A Reflection on Surgeon Simulator 2013 [Fargo Spoilers]

by demonboxed

Surgeon Simulator 2013 is a joke.  Fine motor movements are mechanically exact while simultaneously awkward.  Objects either sink into or rest upon the environment and it’s not always clear which will be the case.  And yet, within the niche that Surgeon Simulator resides, the game stands out as curious and notable.

Mechanically the game is quite narrow.  You can hold, lower, and swivel.  Any direct contact within the game world is a variation of these three inputs (e.g., holding a scalpel, lowering a baboon heart, rotating a fire extinguisher).  These inputs are consistent; that the game is mechanically sound is part of the joke.  The game presents a goal within the confines of a fixed playground (a virtual patient) while employing a control scheme that side-steps convention.  In doing so the game presents clear guidelines, goals, and well-articulated controls.  It also frequently devolves into an erratic and spontaneous play in which culpability is a relaxed condition.

It is worth describing the controls.  The mouse moves the surgeon’s arm, when depressed left-click lowers the arm, when depressed right-click directs mouse movement to pivot the wrist and hand, and AWER[SPACE] control the individual fingers of the surgeon’s hand.  The controls don’t vary and thus can be predicted.  Complications in surgery, though, can quickly escalate.  As such, movement often proves to be slippery and fallible.

The procedures are mostly dotted-line simplistic, in which organs can only be separated by manipulating a pointy object (sometimes a scalpel, though creativity is well-supported) through specific lines of demarcation.  Where the organ will cut is predetermined.  Connecting a tool against other parts of the body will cause additional blood loss but will not allow for dissection.  The exception to this are bones, which can be procedurally cracked, broken, and cleared.  The key to a successful operation is limiting blood loss, which flows freely whenever a tool comes in contact with any part of the body.  The game scores you on how little blood is lost during the duration of a given procedure.

Subjugated by an awkward control scheme the game performs less as a surgery simulator and more as an arm, hand, and finger simulator.  As an arm/hand/finger simulator it fails to connect to the subconscious feelings one associates with natural movement.  It provides both an opportunity for articulated movement while setting this control outside of instinctive and comfortable delineation.

None of this is to suggest that control-based errors are the game’s fault.  The control scheme is consistent, though obfuscated from familiar muscle-memory.  Patient death is generally a result of player-error; a failure to conform to the controls afforded within the game.

Surgeon Simulator 2013 is an exploration into exact, intentional movement placed, mischievously, behind a layer of unfamiliar abstraction.  That the movement/control is outside of one’s expectation is a decision reflected in a handful other notable games, such as QWOP and Receiver.  These three games tap a distinctive nerve and, as such, not everyone is going to appreciate their unique takes on the duality of expectations and expression.

In addition, Surgeon Simulator is a game that encourages revelry in controlled chaos;  recent games like Hotline Miami and Monaco make unexpected comparison pieces.  The player exercises distinct control of progress though often finds themselves awash in a sea of complications.  Though this negotiation of control in chaos could be used to describe multitudes of games, there is a sharpness to the way overall control is served in Monaco, Hotline Miami, and Surgeon Simulator 2013.  There is a specificity and exactness to all three of these games despite the looseness of play.

None of the above addresses a key, unanticipated note: in misdirecting the expectations of the player (e.g. through tongue-tied movement juxtaposed with pin-point objectives) the game reaches a mark of unexpected charm.  Even the title of the game helps to misidentify the experience; it distorts expectations as much as it serves to build them.  Despite assurances implied in the name, Surgeon Simulator 2013 as much about removing an organ as it is about inserting a floppy disk.

Despite inhabiting a main character who commits heinous acts of surgery, Surgeon Simulator 2013 is a game largely defined by its persistent role in diminishing player responsibility.  Thanks to key layers of abstraction the developers grant agency in the horror-show that is Surgeon Simulator while sidestepping transfer of full, unobscured culpability onto the player.  In removing the crutch of familiar muscle memory, plausible deniability allows one to more freely appreciate the dark humor in gameplay failings.

More familiar, conventional control would likely prove to be either too vulgar or too boring.  There is a lot of blood loss in the game.  If the hemorrhaging were due to sadistic gameplay then Surgeon Simulator 2013 would be untenable and grotesque.  Alternatively, if direct control led to surgical accuracy and more demanding procedures any sense of “fun” would likely dissipate.  Surgery simulators have been on the market for decades and these simulators are, notably, not games.  While there are a few examples of surgery being featured in video games  (e.g., the Trauma Center series) these forays are limited.  A key difference between Surgeon Simulator 2013 and actual surgery simulators is the difference between simulation and arcade play.

This game may not be for everybody.  Some players will find the obfuscation of controls to be tedious and sloppy.  Some will find the control scheme to be simply impenetrable.  There are those who will view the experience as a lame joke, without merit.  None of these critiques fully fit into my impression, however.

