Heart’s Medicine: Time to Heal

Title screen of the game.It’s commonplace for a time-management game to feature character-driven plot, but Time to Heal sells itself really hard on narrative. The intro frames it as an original story. The game’s bumf is really focused on storytelling (and, in particular, that most irritating qualifier of Legitimate Narrative, ‘it made me cry’.) The plot opens in media res, in a flash-forward to the mid-game climax. Part of its gloss is an original soundtrack – melancholy singer-songwriter guitar stuff, pitch-perfect for the kind of heartache-by-the-numbers drama it’s aiming for.

The typical plot arc of time-management games, post Diner Dash, is straightforward Horatio Alger: a plucky protagonist grows their humble store into a business empire. Time to Heal aspires to combine this arc with a medical drama show; rather than growing a business, its heroine Allison Heart is building a career.

There are two things that drive a standard TV medical drama. One is the inherently high, emotionally-charged stakes: life, death, fertility, fear, suffering, the drowned and the saved; people at their most vulnerable and broken, on some of the worst (and occasionally best) days of their lives. The other thing is attachment to an ensemble cast, a surrogate family: this succeeds when the audience likes the regular cast, gets the sense of a circle of close friends, and feels included in it.

Heart’s Medicine knows this. It knows that these are emotional notes it has to hit. It devotes a lot of energy to them, and it doesn’t really succeed – and this is entirely due to the sheer weight of constraints it’s under.

As far as I can tell, it was squarely conceived of as episodic, a franchise where fans would develop loyalty to a set of established characters. The first incarnation was Heart’s Medicine: Season One, but that formula doesn’t seem to have quite hit the mark, because the second installment changed the art style around a bit and abandoned the ‘season’ framing. But the idea still seems pretty clear: this is a hospital soap opera, or medical drama, as casual game. (There are romances, for instance, but this isn’t really a Romance Game; romance is mostly important as a component of Drama).

Mechanically and visually, it’s a Diner Dash-style time-management game. Every job, in this idiom, is basically a retail-and-service-industry job, even if you’re supposedly a farmer or a surgeon. All of the individual tasks you perform are simple: the difficulty lies in keeping track of all of them, setting priorities on the fly, and switching rapidly between different tasks. Your success relies on giving every customer what they want, quickly. (As if to emphasize this, some of the bonus levels have you playing Emily, star of the Diner Dash clone Delicious series, who is somehow running the hospital cafeteria.)

This mechanic is combined with a very tightly-determined aesthetic, focused on a casual female market – a perceived audience that has become as narrowly constructed as that of the eternal-teenager straight white male capital-G Gamer market, to which it’s in many ways diametrically opposed. This is a world of soft smooth textures, bright colours, crisp lines, big sparkling eyes; no grime, no haze, nothing frayed or scuffed.  There are a lot of attractive young people – Allison is slender, tall, pretty, sparkly-eyed, always has good hair and skin, invariably wears skirts a few inches above the knee – but this is presented in a cute style that can be read as, if not exactly sexless, a long way from male-gaze raunchy.  Smooth, naturalistic animation is not a priority; a paper-doll cartoon is fine. People’s facial expressions and body language are big and unambiguous, and the primary mood is sunny and cheerful. It’s very much a mass-market style, carefully avoiding any subject-matter that might seem niche, novel, overly personal or unfamiliar. And it’s an aesthetic which really relies on presentation that doesn’t feel cheap; Heart’s Medicine is not the work of a vast studio, but there’s a lot of effort put into professional-looking surface gloss.

That translates to a certain portrayal of health and healing. Almost none of the customers (uh, patients) appear sick. Patients might show up on a stretcher in the ER, but their hair will still be immaculate. You’ll never deal with, say, a gunshot injury; the worst you’ll see is clean shards of broken glass that need to be pulled out of ambiguous flesh.  Fewer patients are elderly than you’d expect to see in a hospital, and none are visibly disabled. The young-adult majority are generally hot and well-groomed, and nobody looks poor. The hospital – ER included – generally looks, y’know, nice, more like a private clinic for expensive elective procedures than a general hospital. There are, to be fair, a handful of character models that aren’t slender mesomorphs, but it’s a rather smaller minority than you’d see in an actual US hospital.

