To be fair, there are other aspects to the game, though they're just as mundane as the whole lifesaving thing. One area of note is the character management system, which feels like a low-rent version of The Sims. Your character has three stats that must be maintained at all times: hygiene, energy, and composure. Each one drops slightly as you go through your 48-hour shift in the ER, and after a while you'll need to replenish them by doing things like going and grabbing some food in the cafeteria, taking naps, taking showers, and even doing quick workouts in the gym. Some patients will even give you special gifts, which are boosts to certain stats and abilities that you can use at your leisure. While all of this sounds relatively decent, the stats themselves don't seem to have nearly the effect on your character that's advertised. One of the warnings Dr. Carter gives early on is that you must maintain your hygiene level carefully, or no one will want to work with you. What he didn't mention is that you can let it get all the way to the bottom before it even begins to negatively impact the game, which can take a very long time. You can go next to forever without taking time to boost your stats, and there's no urgency to any of them.
The gameplay mechanic that had the potential to add the most depth to the experience instead comes off as completely perfunctory. Essentially, you have the ability to socialize with your various hospital colleagues at pretty much any point during the game. Just right-click on them, and select the interact option. A chat menu will appear, with all sorts of topics and emotes you can select from the conversation. It's a great concept, but it's horribly executed. The whole thing is guesswork, since there's no way to clue in on the best way to begin a conversation. Abject praise tends to work, but even that sometimes causes a negative reaction. Generally, once the person you're conversing with picks a topic, all you need to do is pick that same topic next, and you'll get a moderate boost in positivity. This turns into a weird game of mimicry that isn't fun or interesting. Worse, even though the game purports that the social-interaction aspect is key in establishing cliques and good working relationships with the staff, you really don't need to do it much. An occasional conversation seems more than sufficient, and enacting a romance with another character merely gives you a mild composure bonus. It's a pathetically limited system, and it has no bearing on the gameplay.
If the process of saving lives were really this simple, why would anybody need six years of medical school?
ER's presentation is better than its gameplay, but "better" in this case doesn't equate to good. The look of the game is somewhat Sims-like, with the camera taking sort of an isometric view of your character and the hospital and all the characters taking on kind of a goofy, exaggerated look. The animations resemble those of sims, with wild gesticulations representing specific actions. While that works fine in a game like The Sims, which is meant to be kind of off the wall to begin with, the association with the name ER makes the atmosphere in the game feel off-kilter. The same problem arises with the cases. One moment you'll be dealing with weird patients, like guys in superhero costumes, and then the next moment you'll be having a somber talk with the other doctors about how you never get used to losing patients. While the TV show does try to mix the absurd with the melodramatic, the game leans way too heavily on the absurd for its own good. The one good thing you can say about the game's presentation, however, is that the actors involved do a good job with the voice acting. Mekhi Phifer, Sherry Stringfield, and the aforementioned Noah Wyle all reprise their roles, and though the dialogue isn't especially well written, they more than competently act it out.
The problem with ER isn't that it's a game aimed at a casual market, but rather that the components necessary to make an enjoyable casual game are not developed well enough. Its assembly-line approach to the process of saving lives and its utter lack of any meaningful or dramatic storytelling rob it of the two things the TV show is most renowned for--not to mention that all the little gameplay elements it tries to throw into the mix to deepen the experience are barely required, let alone useful. It's a half-baked attempt at best, and even the biggest fans of the show will be thoroughly disappointed by it.
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