When the, ahem, call of nature gets too urgent for a character, they will usually dash towards the nearest bathroom with their hands clutching their... pertinent areas. Leave it too late, and your janitors will be mopping up yellow puddles...or even brown leavings!
- Video Game Cruelty Potential: While your goal might be to cure patients, it's entirely possible to torture them instead. Want to give the entire hospital a single toilet so you can watch hordes of people queue up until they wet themselves? You can do that. Want to block patients in until they starve, dehydrate or die of their illness? You can do that. Want to send them for treatment when the doctors have only the vaguest idea what's wrong with them? Well, it'll get them out of the door quicker, one way or another...
- This can easily be done in freeplay mode, where you can act as a "malevolent god" to your hospital*, and easily get away with your punishments.
- As Let’s Game It Out hilariously demonstrated, you can make extremely bizarre design choices that can be considered cruel in Real Life, such as putting a bunch of windows in a shrink office and putting chairs behind it so others can watch you, putting a bunch of windows in a bathroom so there’s a complete lack of privacy, filling the exercise room with only one treadmill and dozens of radiators, filling the hospital with a bunch of anatomy/skeleton models to make guests uncomfortable, and overall making your hospital look like the architect who made it was on acid. Other than the possible hindering of guest movement, this doesn’t really affect the gameplay that much, but just the sheer thought of a hospital having these features provides a good dose of Black Comedy.
- Video Game Cruelty Punishment: However, every patient death, failed cure and rage-quit will take a notch off your reputation. Do that for too long, and you won't attract patients, you won't be able to pay your bills, and your hospital will inevitably fail since no one will come for treatment.
- Video Game Time: The in-game clock passes pretty quickly, with each day lasting about 7 seconds on normal speed, yet the staff and patients move around at a normal walking pace. This means that patients often spend over a hundred "days" in the hospital, from checking in to checking out (either literally or figuratively). However, rooms are constructed instantaneously, and putting up a new building takes a couple of in-game weeks (a couple of minutes of real-world time).
- Visual Pun: Most of the diseases.
- Animal Magnetism: the patient has little critters stuck to him.
- Light Headed: the patient's head has turned into a giant incandescent light bulb.
- Litter Bug: an infection that causes the patient to randomly drop garbage.
- Rock Bottom: the patient's butt has petrified.
- Weapons That Suck: Patients who die in your hospitals come back as ghosts that spook other patients and staff. Getting rid of them requires a janitor with the ghost-catching skill; they remove the annoying spectres with a hand-held vacuum cleaner.
- Who's on First?: A easily missed joke on the radio- occasionally, the radio would play a song called "Come On Over"- by a group called "What? Where?"
- X-Ray Sparks: Patients suffering from "Shock Horror" randomly emit bursts of electricity, causing them to appear momentarily as glowing skeletons.
