Emergency Room 2

When writing about the first Emergency Room, I chalked its existence up to ER craze meets multimedia mania. That’s definitely true, but it dismisses the fact that there are eight of these games. They clearly sold well enough to support a franchise, and that support for niche interests is part of what I love about early PC games. Every game didn’t need to be a blockbuster, everybody was just trying to figure out what people liked, and what they liked would sometimes surprise you. (See also, our friends at A Force For Good for Rik’s excellent looks at the stunningly prolific CSI games).

The waiting room is redesigned with real people.

However, I hit a snag with the sequel – it’s not really a sequel at all. Emergency Room 2 is a slight remake of the first Emergency Room, primarily dropping DOS requirements for Windows 98 support. The content of the two games appears identical, with the only updates being cosmetic and, of course, the operating system needed.

Most notably, the plastic-looking CG patients of the DOS version get replaced by photos of real actors. This is a clear improvement, though it should be noted that there aren’t that many actors to go around. Twelve “patient models” are listed in the credits, and you’ll see many repeats of the same child with a different name and different injuries. Any blood or gore is still Photoshopped on pretty unrealistically, but having it overlaid photos of real people may tweak the nausea up for some.

The hospital has also been remodeled, though the layout is unchanged. Part of this seems to be allowing for smoother transition animations, part of it just seems to be an aesthetic update. The Pac-Man arcade clone in the lounge is gone, as are the Ad Council PSAs on the televisions. The AI personality Terabyte is cut, with the library computer now just a basic interface with no quizzes. Finally, the door from treatment no longer leads directly into your discharge debriefing. A door to that office doesn’t even appear to exist at all, and I could only reach it (and thus, close a case) by using the menu bar.

Patient photos continue into the exam and treatment. They even move their mouths awkwardly when they talk.

Finally, all patients now have normal names. Medical puns like “Billy Ruben” are out the door. However, the entire cast from the DOS version returns, with their silly names intact – Terrence Knox as “Dr. D. Boss,” Steve Park as “Dr. C. N. Side Yoo,” and so on. I’m assuming it’s because they speak their names in their introduction clip, and these performances definitely were not reshot. They did clean up the compositing though, so the bluescreen halos surrounding most actors in the DOS release are gone from this one.

The DOS release obscured its install data inside proprietary .cab-like files, but the Windows version lays it all out on the disc. Browsing these subfolders, you can see that there are exactly 100 cases. I’m betting this is identical to the DOS release, so the almost 500 library entries were just bonus data. It certainly explains the reappearance of cases you’ve already “solved.” The loading screens promise that you can download more cases from Legacy’s website, and sure enough, you could. Some of the files are even downloadable today via archive.org, but the “case enabler” program to use them isn’t. C’est la vie.

If you’ve finished the first, there’s no reason to come on to this one. If you’re starting new, which one to get is a bit of a toss-up. Ultimately, either version works well, and the cases will be the same. There’s something to be said for the DOS version’s sillier extra content, like Terabyte’s medical quizzes. But in my opinion, having actors instead of CG puppets makes this one the version to get on that point alone. However, one major issue does rear its head for modern players – compatibility.

Emergency Room 2 will install to Windows 10 out of the box. It’s supported by QuickTime 7 (the last PC release). You will need to set Windows’ compatibility settings to 16-color and Windows Vista (for some reason, the others won’t work), but it runs flawlessly after that. EXCEPT all the notes scroll too fast to read. It’s frustrating because you’re so close – there’s no issues with the videos, with the treatments, with the voices, just with the critical information you need to actually treat the patient. I suspect the entire game is running so much faster than expected, but due to its somewhat slideshow nature and “wait for action” design, this is the only part where you notice. There’s no way to page down with the keyboard or scroll with the arrow keys – only the mouse works, and I guess it treats one click like 100 instantly.

Wounds are still drawn on and hardly photorealistic.

Where you go from here depends on your comfort level. In the older days, you could use Mo’Slow or similar processor-busying programs to essentially distract your 2000s-era processor into performing like a Pentium 166. Unfortunately, development on these tools seems to have stopped around 2012, and I have no idea if they would work on modern multi-core processors. Windows 95/98 emulation has definitely improved, so you can play perfectly on a virtual machine under 86Box or PCem, but these can be complicated to set up. Otherwise, assuming you’re familiar with DOSBox, DOS emulation is mature enough that the first Emergency Room might be the best way to go.

If none of the above makes sense or works for you, I don’t know that there’s any more advice I could offer. Other than “don’t buy the game!” You could stumble through a default Windows 10 install using this guide off GameFAQs. That doesn’t seem much fun, but I have to admit, it’s not far off from reading what the CME tells you to do, bullet points and all. I suppose the major difference is the CME often tells you what results to expect and leaves you to guess what tool will give you these results, versus this guide’s straightforward and mindless list of actions to “win.”

That’s Emergency Room 2. It’s a bit of a disappointment that it’s just a remake of the first, and any unique added value (like those downloadable cases) doesn’t work today.  You’re mostly here for the photographs of real actors, while any improved compatibility gained on its release in 1999 has actually just made it more complicated to run today. If you’ve got an old Windows 98 machine in the basement and an itch to play doctor, it’s a great and accessible medical sim. If you’ve already conquered the first, skip on to ER3.


The Good

Photos of patients instead of early CG-renders. The design of the hospital and transition cinematics have both improved. Still a well-made medical sim.


The Bad

No new cases, aside from the few you could download. Occasional confusion between the CME instructions and the game interface still exists. More difficult to run today than the DOS version.


My daddy says if you mess up, he’s going to sue!”


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2 thoughts on “Emergency Room 2

  1. I also had some promising results with DXWnd, though that setup is even more complicated than the options listed above. Didn’t get the CPU limit ratio perfect, but I think it would be doable. Still, virtual (or real!) hardware seems the way to go for now.

  2. Finally my efforts in reviewing the CSI games have been recognised 🙂

    Although technically it should be “Rik from A Force for Good went through and reviewed all of the CSI games on PC before coming to the conclusion that none of them were as good as the ones on Nintendo DS, which he had already played.”

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