(The tokenism is also… not subtle. The main cast contains precisely one black guy, one Asian guy, and one Latina. The Asian doctor is into alternative medicine and this is not handled well. Nobody is visibly queer. The love interests, meanwhile, are both white guys with substantially more senior positions than Allison.)

Patient lying on a hospital bed; a speech bubble comes from him. The speech bubble shows Allison putting on a yellow glove.

I dunno what procedure this guy wants, but it’s worth two hearts.

You will never deal with an uncooperative patient. Patients know exactly what tests and treatments they need, and will tell you clearly about it. (This is at its most troubling when you’re working the pharmacy, dispensing whatever pills the patients ask for – particularly since there’s a major subplot about a doctor who’s addicted to those same pills.) There’s an element here of a “what if dealing with the American medical system, and with the inevitable failure of the body, was about as stressful and scary as getting some Starbucks” fantasy.


Ensemble sense-of-family casts are a common thing for games to attempt, but one that’s difficult to pull off. The most normal failure mode, one that’s typical of CRPGs, has to do with the centrality of the player character: NPCs don’t have much space to develop meaningful relationships with anybody except the player-character, and their relationship with the PC is compromised because of power imbalance – the PC is their boss, or a Chosen One, or is just vastly more dynamic and influential than anyone else around them. This game doesn’t a power-imbalance problem so much, because Allison is low in the hierarchy; and while it’s invested in making her special, it’s not because she’s stronger or more competent than anyone else. Allison is in the overwhelming majority of the scenes, but not all of them rotate around her.

Group scene featuring some of the major characters.

Another failure mode of ensemble casts, though, is when the characters don’t cohere as a group because they’re not compelling as individuals. And Medicine is constrained to the point where individual characterisation is painfully narrow. It’s a different set of acceptable character templates than you’d get in, say, a by-the-numbers action videogame plot, but it’s every bit as limiting.


There’s a clear structure to the game. The campaign is divided up into departments, each of ten main levels, plus a bunch of optional bonus levels. You start in the ward, and progress through the pharmacy, ER, physio, radiology and ultimately get to surgery. Each department has its own minigames and layout, which are gradually introduced in its first few levels.

This provides the main plot structure, too. Each level of a department is book-ended by cutscenes – sometimes with treading-water amounts of plot, sometimes major developments. Often the ending cutscene of a level will have a cliffhanger to draw you on to the next level. Plot arcs tend to build over the course of a department, with big developments happening around the end; and the entire level chain is visible from the outset, so you always have a pretty good idea of where you are in the story. Player choice has no obvious effect on the story at all, other than to advance it; even if you fail level challenges that are presented as critical to the plot, the narrative will roll along as though you succeeded.

Most of your time, though, isn’t dedicated to the story: it’s about doing your job until the next bit of the story unlocks. (The narrative rhythms of film or prose fiction rely on eliding or summarising the routine, repetitive, learnable activity that games are built around.) This means that there’s really not a lot of space for B-plot or crisis-of-the-week elements. In the entire ~12-hour game only two patients are treated as distinct characters, which is on the low end of what you’d see in a single episode of a TV hospital drama. This puts a lot of pressure on the stories that do get told: the one long-arc patient has to be the one who Allison saves when no one else believed it possible, to prove her competence and justify her optimism. On the other hand, someone has to die or the life-and-death-drama thing falls flat, and it has to be on Allison’s watch so that she can angst about it, but there have to be exonerating circumstances so that the audience can know she’s not really a failure. It’s… too neat, and the characters can’t bring it alive. They feel constrained in similar ways, essentially wooden, with nothing allowed through that might breathe life into them. (There’s no voice-acting, and both the writing and the art feel tightly controlled.)

And this lack of space for secondary story sabotages some of the themes the story’s going for. Later in the game, Allison acts as a champion for humanising patients and thinking of them as people rather than procedures – but the game itself presents the overwhelming volume of patients as functionary game-pieces, laundry lists of tasks with a name bolted on. At other times the mechanics work, to be fair: for instance, each level has bonus objectives, and often these involve finding time in the middle of a normal level to dedicate some time to, say, playing with a scared child whose father is sick, or making snacks for a girl’s night. There’s a message here – that to care about someone means actively carving out time and effort in the middle of a busy schedule for their sake – which really succeeds as mechanical rhetoric.

