Game Review: Theme Hospital
Back when video game magazines were a real thing that came every month, when they were the only real source of gaming news other than your friend's uncle who worked at Nintendo, one of my favorite magazines was PC Gamer. Not for the news contained within, necessarily, but for the demo disks that came with it. I got probably thousands of gaming hours of those demos--I remember waking up early every morning for a week while I was in middle school to play the demo of Master of Magic, Merlin against Kali--and one of the ones my sister and I both loved to play was Theme Hospital. There were only a couple levels and a small complement of the full list of diseases, but we extracted all the fun it had and then some. My sister can still quote lines from the game's announcer now, almost twenty years after she first played the game.
So when I saw that GOG had it available and that it was on sale, I snapped it up. I had never played the full game for any length of time and now was my chance, now that all the gaming wealth of the world is available to us. I was deciding between Frozen Synapse and Theme Hospital and did a bit of research on the internet. After finding a few comments about Frozen Synapse's more annoying levels, I decided to go with Theme Hospital. HLTB says it's about 24 hours, which is longish for a non-RPG but not a bad length of time, and about the same as Frozen Synapse. And playing it was so much fun when I was a child, right?
Well, dear reader, let me tell you--sometimes you should let a happy memory remain a memory.
The Gut Rot drug is certainly not 75% alcohol by volume.
This marks the first game I'm writing a review of that I haven't beaten. You could make an argument for Morrowind because I didn't beat the Tribunal expansion pack, but I did beat Dagoth Ur and I played it for 500 hours. Here, I played 2/3rds of the levels, long enough to know what to expect from the rest of the game and why I should quit while I was ahead.
The problems I had with Theme Hospital can all be summed up in one sentence--it's basically a tower defense game. You have a stream of creeps (patients) constantly entering and you need to build towers (clinics) to defend against them. Different creeps have different special characteristics (diseases) that need their own towers to deal with. The main strategy comes in optimizing the placement of towers in order to funny creeps down the proper paths so that your towers can efficiently deal with them. Occasionally, there's a special event that requires new tactics to deal with, like a sudden rush with a time limit. And all the time you have to manage your money, watch for problems to solve them before they happen, and keep the creeps from overrunning you.
The problem is that Theme Hospital copies all the basic problems of the genre as well. The main thing that keeps from enjoying most tower defense games is that the gameplay is unevenly distributed. In the beginning of a level is a frantic rush to build as many towers as possible, and every bit of money coming in immediately goes out again for more towers or upgrades. However, at some point, a threshold is crossed. The towers are more than adequate to deal with the incoming creeps, so the gameplay becomes mostly just watching your level play itself out and occasionally upgrading things for the fun of it. In the worst-paced games, it's a frantic rush at the beginning and then the game basically plays itself. As much as I dislike the community in MOBAs, controlling a single character means that this is a solved problem there.
Creep rush.
It is not a solved problem in Theme Hospital. Each level features a different hospital layout and requires starting over from scratch, so when the level begins there's a rush to build seating, GP's offices, diagnostic rooms, a research facility, staff rooms, and so on. Then a period of watching the bank balance and trying to balance keeping staff happy while building new clinics as they become available and making sure there's enough seating and facilities for everyone. But after that, it's mostly a period of just watching, where I'd crank the speed up to max and watch everyone run around my hospital building, only slowing it down if there was some problem I had to solve or a new room to build. Otherwise it was just passive.
At least in a good tower defense, there are creeps that throw off the usual strategies and require new tactics to deal with. Fliers that can't be stopped by tower placement and require rocket towers to fight, or wizards who can stun towers, or giant turtles who prevent other creeps near them from being attacked, or something. Theme Hospital doesn't have anything like that at all. Sure, the advertising for the game boasts of over forty unique diseases to treat, and some of them are worth a chuckle, but the way of dealing with them is the same--build enough diagnostic rooms to figure out what they are, and then build the right clinic to treat them. Some diseases like Slack Tongue require a special room dedicated to that disease, and some diseases get funneled to the pharmacy or operating room or psychiatrist's office, but in the end, it's just build room, wait. The end. Once you get enough money to put in the operating room and ward and a couple of the more expensive diagnostic machines, then you're mostly just watching.
Click click click click click...
Well, except for all the clicking.
Theme Hospital manages to infuriatingly combine passive management of the hospital's primary purpose of curing disease with an enormous amount of tedious micromanagement of everything else. If staff get fed up due to being overworked, being cold--for some reason you have to put radiators all over every single hospital, even the one the game tells you is in southern California--being too tired all the time, or something similar, they'll demand a raise, and the best way to avoid that is to throw them a tiny bonus every once in a while. That means I was constantly opening the staff screen and checking everyone's status, throwing small amounts of money at those who are unhappy, and then doing it again a few minutes later.
