"Perform a heart transplant." These are the words that greet you at the beginning of Surgeon Simulator 2013. Beyond that, there are no instructions to speak of: it's just you, a table full of surgical instruments, and a patient whose life you hold in your woefully unprepared hands. While that may sound like a recipe for disaster, it's also what makes Surgeon Simulator so wonderful. This is an absurdist parody of one of the world's most skillful occupations, a game that has you fumbling your way through one operation after the other as you drop your watch inside a patient's abdominal cavity, lose entire organs out of the back of a moving ambulance, and giggle with delight over your own surgical incompetence.
In Surgeon Simulator, you exist as an arm hovering above an operating table. Dragging the mouse moves your hand about the screen, and from there you can control the grip of each finger through five keys on the keyboard. Clicking the right mouse button as you drag left and right lets you rotate your hand side to side, while dragging up and down lets you adjust the angle of your wrist. If all this sounds a bit confusing, that's because it absolutely is. Surgeon Simulator makes it incredibly complicated to so much as pick up a scalpel. Performing a successful operation, meanwhile, is like juggling and riding a bicycle at the same time.
And yet, that ungainly control scheme is one of the biggest reasons Surgeon Simulator is such dumb fun. This is surgery as a slapstick vaudeville routine, an eccentric comedy of errors where everything can and will go wrong. Whether you're causing massive blood loss by dropping an electric drill inside a patient's abdominal cavity or seeing hallucinations after accidentally pricking yourself with a syringe, this game is littered with hazards meant to make you giggle with morbid delight. Surgeon Simulator has all the potential to be frustrating, but the sense of humor is so pervasive (the game-over screen reads "Brutal murder achieved") and the gore is so whimsically over the top (performing a brain transplant is like cracking a hard-boiled egg) that you can't help but cackle with glee even as you're fumbling a patient's life away. It's a game that's acutely aware of its own ridiculousness and wants you to join in on the fun.
That fun is spread across three basic types of operations: a heart transplant, a double kidney transplant, and a brain transplant. No matter the procedure, your goal is always to complete the operation before your patient runs out of blood. The challenge lies in removing any ribs and extraneous organs in your way without causing too much collateral damage. When you're done, the game assigns you a grade based on how quickly and carefully you completed the job. It's too bad there aren't more types of procedures, because in addition to some occasionally wonky physics issues, that relatively limited selection of surgeries is one of the game's only flaws.
Fortunately, Surgeon Simulator gives you plenty of reasons to keep coming back. For one thing, each of those three surgeries can be performed in a ridiculously difficult alternate scenario that has you operating during a very bumpy ambulance ride. Your utensils and replacement organs go bouncing all over the place, and the back doors randomly swing open--it's pure chaos. On top of this, there are a number of Easter eggs to discover (like a top secret heart transplant performed in zero-gravity space) as well as some truly inventive achievements, such as completing an operation with less than 10 milliliters of blood remaining, or dressing your patient in a scarf made from his own large intestine.
Throughout all this, Surgeon Simulator strikes a terrific balance between realism--or at least relative realism--and all-out absurdity. Hack away at your patient's ribs with a bone saw, and you might put the whole operation at risk by slicing open a lung; but the only way to get at the heart is to remove the lungs entirely, at which point you can toss them to the floor without the slightest concern. If your patient starts losing too much blood, you need to slow the bleeding with a hemostasis shot; but you can use that very syringe to haphazardly stab your patient in the face as many times as you like, and he'll be right as rain. It all adds up to a wonderful contrast between the grounded and the ridiculous. The result is a game that's both challenging and lighthearted, clumsy and clever.
Surgeon Simulator is a game that defies logic. Even the oddly dance-worthy synth soundtrack has no business working as well as it does. And yet, it all comes together beautifully in one great big symphony of eccentricity. This is a game that makes it an absolute joy to not only fail, but fail spectacularly. And the best part is, you don't even have to worry about malpractice suits.