The Gist: Theme Hospital is a staunchly tongue-in-cheek management sim that puts you in the role of a hospital chairman. Your task is simple - build an efficient, financially successful hospital, and climb your way to medical administration greatness. Hire doctors and nurses, build treatment rooms and keep pumping money into R + D so you can handle everything from simple sicknesses to deeper health-related conundrums. If you can sustain your cash flow and your hippocratic reputation, you might just make it out alive. But watch out for those Bloaty Head outbreaks!
When it comes to considering the all-time classic strategy games of yesteryear, it would be criminal to overlook the works of a certain company by the name of Bullfrog Productions. Their legacy - and what a legacy it is - speaks for itself with no extra brevity needed. Populous, Powermonger, Syndicate, Magic Carpet, Dungeon Keeper… the list of titles that came out of this once-mighty British software house is mind-boggling in its quality and quantity. For me though, it was 1994's Theme Park that topped them all. As the pioneering title that founded the amusement park management genre, it got everything right - its simplicity to pick up and learn, its surprising depth and its droll sense of humour all combined to keep me coming back again and again to its funfair of delights.
Any kind of follow-up would be sure to continue in that vein, you might think - just add better graphics and another instant hit beckons. So what did Bullfrog do instead? Naturally, they took the same mechanics of their original, and centered them around building hospitals instead. A baffling decision, for sure. But, in hindsight, a pretty sound one, too.
Bullfrog's decision to step away from the candy floss and coasters of the first game and into scalpels and surgery certainly didn't do its coffers any harm. Theme Hospital was released in 1997 for both the PC and original Playstation, to the kind of acclaim and sales that the company had grown used to by this point. Over four million copies were eventually sold worldwide - no mean feat for such a niche change of theme (pun maybe intended). It helped that the game still retained much of the comedy of its predecessor, as well as the addictive, fast-paced strategy element. Fast forward twenty years on, and it's also very comforting to see that these qualities haven't diminished, either - even if some flaws prevent it from coming away with a completely clean bill of health.
YouTube: Pixel Theater
Theme Hospital flows on a level-to-level basis, with each level having its own empty isometric plot to build a hospital on, and a certain number of requirements to fulfil ('make X amount of money', 'cure X patients within X years' etc.). You'll also have rival hospitals in the area who will be ruthlessly competing to outdo you in the patient turnover stakes, so you'll have no chance to rest on your laurels while you bid to make your practice number one in each level's region. Fortunately, the simple pick-up-and-get-into gameplay - one of many traits borrowed from Theme Park - shouldn't get in the way. Once you've laid down the brickwork for the building (a simple click n' drag action), you can then continue to tailor it. Drop-down menus at the top of the screen allow you to simply plonk various items straight into your hospital. GP offices, radiators, trashcans, and even employees can all be flung straight into the action with a mere click or two. With its clean graphics and uncluttered UX, getting into Theme Hospital from the outset is an absolute breeze. It all flows just like Theme Park and that's a great thing, too - few other strategy games are as easy as these two are to get into.
And once you start getting into it - boy, what a blast you'll have. Far from being a serious hospital sim, Theme Hospital's world is one of constant hilarity in which your patients can suffer from a various range of daft ailments.
Before long, your hospital will be inundated with infirms suffering from afflictions like King Complex (a psychological disorder in which the afflicted believe they're Elvis Presley), and the infamous Bloaty Head - which causes the sufferer's cranium to be inflated to comically 'bloated' proportions. Treating these unique problems often involve the installation of a wide range of weird contraptions - with many of the 'treatments' they provide offering more than a chuckle or two.
A perfect backdrop is also provided to these on-screen antics by the game's MIDI soundtrack, which ranges from madcap circus top melodies to tongue-in-cheek disco funk. None of it ever feels out of place and many of the tracks are ridiculously catchy. Try playing this game and seeing if you can get the tunes out of your head afterwards - it's another disease to go with all the others.
