War Hospital Review (Xbox Series X|S, PlayStation 5 & PC)

I’ve never been one for making rash decisions in dire situations, which, I’ll be honest, makes me one of the worst possible candidates for War Hospital. As it turns out, the brutally tough world of the WW1 clinic is full of ‘em, to the point where you’ll either need to make sacrifices for the greater good, or pack up your tools and call it a day before the first shift even reaches its tipping point. But, unfortunately for us, there are no easy escapes, nor are there any miracle cures that have the power to remediate every soldier, civilian, and co-worker, either. And so, the pressure to perform to perfection is certainly there. Sadly, though, it didn’t take long for me to realize that, even with all the right tools at my disposal, I was far from being the one to set the benchmark.

War Hospital takes a couple of pages out of Frostpunk’s book, in the fact that each decision you make during your time as a leader can, and often will, impact the day-to-day lives of those around you. And if you can’t make split-second decisions in the heat of the moment, then you’ll quickly find yourself bound for the outskirts — and with no time travel mechanic to nudge you back to your preliminary exercises, either. So, if you’re looking to grasp the basics of a relatively straightforward, hand-holding strategy sim, then you might want to seek shelter in an alternate universe. War Hospital is tough, and it’ll force you to suffer from every moral loss and death that takes place on your watch.

So, how did it all come to be? What was it like to dive headfirst into the frontline of a war clinic with no prior experience in the field? Let’s talk about it.

Clocking In

War Hospital slumps you into the rather unfortunate reality of being the administrator of a war clinic—a role that just so happens to involve taking drastic measures to assure not only the wellbeing of the VIPs, but an entire community of ill-fated civilians, many of whom come to you with all odds against their favor. As the governor of this small-time hospital, you must set out to save as many lives as humanly possible, even at the expense of those who lack the strength to receive the proper medical treatment. Surprise surprise, not every patient will survive to see the dawn of a new era, which means you, the involuntary reaper, must balance out your schedule and supplies, and decide who to keep alive, and who to let slip in order to prioritize other victims’ safety.

To make it absolutely clear, there are no winners in War Hospital, only those who have a moral compass thick enough to withstand the pressure of being wound up and thrown about for extended periods of time. Knowing this, and how there are quite literally zero victors in the bitterly cruel game, means you’ll have to button up and act on impulse, even if it means alleviating the final blow just a smidgen before starting a new shift.

In addition to the patients that wind up on your bedsides throughout the campaign, there are also medical practitioners—staff who, like any worker in a world ravaged by war, have a moral compass hovering over their heads. It’s your job, as their overseer, to manage their duties, and ration their limited supplies in order to cure, save, and also provide emotional support during the final hours of hundreds of patients’ lives. Again, no pressure or anything.

The Longest Shift of Your Life

In order to make progress in the world of War Hospital, you must allocate one of several units to aid the rehabilitation of the wounded and mentally traumatized, even if it means forcing your medics, surgeons, or nurses to battle their own internal battles. Along the way, you’ll come across last-minute requests from those who’ve wound up on your patient list—needs that will exhaust one of several supply caches in return. There are food rations to balance, medical supplies to distribute, and a seemingly endless number of new patients all crying out for the smallest of things. These things, really, are what make the unsanitized world of War Hospital go round — and it’s brutal, truly.

To reflect the real-life issues of war in a virtual format, War Hospital doesn’t hold your hand, nor does it provide you with any suggestions. Heck, it doesn’t even tell you if what you’re doing is the right thing, but instead leaves you to cope with the consequences of your actions. Sure, you could save a VIP, but at what cost? Chances are, saving one soldier from their post-frontline trauma will lead to the death of several children, and vice versa. It’s an incredibly tough pill to swallow, and if there’s one thing I came to learn relatively early on in the campaign, it was that War Hospital had no shortage of such drugs.

War Hospital isn’t a game that you can quite easily slip into and learn on the fly. On the contrary, it’s a game that requires copious amounts of replays and harsh lessons in order to tolerate. And that’s fine, so long as you have the mental capacity to learn from past mistakes and channel newfound knowledge into future projects. A tall order, for sure, but a rewarding one, nonetheless.

An Inescapable Truth

The thing that impresses me most about War Hospital is that it doesn’t even attempt to add color to an evidently charcoal canvas. Thanks to the developer’s cooperation with the Imperial War Museum, nothing, and I mean nothing is buttered up or painted to be something it isn’t. It’s an inescapable darkness that simply cannot be glossed over with a fine-tooth comb, and it does all in its power to reveal the true horrors of war without the unnecessary video game tropes and overused anchor points. It’s a grizzly reality, but it’s also one of the best pieces of eye-opening drama I’ve seen in weeks, months, and perhaps even years.

Of course, there are one or two issues that bog an otherwise exceptional journey down; the fact that you’re only given a limited amount of time to make tall orders happen, being one of them. With that said, the game does perform all rather well, and at no point did I stumble upon any game-breaking bugs during my time in the hot seat. And sure, I might’ve wanted to excuse myself from the role of administrator every once in a while — but that was a luxury I simply couldn’t afford, let alone entertain.

Visually, aurally, and mechanically, War Hospital fires on all cylinders, and, when merged into one product, delivers one of the most immersive strategy simulation experiences, and then some. Sure, it can be a little rough around the edges, but then, isn’t that the exact thing that Brave Lamb Studio was aiming to capsulate? If so, then consider it a job well done.

Verdict

In my twenty-something years of gaming, at no point have I had to deal with the consequences of literally abandoning an ill patient — especially one who’s looked to me for comfort in a desperately perilous time. But that’s just it. War Hospital put me to the test, and I can’t quite figure out if I’m a slightly stronger person because of it, or if I’m something of a morally bankrupt virtual practitioner with nothing else to blame except my own lack of understanding. Even still, when I thought I was doing the right thing, I was often putting something, or someone else at risk, and that sort of ill feeling stuck to my head for all the while I chose to sport the coat and clipboard.

Let it be said that, as far as difficult strategy simulation games travel, War Hospital is definitely up there as one of the most menacing of the bunch. Due to it also having no auto-save feature or basic tutorials, it’s also a game that thrives in seeing you struggle to make ends meet. Does this make for a captivating experience? Sure. But having said that, if unforgiving worlds with strict guidelines are not for your liking, then there’s a good chance that you’ll struggle to topple over the countless hurdles that War Hospital serves up by the boatload.

To answer the question, is War Hospital worth the numerous headaches and endless fatigue? Yes, it is — but only if you’re able to grasp the fact that, win or lose, there aren’t any real happy endings to unlock. Sure enough, you’ll try, and you’ll fail, but at some point along the way, you’ll also discover that, if War Hospital is the incarnation of any realm in the universe, you’ve just entered the darkest depths of Hell.