If nothing more, Trauma Center: Second Opinion certainly represents a neat idea. I mean, heck, virtual surgery. All the fun of holding someone's life in your hands without any of the real-life consequences. The ability to live out fantasies inspired by our favorite medical shows. How could it go wrong? It's a simple question, with a sadly simple answer.

Choosing arcade-esque gameplay and outlandish scenarios over a grounding in reality, Trauma Center: Second Opinion loses a lot of its appeal. Early on, the surgeries seem relatively normal, such as removing shards of glass from a patient's arm. Things soon escalate though -- bombs embedded within innards, another wave of cysts appearing just after the last group dissipates, a cognizant virus -- making it abundantly clear that the folks behind Trauma Center wanted to develop a game, not an accurate simulation.

With these scenarios designed around the challenges of a more traditional game, the experience ends up far different than many would expect from the cover. Emphasizing the importance of quick reactions and pinpoint accuracy within a time limit, Trauma Center often feels like a collection of mini-games thrown together instead of a game based around surgery. Highlighting this is the repetition of in-game tasks, accomplishment often causing the sudden appearance of more of the same tasks.

Compared to the Nintendo DS version, which hit in the fall of 2005, Second Opinion refines things, reworking some notoriously difficult instances and adding additional surgeries. Instead of tapping the side of the screen to choose between the available tools, players simply rotate the analog stick of the Wii Nunchuck to quickly swap between the various instruments. Not only does this permit quicker procedures, it also provides a cleaner interface. Furthermore, the larger display of a television screen and increased accuracy of the Wii Remote, complete with on-screen indicator, allows greater precision over the DS version.

Yet despite some rebalancing, Trauma Center: Second Opinion is still rather difficult, and not always for the right reasons. Tight time limits and tricky surgeries are one thing, but fumbling through the many steps of a procedure without guidance showcases another far-less-forgivable flaw. After the initial instruction of a new gameplay mechanic, the game then treats it as second nature, leaving infrequent players struggling with harder missions as the clock ticks down. Since the game grows more and more unforgiving throughout its course and fails to offer any type of quick reference guide or helpful hints, Trauma Center doesn't lend itself to casual or periodic play. And given how frustrating some of the more advanced surgeries get, punishing players for their lack of memory only provides more frustration, leaving little incentive to return and progress further.

That said, Trauma Center: Second Opinion still represents a neat idea, and it's worth playing just to experience a sliver of the potential that idea offers. As a game though, Trauma Center: Second Opinion doesn't work as well. It's frustrating, often needlessly so, and frequently loses its enjoyable premise behind the guise of arbitrary design decisions. Give it a rent to see what it's all about, just don't be surprised if the game remains mostly unplayed beyond the first few hours.