Some machines require maintenance, which is one of the jobs of the handymen. But sometimes they get too caught up in other tasks and won't get to a machine before it suffers too much damage, and if a machine is in danger of breaking when an earthquake occurs, the entire room breaks. And if that happens, it can't be repaired and it can't be deleted, it just takes up space forever. So in addition to all the messing around I was doing in the personnel screen, I was clicking all around the hospital and looking at my machines, ordering repairs on them, and then going back to watching.
I think if there was no ability to adjust the speed I'd be annoyed but understand, because then the challenge would be time management and setting things up efficiently. But the ability to adjust the speed means that it's not a challenge to respond to any of these problems, it's just an annoyance. If I really wanted to squeeze extra efficiency out of my staff, I could have been manually moving them around the hospital so I wouldn't have to account for staff travel time, but I was already clicking enough.
It's not easy being green.
The other major problem is the inconsistent and often confusing feedback. The level announcer can be amusing when she's asking patients to kindly not die in the corridors, and she'll announce that doctors are required in certain areas, but not what requires that announcement. Are the other doctors all busy? Did the doctors get tired and the staff room is too far away? Are there simply not enough doctors? Obviously figuring this out is part of the game and I don't want to the announcer to run my hospital for me, but I would like at least a bit more granularity in the information I receive so I don't have to do even more clicking around to find out what's wrong.
It's the same with all announcements, really. My machines are starting to fall apart, so I have to click around to find out which one they're talking about. An epidemic starts, so I have to click around and find out who's infected. The personnel screen allows for a single place where I can see what doctors have what specialties and go to where they are in the building, so why isn't there one for the clinics I've played and the machines I have?
Then again, the last level I played before I quit in disgust, I was repeatedly told that people hated my poorly-run and managed hospital, all while I was making money hand over fist and my reputation was 800 out of a 1000. So.
Alright, here they had a point at least.
I wanted to play a sim game because the last time I had done that with any depth was a couple years ago when I wrote about Civilization Iv's Fall from Heaven mod, and I had fond memories of Theme Hospital. And like tower defenses, in small doses it was fine. Sitting and playing it for hours at a time, though...
I think this is the first time I've really felt like the passage of time and changes in game design have meant I can't enjoy a game I used to like. I still play Master of Magic because no modern game has done exactly what it does, and I have fun with the old console games I go back to. I even kind of liked Zelda II. Older PC games are notorious for having obtuse interfaces, though, especially sim games, and that's something that Theme Hospital suffers hugely from. There are people working on an open source clone of the game, and maybe they'll be able to change the interface to the point where I would feel like I didn't spend half my playtime clicking around trying to see what was wrong. Or what the game thinks is wrong even if nothing is wrong, as with the last level I played.
I think in the end I just picked the wrong game for me. As a high schooler with infinite time during the summer, I probably would have loved playing Theme Hospital if I hadn't been playing Diablo or Fallout. Nowadays, though, I have better ways to use my time.
So when I saw that GOG had it available and that it was on sale, I snapped it up. I had never played the full game for any length of time and now was my chance, now that all the gaming wealth of the world is available to us. I was deciding between Frozen Synapse and Theme Hospital and did a bit of research on the internet. After finding a few comments about Frozen Synapse's more annoying levels, I decided to go with Theme Hospital. HLTB says it's about 24 hours, which is longish for a non-RPG but not a bad length of time, and about the same as Frozen Synapse. And playing it was so much fun when I was a child, right?
Well, dear reader, let me tell you--sometimes you should let a happy memory remain a memory.
The Gut Rot drug is certainly not 75% alcohol by volume.
This marks the first game I'm writing a review of that I haven't beaten. You could make an argument for Morrowind because I didn't beat the Tribunal expansion pack, but I did beat Dagoth Ur and I played it for 500 hours. Here, I played 2/3rds of the levels, long enough to know what to expect from the rest of the game and why I should quit while I was ahead.
The problems I had with Theme Hospital can all be summed up in one sentence--it's basically a tower defense game. You have a stream of creeps (patients) constantly entering and you need to build towers (clinics) to defend against them. Different creeps have different special characteristics (diseases) that need their own towers to deal with. The main strategy comes in optimizing the placement of towers in order to funny creeps down the proper paths so that your towers can efficiently deal with them. Occasionally, there's a special event that requires new tactics to deal with, like a sudden rush with a time limit. And all the time you have to manage your money, watch for problems to solve them before they happen, and keep the creeps from overrunning you.
The problem is that Theme Hospital copies all the basic problems of the genre as well. The main thing that keeps from enjoying most tower defense games is that the gameplay is unevenly distributed. In the beginning of a level is a frantic rush to build as many towers as possible, and every bit of money coming in immediately goes out again for more towers or upgrades. However, at some point, a threshold is crossed. The towers are more than adequate to deal with the incoming creeps, so the gameplay becomes mostly just watching your level play itself out and occasionally upgrading things for the fun of it. In the worst-paced games, it's a frantic rush at the beginning and then the game basically plays itself. As much as I dislike the community in MOBAs, controlling a single character means that this is a solved problem there.
