You may well have been taken by surprise by the release of Surgeon Simulator 2013 last week -- a full version of the original Global Game Jam title that was pieced together in 48 hours at the start of the year. This version itself took less than three months to put together.
But once you witnessed the game in video form, it no doubt stuck in your mind thanks to its silly, messed-up approach to open surgery. A video game take on the classic Operation board game, Surgeon Simulator sees players using the most ruthless control scheme possible to take control of a surgeon's hand, and attempt various heart, kidney and lung transplants.
"The decision to make it our next game actually came after the huge response on the internet," Bossa Studios designer Luke Williams tells Gamasutra.
"While we were restricted to the 48 hours, we had a lot of ideas and stuff we'd like to do," he continues, "but you rarely get a chance to go ahead and do it, so we suddenly had the opportunity to put all those ideas in there."
Forget WASD: This is AWER
It was after the team had implemented the insane control scheme -- by which players control the hand's movement using the mouse, and each individual finger with A, W, E, R and Space -- that Bossa released "hey, this is pretty fun."
"The control scheme had a very organic development," says Williams. "The initial idea was just a bumbling surgeon, having to perform heart surgery with a Jurassic Park: Trespasser [EA-published PC game from the 90s] type of hand. Then one of the 'bonus' points during the Global Game Jam was if your game used more than 10 keys and we figured if we had a key per finger we would hit 10."
"Of course, this ran into the problem of not being able to move your hands around or pick stuff up so we knew we needed the mouse and we ended up with just mapping the left hand and using the right hand on the mouse to move around. We ended up not hitting the 10 keys for the bonus points but it helped us get to our final control scheme."
The video below, as provided to Gamasutra by the Bossa team, shows the first time the devs managed to get the separate fingers mechanic up and running. As Williams explains, the team found that any other control scheme that it experimented with, including more traditional layouts, simply didn't feel right.
"We knew that while difficult, it was something you could actually adapt to quite quickly," he adds. "The controls also put everyone on an equal playing field - I think this allowed anyone to have a go."
As Williams notes, those people who play lots of video games don't really have a huge advantage over more casual players, as the controls are just as tricky for whoever gives it a shot.
"Also, with failure not being embarrassing but funny to the person playing and anyone watching, people wouldn't turn down having a go in the same way they would if a controller was put into their hands," he says.
If QWOP had a surgeon's license
Games like Surgeon Simulator 2013 have become increasingly popular in recent times -- those games that purposely give you a difficult control scheme and ask the impossible.
Some developers like Bennett Foddy and the team behind Octodad have revelled in both making the player laugh, while simultaneously making them rage. Bossa's Williams believes that creating a game that is just as fun to fail at and to watch is key to drumming up huge support online.
"YouTube is the reason the game is where it is," he reasons, although he adds, "We were never aiming for the game to do really well in videos."
"While making it we would just laugh at ideas and put them in," he continues. "We asked ourselves a few times if this was genuinely funny, or was it just because we were sleep-deprived and giggling. We didn't realize how watchable the game was until we did our presentation at the London Global Game Jam location to the rest of the teams there, we literally couldn't get through our presentation on it because the whole room was in laughter, with people shouting out 'Use the hammer!'"
Williams believes that part of the appeal of watching Surgeon Simulator videos is that non-gamers can easily understand the absurdity of the game, and can treat is as a video in its own right, rather than a video of a game. With this in mind, they'll be more likely to share it around, and therefore the game ends up grabbing the attention of a wider spread of gamers.
The science behind Surgeon Simulator 2013
I asked Williams whether the team had got in touch with a real-life surgeon, or researched real procedures when approaching the game's decision. As you'd expect, this was quite a far-fetched idea.
"Aside from looking at a few models and diagrams of the human body, there is pretty much zero science going on in the game," laughs Williams. "For one, his entire chest cavity has been removed which is about as invasive as surgery can get.
"We're fairly sure the real procedures are nothing like what happens in the game," he adds. "We didn't need real surgeons to tell us kidney transplants are not done from the front, but it worked better from a gameplay perspective as well as being absurdly funny.
"Also, I'm convinced brain transplants aren't possible yet."
Surgeon Simulator 2013 is now available to buy on Steam for Windows PC, Mac OS and Linux.
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