Fangirl Flashback: Theme Hospital

A while ago I compiled a list of many of the games I grew up with. I’ve recently started replaying them to see whether what I thought about them is just nostalgia or whether they’re actually still any good.

This time, we’re taking a look at the 1997 manager game Theme Hospital.

Theme Hospital - dealing with puke...

Theme Hospital is one of those strange games that I think everyone played at some point, but it still didn’t have such a big impact on gaming as a whole. And why should it? It’s a frickin’ hospital manager. You couldn’t tell anyone about this game without making some apologetic reference – “no, really, it’s actually fun!”

So what is it about this game? Well, first off, I still adore the graphics. They’re just so cute – look, there’s a little ring-book calender, the tiny icons for everything, the tiny hospital furniture… it’s got that general appeal that all of the “Theme” and “Tycoon” games have: just building cute-looking stuff. Needless to say, I also loved Theme Park and even Theme Park World, and hopefully I’ll get around to them in the course of this “series”.

The gameplay seems simple enough: You build rooms with the right equipment to diagnose and treat the incoming patients. If you cure them, you get money, but if you let them hang around for too long without curing them, they might die. You need an efficient hospital with enough space, toilets and friendly staff; you need to take care of the heating, hire janitors, shoot rats; if your staff sucks, you need to train them… and why did I say it was simple again?

Theme Hospital is a complex game. In most manager games, you would think there is always that one, perfect solution that solves every problem, beats the system and makes you rich on a daily basis. But in my opinion, a good manager simulation does not have that perfect solution. This rule applies to most strategy games – board games as well as computer games! If there is one perfect way of playing, it’s boring.

Aung Sang Su Kyi?! IN MY HOSPITAL?!

Theme Hospital, in this respect is so un-boring that it’s infuriating. There’s never enough room to build everything nicely; you have to wait until certain machines are researched before you can build them, and there are never the right doctors available for hire!  The game even gives you specific challenges with each new level you start, but you still need to figure out the rest by yourself.

For example, in one of the early levels, the game introduces the Training Room. In here, experienced doctors can train others to increase their job performance, and also pass on any extra qualifications they might have, like Psychology, Research or Surgeon. These qualifications are essential to your hospital: Without psychologists, you lack a fundamental diagnostic and treatment room, without research you don’t get new machines, and without a staffed operating theatre, you miss out on some lucrative treatment fees!

DOSBox 2013-07-19 17-44-24-06

Now in this level, right at the start, there is ONE doctor available for hire who has all qualifications, but hasn’t got a high performance rating. You might think that you don’t need one guy with all qualifications and that you might find better doctors as the level progresses. Wrong. I waited and waited but there are no more, or hardly any doctors coming up with the required traits. So the game expects you to understand this, get this one asshole and make him teach everybody else – which costs you money and doesn’t immediately pay off. Seems easy enough, but I think I had another case of “Modern Gameitis”. I sometimes forget that older games expect me to think for myself.


The game progressively gets harder as it gets more complicated. Soon you’ll have to balance so many elements of the game that you’ll really be challenged – and probably re-start the levels several times just to get it all right. Or maybe that’s just me, being a perfectionist. The result is surprisingly rewarding, literally: Every year you can get trophies and cash prizes for the cleanest, friendliest and wealthiest hospital; oh, and also there’s an award for how many sodas you sold.

And then there’s humor. Sure, after a while you might stop caring what the diseases are called, but especially when you start out, this aspect of the game is what makes it fun. Bloated Head, Slack Tongue Syndrome, King Complex… I remember back when I played this as a teenager, I was always waiting for new diseases to be discovered, just to see what they’d look like, what they were called, and what odd contraption I needed to cure it. The many little ideas that went into this game made it interesting and entice you to keep playing – even now.

It seems Aung Sang Su Kyi prefers suits now

The little animations in each of the different facilities, and the many different sound effects turn this game into a kind of Wimmelbild. There’s so much going on on the screen, especially later in the game. Theme Hospital certainly walks the line between amusing simulation and headache-inducing noise machine. In the past there were moments when I couldn’t take the sound effects anymore: there’s puking, dying, cheering, doors opening and closing, hospital announcements, machine noises etc. etc.

But it’s still a lot of fun. In the days of failed Sim City sequels, I am sometimes just happy to have a somewhat reliable game with no DLCs, no internet connection, no weird social features etc…. just me, running a hospital full of dying, puking patients and whiny doctors.

“Please form orderly queues!”

4 thoughts on “Fangirl Flashback: Theme Hospital

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