But while Theme Hospital is certainly aware of its funny bone, Its 'humerus' presentation (pun definitely intended) does not betray its status as a challenging strategy game.
Putting up a functioning hospital to treat your inbound patients is certainly a cakewalk. But if you can't keep it profitable, your administrative career will have its life support cut off before you know it. With building costs, drug research funds (new diseases come in thick and fast) and your army of staff to pay, keeping a balancing act on your finances is vital for success. And the complexity that each new level unveils can make this teeth-grindingly difficult.
Before long, you'll find that the star surgeons and psychiatrists you were able to hire so easily on previous levels are nowhere to be found, and you'll need to train any hires up in-house to fill your more specialist medical roles. Disease epidemics which must be wiped out within a certain time limit are also a common occurrence. Failing them can easily break your hospital's reputation, making success absolutely paramount. As if all that wasn't enough, layout design is also vital for the situations where patients who come to your hospital with viral infections don't run the risk of passing them on to their fellow sufferers. With the game also playing at a relentless real-time pace, it makes for an experience where every single split-second decision counts. Reward and frustration come in equal measure - much like cardiac surgery, playing Theme Hospital is not for the faint of heart.
It's all the more irritating that Theme Hospital's difficulty curve hits you with these harsh challenges with little time to prepare. The initial levels are manageable enough, but halfway through you're suddenly hit with more epidemics, viral infections and projectile vomiting than you're ready to handle. It's quite the rude awakening considering how joyful those first few levels are, and it takes a chunk out of the sense of fun that was previously so abundant. Perseverance and expert understanding of the game's complexities are certainly needed to finish this game - but when it punishes you so mercilessly, you may well have given up on it before you even get close.
Furthermore, not all of Theme Hospital's quirks are necessarily welcome. Hiring a receptionist for your hospital is an essential goal to get patients referred to the right doctors. For some reason though, the game's developers determined that she should also possess the vocal skills of a seal in labour. Having her wailing klaxon of a voice calling different doctors to the areas of the hospital they're needed at ("DOCTOR REQUIRED IN INFLATOR ROOOOOM") is unbelievably irritating. It's a welcome mercy indeed that the game does give you the option to turn off any sound effects related to her. After all, the last thing you need when you're trying to ferry critical patients through the hospital before they die is some shrieking banshee apologizing to the other residents for the amount of litter.
And of course there wouldn't be litter if the handymen you hire to clean the place actually cleaned up the areas you pointed them to. Another contributor to the game's difficulty is the fact that the staff you hire, even if their skill levels are of a decent standard, have a tendency to roam around the hospital rather than actually do anything useful. Doctors can and will skulk out of their offices in the middle of a patient crunch if they feel the urge to recharge in the staff room, and those bloody handymen leave the odd discarded soda can lying around even if it's right next to the trash can. Menial micro-management is thus required to keep your staff on the ball, and given the way the difficulty ramps itself up, constantly prodding your employees to do their jobs can end up being a severe pain in the arse.
And then, there's your dedicated advisor. In a similar fashion to Theme Park, the game's intention is to give you an advisor character who pops up now and then to offer you various tips on how run your hospital. At least that's the expected intention. Instead, he patronizes you any chance he can get. He'll still demand you to install radiators even if your hospital's heat map is satisfactory to your patient's needs.
He'll also really come down on you with a holier-than-thou attitude when you have the first inevitable event of a patient kicking the bucket. On cue, up his head pops. "You've just killed your first patient," he condescendingly observes, "How does it feel?" Absolutely marvellous, thanks. Now kindly disappear so I can drag a doctor to actually work the office they just died outside of.
These annoyances aside, Theme Hospital is still a landmark - a title whose creativity and quirkiness continue to inspire the release of games like Sega's Two Point Hospital. They say laughter is the best medicine, and there is plenty to be had here with the game's madcap sense of humor. At least until the monotonous micro-management and sharp upswing in difficulty kick in… leaving you screaming for the painkillers.
Media utilized in article is property of: Bullfrog Productions / mobygames.com