War Hospital review

As someone who grew up on a healthy diet of colourful Nintendo platformers, I often spend a lot of my time playing lighthearted and cheerful video games. That’s not to say I can’t appreciate those bleaker titles though, be they harrowing apocalyptic adventures like The Last of Us Part II or survival games like This War of Mine. War Hospital is anything but a happy game, placing you in the role of commander of a World War 1 field hospital and tasking you with keeping as many wounded soldiers as possible alive. You’ll have to make a whole lot of tough choices along the way, but that’s war for you.

Our protagonist Henry Wells is a retired British combat medic, who has been called back into the action to take charge of a field hospital in peril. Having just lost his son to the war, Wells is not in a good way and hopes that having an important job to do will help him get through the grief. When he arrives there’s a distinct lack of supplies and a whole lot of staff who are losing hope waiting for him, and it’ll take all of his (and your) management skills to turn this run down facility around.

War Hospital starts very slowly, introducing you to how the game works one step at a time. First you’re sent to the Casualty Clearing Station (or CCS for short) where the wounded arrive and have their doctors assigned. Once you decide who will be operated on first they’re carried by a medic team into surgery, and as long as everything goes well they are moved to the rehabilitation center. After a bit of aftercare from a nurse and some rest they’ll be free to go, and you can send them to the trenches, to HQ or relieve them from duty. That’s the basic gameplay loop of War Hospital, but it becomes clear almost immediately that it’ll rarely be that simple.

The harsh conditions of war just aren’t an ideal setting for healing injured people, so often things go wrong. Even the most routine of operations have a chance of going awry and a patient dying, and some of the operations are anything but routine. When faced with a long list of deteriorating soldiers you’ll have to prioritise those who have a chance of surviving, and often that means sacrificing a patient and denying them help. Moving a patient (whose life back home and family you can read about if you don’t feel bad enough already) to the Denied list never feels good, and it’s made even worse when you drag and drop them over to seal their fate and a text message pops up of them begging you to help. Harrowing doesn’t even begin to describe it.

As well as simply not having the technology to successfully cope with the intake at the War Hospital, there’s also a distinct lack of supplies in the warehouse. Each operation requires a specific amount of medical supplies, and if they run out then you’re pretty much screwed. Supplies can be sent to you by train if you can spare the drafts to ask for them, or you can get the engineers at the pharmacy to make them for you. This is easier said than done though, because they’re also needed to manufacture the food for everyone at the hospital, upgrade your buildings, and also want to nap every so often.

Staff are in short supply in War Hospital, and despite everyone pulling together to help save lives there’s only so much your workers can take. A big part of your job is rotating out people when they’re tired and prioritising which departments are kept staffed at all times. Having nurses at the CCS helps the wounded that are waiting deteriorate slower, but if there’s not enough of them to go around you might decide that them upping the chance of survival in surgery is more important. Pushing your staff hard might help in a pinch, but you’ll never forget the first time a surgeon collapses during an operation and a patient dies because of it.

When patients die, the morale at the hospital falls, and out of everything your hospital needs, morale is the most important. Death is the most common cause of a morale drop, but poor meals when you’re low on food don’t help either. Sending healthy patients home is the best way to boost the mood, but sometimes you get the opportunity to raise morale in other ways. Early on I was able to assign engineers to spruce up the graveyard, and it made everything a little less bleak for everyone.

It might sound tempting in this harsh situation to send all the people you heal home to make the masses happy, but unfortunately that’s just not possible. The enemy is on your doorstep at all times in War Hospital, and a meter at the top of the screen lets you know when another wave is on their way. Supplying the trenches with extra soldiers is vital if you want the hospital to survive at all, and unfortunately that means sending anyone healthy enough to fight back into the thick of it.

It’s rare for you to ever feel like you’re on top of things in War Hospital, but it can happen if you’re able to upgrade your facility enough. There’s a huge upgrade tree to invest resources and manpower in, full of everything from housing that allows you to hire more staff to the ability to treat patients struggling with trauma. The most useful upgrade I ever unlocked though was the ability to amputate patients, as doing so makes operations much less likely to go wrong and only requires half the resources. I probably ended up taking off more limbs in War Hospital than I did playing through Dead Space, but it was for the greater good.

War Hospital is a well made and engaging game for the most part, but it does have a few issues. The opening of the game is incredibly slow, which is in some ways understandable as you’re taught the mechanics, but it does feel like it could be streamlined a bit. In general things move a bit slowly throughout all of War Hospital, and even at triple speed I often found myself wishing time would pass a bit quicker.

War Hospital is a game that isn’t for the faint of heart and likely won’t cheer you up after a tough day, but it’s compelling and shines a spotlight on some of the most important people of WW1. If the stress of making life or death decisions sounds exciting to you then you might just be the commander the War Hospital needs, but don’t expect that role to be a barrel of laughs.