War Hospital is a title that brings with it unmistakable gravitas. Its opening slides are dedicated to the memory of those who had to make the toughest of choices, those whose spirit was tested and strewn out by events beyond any one human’s control. “Honor their memory” one says. Unfortunately, none of this comes through once the animated intros end and the gameplay begins.
The experience is flat-out uninteresting, often mindless. To look at an experience that directly presents someone with matters of life and death during times of war and feel nothing is incredibly disheartening. Not even for a second, however, did this seem to be a deliberate choice by the game. The ineffectiveness of its main tool—that being typical management sim stress—is the clear cause instead.
Though the clean menus and building models certainly impress, in the grand scheme of things they just seem like good first impressions. Even without delving into the mechanics, the dry voice acting (except Angus MacFihiogain in charge of troops, whose ardent screams before skirmishes are a highlight) and drab soundtrack quickly balance them out.
The first thing the player does as the person in charge of the hospital is assign a patient to surgery, have them die of complications in a scripted event, and bury them, only to soon after learn about assigning people to the “denied” pile. Death is immediately taught to be a mechanic, a resource, which clashes rather unfavorably with the tone set by the opening. I am sure anyone going into War Hospital is aware that people will die, but having this happen every time you want to replay the game seems to go against its messaging. It focuses on death so much that it chooses to put it forward first, even before explaining how a successful operation works.
It certainly desensitized me to the growing number of deaths as I progressed. Though morale would fall with each denied patient, I could restore it through gameplay means. With experience, surgeons gain perks, some of which may improve the chances of events that boost morale. If that is not consistent enough, sending soldiers back home instead of to the front or back to HQ may do the trick.
As morale dropping to zero is one of the two fail states, it certainly feels important, but the simple game over screen does not instill fear when saving and reloading is always an option, and the easy ways of circumventing the downsides of failure turn the game into quite a slog. The final of the three chapters consisted mostly of me having to let people die and then sending those I could save back home. I ended with roughly the same number of those saved and those who died. Yet even with a hundred bodies awaiting burial at the cemetery, the morale was so high that characters were chirping about how good of a day they were having.
The other fail state is losing a skirmish at the trenches near the hospital, caused by not sending enough men to defend from incoming attacks. These are always displayed at the top of the screen so that the players know they are coming, and are never a surprise aside from one or two scripted events. This means they are something you can prepare for, once again timing and playing around with resources in a way that feels appropriate for a management sim, but less so for a war story.
Even then, removing surprise from attacks feels like an odd choice. These kinds of games operate best on chaos, which here is largely forgotten about. The few random or unexpected elements come in the form of surgery results and the kind of patients that arrive. Some may require a doctor of a certain specialization, so consistent building improvements are certainly encouraged. The second chapter is actually an absolute torture without fully upgrading one of the wards as early as possible, not knowing that beforehand. I guess that is an element of surprise, but not one I welcomed.
Each chapter is a scenario of its own, lasting around four to five hours. I had to restart that one, and it was enough to make me realize the game could use an even higher speed option. Replaying lull sections in War Hospital is as boring as management sims get. On the highest speed and with pause, everything is more than manageable. I never even had to use the shift system for workers, nurses, and medical teams, instead assigning them all by hand, which seems to be a big deal seeing how I got an achievement for it.
I wanted to try and be as involved as possible to stave off the monotony, as well as preserve supplies, but nothing helped. I only hoped to see some meaningful change. No luck.. Same map, same gameplay loop, same goals. An occasional beacon of light came in the form of scout missions, which are events that require time and follow small, unique stories that can be taken in multiple directions. These showcased some great art and served as a welcome distraction a couple of times during each chapter, unlike the VIP patient mechanic which occasionally forced me to perform a specific action according to an attached letter, adding little to nothing to the experience.
All that is to say, my favorite part of War Hospital has little to do with the actual hospital management aspect. I enjoyed twists that occurred while following stories of a couple who tried to run away from an angry father way more, even though it provided little to no tangible benefits. It shows that war stories can be so special that even little glimpses can carry emotional depth if given a chance.
Yet instead of incorporating these stories more meaningfully into its gameplay, it opts out for hours of dragging portraits from one slot to another, which elicits little reaction aside from occasional bug-related anger. These can be very significant, and cause hours of lost progress. Issues such as items becoming inaccessible without reloading or softlocks caused by two events overlapping only get worse when the game suddenly removes a player’s ability to access the save menu. I was forced to complete the last chapter in one sitting because pressing escape just did not work.
Frustrations aside, even once it is free of its most egregious issues, War Hospital has just too little going for it. From its ineffective portrayal of death to its uneventful gameplay loop, it does little to convince me that anything can be achieved with such lackluster foundation. In the end, I sighed with relief not just because I managed not to lose several hours of progress due to a bug, but also simply because I did not have to play it anymore. A reaction that sounds similar to the ones I had while experiencing so many great war stories, yet so distant from all of them for all the wrong reasons.
Mateusz played War Hospital on PC with a review code.
