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Life and Death is a medical simulation game released by The Software Toolworks (who would eventually go on to make Mario Is Missing and Mario's Time Machine) for the DOS PCs and Mac in 1988, with ports to the Amiga, Atari ST, and Apple IIGS following years later. You must diagnose, treat and operate on patients. It is generally known for its painstaking realism in surgery and overall difficulty.

It was followed by Life and Death II: The Brain in 1990. Playing a brain surgery sim is more like running through a very long, difficult checklist than anything, but drat if using a bone drill on a patient's skull isn't more tense than some entire survival horror games.

The original game focused on abdominal surgery such as appendicitis and aneurysms, while the sequel focused on brain surgeries like tumors, subdural hematomas and... aneurysms.

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Some gameplay footage of the original can be found here. The sequel can be watched here.

It has no relation to the webcomic of the same name.

This game contains examples of:

  • Autopsy Snack Time: In the second game whenever a patient dies, the morgue staff will be eating a pizza in front of it.
  • Artistic License – Medicine: While the game is more accurate than a lot of other games and shows in this regard, it still has its moments, some of which may be able to be chalked up to medicine marching on or a similar trope. One example is that you, the surgeon, are responsible for setting up the IVs, turning on the anesthesia, and monitoring the patient for abnormal rhythms. All of these are jobs that would normally be done by someone else- the former would be done by one of the nurses in all likelihood, and the latter two would all be handled by the anesthesiologist. The sequel has you dealing with PCO2 levels as well, and switching the respiration between low/high, which is also something that would be handled by the anesthesiologist.
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  • Don't Try This at Home: The game's manual has a disclaimer saying that Life and Death is a game for fun, not education, and should not be relied on in making any health-related decision.
  • Feelies: The first game not only comes with a booklet on the history of surgery, but it also includes a surgical mask and pair of latex gloves.
  • Funny Background Event: In the second game, go into the lounge. You can see someone endlessly pouring coffee into a cup until it overflows.
  • Medical Game: The original may be the Ur-Example of the trope.
  • Speech Bubbles: The clinic's receptionist converses with you in this manner.
  • Spiritual Successor: The Trauma Center games are pretty much this.
  • Ultimate Job Security: No matter how many times you screw up and kill dozens of patients, you simply get sent back to med school.
  • Video Game Cruelty Potential: Oh so much. You can slice open your patient with the scalpel without anesthetizing them first, causing them to scream in pain; you can dope them up with antibiotics and anesthetics until they die; among other things.
  • Welcome to Corneria: The doctor supervising you often has just one line for the specific actions you do, and it can grate if you have to do them repeatedly during a single operation. For instance, an appendix surgery site may have six spots you need to clamp, and so you will see "Looks good doctor. You have clamped that bleeder." five times (sixth line will acknowledge you dealt with the final one), and then you'll get "Doctor, the bleeder has been cauterized" five more times immediately after.
  • What the Hell, Player?: During examination, if you poke a patient in their painful areas enough times (where they yelp in pain), they start to get tired and wonder whether or not you're a real doctor.
    • If you do all sorts of stuff the game makes sure to yell at you. Screw up during brain surgery, then they start giving you a bunch of hysterical people, drug addicts, people with neuropathy and migraines before getting a surgery.
    • Pick up the pin. Click on the patient's eye. Your director then says, "The staff was not amused by your impression of Freddy Krueger."
    • Multiple cuts on a single layer? Nice going, Jack the Ripper.

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