My arm sticks straight out as I prod a sedated man's gangrenous leg. His name is Bob. He is my patient. My surgical assistants stand arrayed around me, ready to administer drugs and blood transfusions to Bob. They're some of the lead developers of Surgeon Simulator 2. Everything is set. I take firm hold of Bob's leg around the calf and step back from the operating table. The leg pops off just below the hip and I spin around on my heel, carrying off Bob's floppy appendage like an athlete proudly bearing the Olympic torch.
My assistants descend on Bob, ready to preserve his life while I open a limb-coded door lock. Somewhere in the store rooms and diagnostic labs beyond I'll find a replacement leg. I wasn't able to make sure I knew where it was before starting the procedure because, well, I needed a leg to open the door. This is a strange hospital.
The original Surgeon Simulator has been the subject of thousands of rib-tickling YouTuber Let's Plays and reaction videos. Videos of players literally trying to get to grips with a clumsy hand - as well as a bunch of surgical tools, both professional and improvised - helped set off a wave of physics-driven comedy games. That was all with one hand perched over an operating table. Then the PS4 and Switch versions added another arm for another player.
"Part of the positive reaction to that was what inspired us to keep doing multiplayer, really, and dial into that and the chaos that comes from four players occupying the same space and doing things similar to Surgeon 1," Surgeon Simulator 2 senior producer Marc Pick tells me after our hospital rounds are over. "It's just a recipe for disaster in a positive sense."
You can play through all of Surgeon Simulator 2's campaign (beyond the tutorial) in up to four-player multiplayer. It would get crowded with four people all locked around the patient, but now the entire operating room and its surroundings are open for exploration. Surgeon Simulator 2 is a first-person walker as well as a first-person grabber. Senior game designer Nate Gallardo says the idea initially came out of a Bossa Studios game jam. With that seed of inspiration, the team worked on making a game where you could move around and manipulate things in a satisfying way while preserving that "essence of clumsiness."
"It's actually possible to do precise, accurate movement, but obviously everything that is normally simple is really difficult," Gallardo says. "As the controller got more and more honed, and it started to feel really nice and expressive, we realized that if you're moving around in this space, you want to be able to do something meaningful with the hand beyond just Bob. Which is why we tried to take the essence of Bob in the first game, which is getting in there and doing some really specific things, and cutting in really specific points, and taking organs out in very specific orders, just sort of spreading that out into the world."
Thus the door that will only open for a leg offering was created. Other levels require you to search around labs and offices for a specific item, such as a cassette tape, before you can proceed; like Gone Home, only if you were playing as a handful of tiny martians operating their human disguise for the first time.
Lending a hand
Surgeon Simulator 2 expands the formula from a one-person surgery/comedy show to a four-player improv medical team (though you can still do the whole thing in single player if you prefer). You'll need to coordinate your efforts with your new colleagues to be effective. Voice chat works, of course, but you've also got that hand sticking out in front of you. A series of pre-programmed gestures let you put it to use for more than just yanking off limbs and pushing big buttons. Need two lungs? You could snap to get your teammates' attention, then point to a lung and hold up two fingers.
"It's quite a unique thing that I haven't seen in a game before where you're using this very expressive controller to actually give instructions nonverbally," Pick says. "That's been really nice to see, this unintended design consequence from having the hand feel as physical as it is."
The gestures replace one of my favorite features from the first game: individual finger control. Yeah, it was a bit of a gimmick since there was rarely any reason not to just open and close all of them at once. Its biggest use case was probably closing all of the fingers except one so you could be extra rude to your patient before cracking open his rib cage with a claw hammer.
But I loved it, enough to make my own crummy puzzle game inspired by the unique control scheme. Still, there's enough potential for new goofiness here that I'm willing to let my beloved individual finger controls go.
"That's your toolkit, physics things, things going wrong, chaos, and then you as a performer, as a player, you bring your own element to it," Pick explains. "So this time around we have that same context, but it's just compounded a thousand times in terms of scale and expressivity of the character. One of the reasons we really doubled down on things like gesturing and the hand being a little bit more accessible this time around, if we've done our jobs right, is that so players can really use this as a platform to do that kind of physics-based comedy themselves."
Most of the laughs in Surgeon Simulator 2 will come from what you and your friends do, or just as importantly, what you fail to do. However, you'll also hopefully enjoy some incredulous guffaws as you learn more about the strange world of surgery that you inhabit.
Surgeon Simulator 2013 was packed with secrets, which could lead all the way up to you performing organ transplants on an extraterrestrial lifeform in outer space (that's still one of my proudest Steam Achievements). Just over the course of the brief preview session, my team was sent through several human-sized pneumatic tubes and witnessed what could only be described as a Cabin in the Woods style grid of operating theaters. Something strange is going on here, though Gallardo is naturally hesitant to reveal any specifics.
"We want to make sure that the things that inspired players to write wikis of the lore about the first game, we want to make sure that we're providing that for those players as well this time around," Gallardo says. "In story mode there's references back to the first game, there's also just a bunch of new stuff we're doing. We're creating a whole bunch of new lore around Bob, and what is this place that you're in. I think there's a lot of really fun stuff for players to dig into in that area."
Build a better operating room
Bossa Studios plans to turn over all the tools it used to make its Surgeon Simulator 2 levels over to the community. A new editing experience called Bossa Labs is meant to feel as close to the standard experience of playing Surgeon Simulator 2 as possible: you don't need to install anything extra to do it, it's all in first person, and you and three friends can all collaborate on the same level in real time - laying out environments, hooking up logic elements, and so on. There are some affordances to convenience, of course: you don't need to use the clumsy hand to manipulate objects, and you can ghost straight through the environment to speed up your work.
You also don't need to make any of it about surgery. Pick and Gallardo told me about a weird phase the team went through where they just kept making Rube Goldberg devices out of in-game objects. Surgeon Simulator 2's playtest community has pushed it even further, creating sports that use Bob's head for a ball or recreating moments from other games in surgical form.
"There's a real chaotic energy that threads all these things together, but we're really pushing for this endless stream of user-generated content, that's gonna constantly surprise players and throw them into new scenarios and new situations," Pick says. "And keep them laughing for quite a while, hopefully."
I'll be honest - I always go into level creating tools with the best of intentions and end up with a half-finished mess of unexecuted ideas. But if it means having even more operations and stranger fare to clear once Surgeon Simulator 2 hits PC this August, I'm all for it.
See what else is coming this year with our guide to the upcoming games of 2020.