There’s also a general failure to adequately develop the supporting cast, and the writers don’t always seem to fully realise this. For example, you’ve got Mason, who usurps your position in Surgery at the start of the game; he’s meant to be your asshole rival. And there’s Jenny, a medical intern who’s blonde and somehow even more perky and enthusiastic than Allison. There’s a vignette in the epilogue where Mason asks Jenny out and gets shot down, because she’s too busy studying – and this is obviously meant as a moment of reversal, with the confident always-gets-what-he-wants asshole humbled and the airhead hitting the books. But it doesn’t really work unless you extrapolate like crazy – we haven’t really seen enough of either character for their roles to settle in, even as cliches. You can take a pretty good guess about what kind of character tropes they were meant to embody, but that’s at least two steps away from feeling like you know them.

Scene in an ambulance, with Allison leaning over an unconscious Daniel. Allison: "That's because he's bleeding out, Jenny! We'll need to clamp this artery."The most major plot developments come with their own custom minigames. (Considered purely as a time-management game, it’s solid craft; everything works smoothly, and there’s a decent amount of variation.) Design is serving plot to some extent – this isn’t a case of coders developing gameplay and then calling in the writers to superimpose a plot on top of it. Story was not an afterthought.

While you’re actually playing the game, it feels as though the central plot is being delivered fairly slowly, because it’s spaced out in cutscenes between lots of levels. Since every ward has the same number of levels, the plot often has to tread water a bit in order to make each ward a self-contained narrative act. But when I went to summarise the plot, or even particular plot arcs, I found it took quite a lot of doing; with 60 main-line levels, you’ve got 120 scenes even before special cutscenes and side-missions. Even if a lot of those scenes tread water a bit, that should be a lot of room for story. So what’s going on here?

The game’s fairly ambitious about its cast; by my count there are 16 named characters, not counting two pets. But a capable writer should still be able to give at least a distinctive sketch of personality within that space. To realise what’s going on, you have to take a look at the actual writing; here’s a representative scene.

SOPHIA and JOE are dancing as ALLISON enters the ER.

SOPHIA: Hey Allison! Meet Joe.

(SOPHIA twirls, then JOE pulls her into a dip)

JOE: Hey! I would give you a hand, but then my fair lady would fall to the floor.

(ALLISON giggles; SOPHIA returns to standing)

JOE: My name’s Joe and I drive one of the ambulances here…

JOE: I also managed to somehow get this amazing woman over here to fall madly in love with me.

SOPHIA: I’m just dating you for your car…

JOE: Is that right? Hmm… It does have a siren and it is pretty impressive…

JOE: Ah, whatever…

(JENNY enters; SOPHIA and JOE kiss)

JOE: Speaking of my car… I need to get going.

JOE: You ready, Jenny?

JENNY (extremely happy pose): Totally!

JOE (to SOPHIA): Love you and see you after my shift!

(exit JENNY and JOE)

SOPHIA: That man… He’s just so perfect!

SOPHIA: Life is so much better when you have someone to share it with.

(exit SOPHIA; scene)

This is Extremely Videogame Writing: it aims to make only simple points, and to do so in a way that avoids any ambiguity. The language is clear, people express their feelings directly and explicitly, and the same points are stressed over and over. There’s a joke in there, but it adds no confusing new information to the scene – it’s just re-emphasis of the scene’s main pieces of information (Joe and Sophia are in love; Joe is an ambulance driver; Joe is a good guy).

So this is one of the basic issues, and it’s one that’s very common across videogame storytelling: the requirement to labour the point takes up a lot of space. And the requirement to avoid ambiguity or extraneous information makes the characters feel wooden and cliched. The upshot is that you can spend a lot of time with these characters without that paying off in character development.

(OK, and why’s Jenny in this scene? What does she add? What do we learn about her? My suspicion is that there wasn’t enough going on in Jenny’s arc, but someone decided she had to appear in X number of scenes, so, welp, here she is.)

