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Learning To Use Your Hands: Surgeon Simulator & Disability


I was diagnosed with Dysgraphia shortly after I turned eleven years old. Dysgraphia is a collection of writing deficiencies that can mean anything from the physical act of writing by hand to comprehending the meaning of written text. My brand of Dysgraphia affects my fine motor skills and also comes with a side of ADHD, a commonality for those with the disability.

The diagnosis came after five years of well-intentioned teachers taking it upon themselves to help me learn to write legibly. The note I received from the doctor put an end to all that, but it didn’t keep my peers from mocking my “kindergartner” hand script. I learned to half-heartedly accept my condition for what it wasn’t: a more debilitating condition. My Dysgraphia faded into the background of my life, only to surface whenever I had to sign my name on a receipt or write on a dry erase board while teaching. At least, this is the story I’ve created for myself.

The inability to perform a simple action-like twisting your hand to grasp a syringe-struck a different chord with me

I found myself reflecting on my disability shortly after sitting down to review Bossa Studios’ Surgeon Simulator 2013. Despite its rather serious name, SS13 is an absurd game with a deliberately awkward control scheme that makes pulling off the simplest actions ridiculously difficult. Controlling the titular surgeon’s fingers means using the letter keys that correspond to each finger while the mouse controls the movement of the doctor’s stiff hand. Without practice, picking up and using surgical tools is an almost insurmountable task.

Surgeon Simulator‘s humor serves as a unique justification of just how hard the game is. It’s different from Dark Souls’ difficulty, which is designed to make the player feel that each triumph is one they’ve truly earned. Surgeon Simulator is there to give the player a challenge and serve them up a laugh at their own expense. However, the inability to perform a simple action-like twisting your hand to grasp a syringe-struck a different chord with me, one that made me queasier than the cartoonish gore could.

I was curious enough about my experience that I contacted Bossa studios and was given the opportunity to chat with Luke Williams, Bossa’s junior designer, about the game’s control scheme:

Luke: Well, we took part in the Global Game Jam 2013….The control scheme came about when we were looking through certain “points” you could get for including things in your game that the Global Game Jam team set out. One of these bonus points was to use more than 10 keys. We figured if we had a key for each finger then that equals 10, but as we tried to figure it out we realized we’d lose the ability to move around the space. We kept the key for each finger but only on one hand, while the mouse was used to move the hand around. We ended up not hitting the 10 key target, but it made us reach our final control scheme-more or less. All the tilting and pitching the hand with the mouse was just further refinement on how to get some degree of movement from the hand….It was designed primarily to amuse us; we never imagined it would go much further than even our team. The whole premise of the game was to create something fun and amusing for us as we suffered from sleep deprivation. Everything came from making us laugh, so the act of having to relearn how to use your hand was funny, but then we made you perform probably one of the most complex tasks you could do with your hands in the real world.

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As a child and, later a teenager, I refrained from dramatizing my inability to write a legible sentence. My parents were supportive, but there’s something uncanny about growing up in a small South Carolinian town that can overpower the support of loved ones. A communal, hyper-masculine hostility hangs in the air that often breeds the internalized belief that expressing an anxiety is the equivalent of exposing a weakness. The process of accepting my disability was filled with angst, mostly stemming from my refusal to acknowledge the condition: It was my fault that no one could read my handwriting while my peers had beautiful hand script. I was lazy, stupid. Teasing from my classmates didn’t help the matter, but, as is often true of people dealing with insecurities, a lot of the damage done was self-inflicted.

It was my fault that no one could read my handwriting while my peers had beautiful hand script. I was lazy, stupid.

Surgeon Simulator uncomfortably brings up the consequences of that damage several times in a single surgery session. The game wants me to laugh when I fumble and drop a tool inside a guy’s chest cavity. I do, but there’s nervousness behind each chuckle. With each mistake, my frustration builds and then all I can think about is how pissed off I get when I can’t accomplish a simple task in real life, like holding my hands still, or wondering if an application I just filled out is readable. That isn’t to say that I think Surgeon Simulator is insensitive or offensive; on the contrary, I feel kinship between the titular surgeon and myself. The frustration caused by being unable to accomplish such a simple, mundane task is an occasion for deflation-it’s also one for self-deprecating humor. We laugh at ourselves when we fuck up. We have to have that joke at our own expense; otherwise, there might be nothing to get us back on our feet. In its own absurd way Surgeon Simulator embraces this procedure: screw up, laugh at yourself, keep going.

Surgeon Simulator 2013 caught me off guard and became something more than a goofy game: an occasion for reflection. It’s this element of surprise that reminds me games are capable of establishing meaningful, if unintended, connections to their players. When I pop the thematically heavy Spec Ops: The Line into my disc drive, I’m expecting to have a miserable time, but for such an absurd bit of entertainment to make me angry enough to confront my anxieties and fears is unexpected. It’s an accident, but it doesn’t make the effect that Surgeon Simulator had on me less powerful.

I explained my disability and asked Luke how he felt about someone coming away from Surgeon Simulator with a positive reaction that had little to do with the game’s humor:

Luke: I guess that’s why games are pretty amazing: people can have such varying experiences from each other….These controls may have affected you in such a way because we essentially make players relearn how to use their hands. It’s interesting that we may have lead players to experience something similar to your motor disability and give them a real understanding of how simple tasks can be very difficult in certain circumstances.

The greatest novels and films I’ve ever experienced have made me feel more whole as a person, as if the simple act of reading, watching, and reflecting has laid bare some aspect of my personality. Surgeon Simulator has helped me examine an integral, embarrassing component of my being and come to an uneasy peace with it. That a game like Surgeon Simulator could make me feel this way is a testament to the idea that all games can engage in significant interactions with the player. Regardless of its quality, the possibility of that accident, when someone’s personal experience collides with game design in an unexpected way, exists. That’s why we keep playing.

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