Creep rush.
It is not a solved problem in Theme Hospital. Each level features a different hospital layout and requires starting over from scratch, so when the level begins there's a rush to build seating, GP's offices, diagnostic rooms, a research facility, staff rooms, and so on. Then a period of watching the bank balance and trying to balance keeping staff happy while building new clinics as they become available and making sure there's enough seating and facilities for everyone. But after that, it's mostly a period of just watching, where I'd crank the speed up to max and watch everyone run around my hospital building, only slowing it down if there was some problem I had to solve or a new room to build. Otherwise it was just passive.
At least in a good tower defense, there are creeps that throw off the usual strategies and require new tactics to deal with. Fliers that can't be stopped by tower placement and require rocket towers to fight, or wizards who can stun towers, or giant turtles who prevent other creeps near them from being attacked, or something. Theme Hospital doesn't have anything like that at all. Sure, the advertising for the game boasts of over forty unique diseases to treat, and some of them are worth a chuckle, but the way of dealing with them is the same--build enough diagnostic rooms to figure out what they are, and then build the right clinic to treat them. Some diseases like Slack Tongue require a special room dedicated to that disease, and some diseases get funneled to the pharmacy or operating room or psychiatrist's office, but in the end, it's just build room, wait. The end. Once you get enough money to put in the operating room and ward and a couple of the more expensive diagnostic machines, then you're mostly just watching.
Click click click click click...
Well, except for all the clicking.
Theme Hospital manages to infuriatingly combine passive management of the hospital's primary purpose of curing disease with an enormous amount of tedious micromanagement of everything else. If staff get fed up due to being overworked, being cold--for some reason you have to put radiators all over every single hospital, even the one the game tells you is in southern California--being too tired all the time, or something similar, they'll demand a raise, and the best way to avoid that is to throw them a tiny bonus every once in a while. That means I was constantly opening the staff screen and checking everyone's status, throwing small amounts of money at those who are unhappy, and then doing it again a few minutes later.
Some machines require maintenance, which is one of the jobs of the handymen. But sometimes they get too caught up in other tasks and won't get to a machine before it suffers too much damage, and if a machine is in danger of breaking when an earthquake occurs, the entire room breaks. And if that happens, it can't be repaired and it can't be deleted, it just takes up space forever. So in addition to all the messing around I was doing in the personnel screen, I was clicking all around the hospital and looking at my machines, ordering repairs on them, and then going back to watching.
I think if there was no ability to adjust the speed I'd be annoyed but understand, because then the challenge would be time management and setting things up efficiently. But the ability to adjust the speed means that it's not a challenge to respond to any of these problems, it's just an annoyance. If I really wanted to squeeze extra efficiency out of my staff, I could have been manually moving them around the hospital so I wouldn't have to account for staff travel time, but I was already clicking enough.
It's not easy being green.
The other major problem is the inconsistent and often confusing feedback. The level announcer can be amusing when she's asking patients to kindly not die in the corridors, and she'll announce that doctors are required in certain areas, but not what requires that announcement. Are the other doctors all busy? Did the doctors get tired and the staff room is too far away? Are there simply not enough doctors? Obviously figuring this out is part of the game and I don't want to the announcer to run my hospital for me, but I would like at least a bit more granularity in the information I receive so I don't have to do even more clicking around to find out what's wrong.
It's the same with all announcements, really. My machines are starting to fall apart, so I have to click around to find out which one they're talking about. An epidemic starts, so I have to click around and find out who's infected. The personnel screen allows for a single place where I can see what doctors have what specialties and go to where they are in the building, so why isn't there one for the clinics I've played and the machines I have?
Then again, the last level I played before I quit in disgust, I was repeatedly told that people hated my poorly-run and managed hospital, all while I was making money hand over fist and my reputation was 800 out of a 1000. So.
Alright, here they had a point at least.
I wanted to play a sim game because the last time I had done that with any depth was a couple years ago when I wrote about Civilization Iv's Fall from Heaven mod, and I had fond memories of Theme Hospital. And like tower defenses, in small doses it was fine. Sitting and playing it for hours at a time, though...
I think this is the first time I've really felt like the passage of time and changes in game design have meant I can't enjoy a game I used to like. I still play Master of Magic because no modern game has done exactly what it does, and I have fun with the old console games I go back to. I even kind of liked Zelda II. Older PC games are notorious for having obtuse interfaces, though, especially sim games, and that's something that Theme Hospital suffers hugely from. There are people working on an open source clone of the game, and maybe they'll be able to change the interface to the point where I would feel like I didn't spend half my playtime clicking around trying to see what was wrong. Or what the game thinks is wrong even if nothing is wrong, as with the last level I played.
I think in the end I just picked the wrong game for me. As a high schooler with infinite time during the summer, I probably would have loved playing Theme Hospital if I hadn't been playing Diablo or Fallout. Nowadays, though, I have better ways to use my time.