Let me just get on my soapbox for a second. I’ve seen a number of games recently which sell themselves really hard on Story, but which are unable to deliver because they weren’t willing to do what was necessary to actually have good stories. (Here’s a much more comprehensive dragging of T.I.M.E. Stories.) If you want your Story to be better, it’s not enough to give more space to that story: you also have to give more creative control to writers. Otherwise you’re just going to get tedious shit in larger volumes.

Let’s go for a specific example of this failure. The first love-object of the story is Daniel, who’s in charge of the hospital. (The power imbalance of him dating a medical intern is never made an issue, but that’s not even the point here.) Under intense stress and unappreciated by his father, Daniel has become addicted to amphetamines stolen from the hospital pharmacy. He’s stealing so many drugs, in fact, that the hospital fucking runs short, endangering patient lives. When Allison investigates, he makes her feel shitty for suspecting him; when he’s caught, Allison agrees to cover it up and help him privately go cold turkey.

A hidden-object level, caption: Find all of Daniel's medication!


This is all kinds of bad on a relationship level, especially given that the game kind of wants this to be a Bonding Experience between the two. And it’s also bad on a medical-ethics level: Daniel’s actions endanger patient lives, and later on will literally result in the only death in the game. This runs massively counter to the central thing that the sequence is attempting to do – show Allison as a deeply caring person. Daniel shouldn’t be going back to work in an environment where he’ll be constantly given opportunities to swipe medications, and he definitely shouldn’t be allowed to endanger patients again. The plot’s so focused on the appearance of care – the sweet kind woman soothing the poor damaged man – that it completely fucks up on the reality of care.

The failure here isn’t the events that happened: it’s that the story isn’t permitted to explore their ramifications unless they line up with the script. The game’s tone aims to thread a pretty narrow needle – moments of Serious Life-and-Death Drama together with an overall cheery tone and mostly nice characters. That’s an ambitious writing goal, one that needs a lot of flexibility and nuance to get right. Instead, Time to Heal consistently fucks up the balancing act, because it’s never allowed to consider whether the Drama might have unplanned implications for who these characters are. And this disassociation, this sense that things only matter if the script needs them to matter, that characters are only allowed to develop along a simple predetermined arc, contributes to a deeply artificial feeling.

Time to Heal delivers a lot of the signals of being a high-emotion medical drama, without succeeding at being one. I think it works pretty OK as soap opera, if the defining audience motivation of soap opera is being regularly steamed about how none of the characters come across as intended and the producers are making terrible decisions, but you’ve got to keep watching so that you can be properly mad about it.

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2 Responses to Heart’s Medicine: Time to Heal

  1. Kaj Sotala says:

    Time to Heal delivers a lot of the signals of being a high-emotion medical drama, without succeeding at being one.

    Throughout this whole review, I kept thinking premium mediocre, and that final paragraph confirmed it:

    > A few months ago, while dining at Veggie Grill (one of the new breed of Chipotle-class fast-casual restaurants), a phrase popped unbidden into my head: premium mediocre. The food, I opined to my wife, was premium mediocre. She instantly got what I meant, though she didn’t quite agree that Veggie Grill qualified. In the weeks that followed, premium mediocre turned into a term of art for us, and we gleefully went around labeling various things with the term, sometimes disagreeing, but mostly agreeing. […]

    > Premium mediocre is the finest bottle of wine at Olive Garden. Premium mediocre is cupcakes and froyo. Premium mediocre is “truffle” oil on anything (no actual truffles are harmed in the making of “truffle” oil), and extra-leg-room seats in Economy. […]

    > Premium mediocre is Starbucks’ Italian names for drink sizes, and its original pumpkin spice lattes featuring a staggering absence of pumpkin in the preparation. Actually all the coffee at Starbucks is premium mediocre. I like it anyway. […]

    > Premium mediocre is international. My buddy Visakan Veerasamy (a name Indian-origin people will recognize as a fantastic premium mediocre name, suitable for a Tamil movie star, unlike mine which is merely mediocre, and suitable for a side character) reports that Singaporeans can enjoy the fine premium mediocre experience of the McDonald’s Signature Collection.

    > Anything branded as “signature” is premium mediocre of course.

  2. Pingback: Caregiver Fantasy | These Heterogenous Tasks

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