For me, Surgeon Simulator is a game about tempered control in a cartoon world.  I find this theme to be explicit in all control exercised in the game world.  As such, their is a light connection between player action and culpability. What would otherwise be responsibility is transferred to a sense of macabre humor in chaos.  Much what I find effective in the game can be pinpointed to the gains afforded in misdirecting player expectations.

In 2001 Takako Konishi visited Minnesota, far from her home in Tokyo.  She died in a snowy field.  It was theorized at the time that she froze to death attempting to uncover the money buried by the character Carl Showalter in the film Fargo.  This theory is likely only a fiction.

Despite the reality of Takako’s passing, this urban legend plays well into many of the themes of Fargo.  One critical element to the film is a traumatic disconnect between intent and resolution.  As the players in the film progress the plot there is an unraveling in the gulf between their expectations and the execution of these expectations.  One of the key victims of this rift being Jerry Lundegaard, who reasonably may not have wished for the death of his wife.  He is, though, responsible.   Another notable example is the distance between the expectations of Carl Showalter at the start of the film and the conclusion of his thoughts near the end.

Some viewers find Fargo to be off-putting. While I do not agree with this assessment, there is a sharpness to the film that clearly underscores its overall impact.  I find the exercise of working against the expectations of key characters mischievously enticing.  In many ways, the film serves as a reflection on the loose binds of control in chaos.

There is a significant weight to the film when measuring the cost of tragedy earned through soiled choices.  These are characters who do not, if anything, avoid culpability.  If the urban myth is true and the death of Takako Konishi is tied directly to Fargo then the tragedy is further heartbreaking in some deeply unintentional ways.

There is an underlying humor throughout much of the film, despite the tragic outcomes of many of the chief characters.  This balance works in a film.  Once tragedy is brought to the material world, there is a bluntness that deflates any humor.  While Takako Konishi’s death is possibly linked to her comprehension of the film, the creative minds behind Fargo are not responsible for her loss.  This potential consequence, though, does open a space to consider audience expectations and the impact of subverting these expectations.

            In 1996 I did not realize that directors could lie to you in the way that the Coen brothers lie in Fargo.  The film starts with the following disclaimer:


 The events depicted in this film took place in Minnesota in 1987.

 At the request of the survivors, the names have been changed.

Out of respect for the dead, the rest has been told exactly as it occurred.

 -Opening credits, Fargo

Or, at least, this reads like a disclaimer.

This opening text is actually a part of the fiction of the film.  I watched Fargo for the first time in 1996.  I blame the lack of pervasive internet in my life, but in 1996 I still believed in the validity of a number of conventions.  One such convention was my trust that filmmakers, in balance, were honest with their audience.  When I saw the film hadn’t I really considered the potential gains in manipulating an audience this way.  As such, for over a decade I was convinced that the film was based on true events.

I’m clearly not alone in blindly trusting the directors’ words about respecting those killed in the course of events depicted in Fargo.  Currently there are over 2,500 Google hits to the search, “Is Fargo a true story.”  If there is any truth to the rumor of Takako Konishi’s death being related to the film it serves to underscore how effectively the Coen Brothers marry myth to reality.  The directors sew seeds of confusion with a beginning that misdirects the audience’s expectations.

It is in this space, considering how an author can misplace culpability through misdirection, that I see some of the most interesting elements of Surgeon Simulator 2013. The schism between presentation and play begins unbalancing player expectation at the moment the game redefines what movement is; the moment the game begins.  There’s a value to such types of misdirection, especially before presenting tragedy and horror.

Like the misdirection that proceeds it, grotesque consequences are fundamental to the experience of both the game and the movie.  Sharp misdirection in cinema is not new, just highly rewarding if deftly balanced.  Other examples of great films balancing whimsy and misery include Doctor Strangelove or; How I Learned to Stop Worrying and Love the Bomb, Pulp Fiction, The World According to Garp, and Being John Malkovich to name a few scattered examples from popular culture.  While each of these films have a quirkiness, the tone works to underscore intense loneliness and horror found in the narratives.  A balance in misdirection provides a unique opportunity for filmmaker and audience.

The suggestion isn’t that Surgeon Simulator is elevated by virtue of shared themes with noted films.  The opportunity, rather, is to touch on Surgeon Simulator 2013 in review of it’s mechanics and themes.  The controls are both exact and unbalancing in a number of ways.  The manner of Surgeon Simulator 2013 is chaotic and often unpredictable.  This unpredictability isn’t always satisfying; for some players, this unpredictability may never be satisfying.  While this criticism is valid, it isn’t particularly interesting to discuss in long-form.

There is otherwise room to discuss Surgeon Simulator in considering how the construction of the game- from the title to the reinvention of movement- works to heighten a theme of misdirection in audience experience.  In Surgeon Simulator 2013 misdirection is the spoonful of sugar which helps the medicine go down.  Keeping with this analogy the “medicine” is sometimes a rotary saw, sometimes a floppy disc, and sometimes a refrigerator.  The ridiculous nature of the game does much to undercut the weight of consequences.  For many, the game will just be about cutting people in wacky ways.  For others, there is opportunity to consider the space carved out by operating in a world of misdirection.