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Two Point Hospital is a 2018 Space-Management Game video game and Spiritual Successor to the 1997 game Theme Hospital, sharing a similar cartoonish aesthetic and tongue-in-cheek sense of humour. Developed by Two Point Studios by former staff members from Bullfrog, Lionhead and Mucky Foot, Two Point Hospital puts you in the role of a hospital manager and challenges you to build and maintain a network of hospitals, treating patients with a range of bizarre ailments, from "mock star" (an irresistible compulsion to dress and perform like Freddie Mercury) to "light-headedness" (having a giant light-bulb for a head).

As you progress you unlock new towns, each in need of a new hospital and each with their own particular challenges and quirks. In each hospital you will have to build diagnosis and treatment rooms, as well as providing facilities, refreshments and entertainment for the staff and patients to keep them comfortable and happy. As you progress, you will need to add training facilities, research departments and even marketing teams to attract patients and potential employees.

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The underlying gameplay, as in its spiritual predecessor and similar titles, is space-management. Each mission map is limited in space and usually can't comfortably fit everything, so you need to make sure to skimp on space as much as possible while keeping rooms roomy enough — otherwise everyone (including your employees) will get moody and leave. Narrow corridors and rooms without windows are likely to end up bankrupting you. On some levels you can also spend money to purchase extra adjacent buildings to expand your hospital. Of course, distance between the various facilities is very important: staff need to reach the toilets and staff rooms quickly so they can get back to their jobs more often, and patients don't want to spend forever walking the hallways between the various diagnosis and treatment rooms. Not to mention the fact that emergency situations occur often, in which you'll need to provide treatment to a lot of patients within a very short period of time, including the time it takes for them to disembark from a medical helicopter or ambulance and WALK to the treatment room, and wait in line for the nurse!

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Two Point Hospital was released on the 30th of August 2018 for PC on Steam. A free DLC, The Golden Toilet, was made available on launch day, all you need to do to get it was to sign up for the Two Point Studios newsletter. The first proper DLC, Bigfoot, was launched on December 5th, 2018, and introduced three more hospitals and 34 new illnesses, as well as a plethora of deco items. Workshop support was introduced on February 7th, 2019. A second paid DLC, Pebberley Island, launched on March 18th, adding three more hospitals.


Tropes Used:

  • And Now For Something Completely Different: The town of Duckworth-Upon-Bilge challenges you not to build a private hospital from scratch, but to expand and maintain a public hospital. This means you don't get money from diagnosis and treatments, or even vending machines, and instead have to fund your hospital by completing challenges.
    • The Underlook Hotel level in the "Bigfoot" DLC has a similar mechanic; patients do not pay for diagnosis or treatments, but the resort hotel covers a percentage of your operating costs, based on your cure rate over three (in-game) months, and you get bonuses for completing additional challenges.
    • Overgrowth in the "Pebberley Island" DLC gives you the challenge of building an outdoor hospital. The same basic rules apply, and the room building mechanics are identical, but patients and staff are freer to move around between areas of the hospital with no walls to constrain them. Rather than purchasing new plots of land, new areas to build on are instead unlocked by completing challenges (curing a certain number of patients, promoting and training staff, etc.), and you advance through the star ratings by unlocking more plots of land.
    • Topless Mountain in the "Pebberley Island" DLC has patients arrive in waves instead of continuously, with each wave bigger than the last. This places a greater emphasis on staff and queue management, as you'll need to clear the wave as quickly as possible to avoid operating at a loss for too long.
  • An Entrepreneur Is You: The game revolves around setting up a profitable hospital. While not as numbers-driven as some business sims (you can easily breeze through the first few towns without having to pay attention to anything besides how much money you have left), you will still need to juggle staff wages, loans, prices and operating costs to some extent.
  • An Interior Designer Is You: You are able to decorate your hospital corridors and rooms with all sorts of decorative items, including posters, potted plants, artworks, and gadgets like radios and clocks. Most have no direct effect, but they do increase the attractiveness of the environment which in turn improves the mood of patients and staff.
  • Announcer Chatter: As in Theme Hospital, the receptionist will frequently announce the need for staff in a particular area of the hospital, as well as providing a few snarky comments from time to time. Two Point Hospital also adds a trio of radio DJs who burble away about various things between songs, and advertise various products.
  • Ascended Fanboy: A number of the junior staff that worked on Two Point Hospital were big fans of Theme Hospital back in the day[1]. Now they got to work on a spiritual successor with the creators of the original game.
  • Bedsheet Ghost: If a patient dies, they might come back as one of these. They spook staff and other patients and drop ectoplasm on the ground. A trained Janitor removes these with a giant Dustbuster.
  • Black Comedy: The entire game.
  • Bottomless Bladder: Averted. You have to build toilets for your patients and employees.
  • Brainwashed: Occasionally the CEO of a rival hospital organisation, The Orb Foundation, will show up at your hospitals and walk around, hypnotising patients and staff (by doing a silly dance). Brainwashed staff will quickly grow miserable, and brainwashed patients will either storm out or refuse to pay.
  • Church of Happyology: The Orb Foundation.
  • Classically Trained Extra: Sir Nigel Bickleworth, one of the radio DJs, is portrayed as a jobbing classically-trained actor reduced to hosting local radio. He sounds like a cross between Rex Harrison in My Fair Lady, and Frasier's Gil Chesterton. He shows open contempt for both the listeners and his job, regularly complaining about the music he is forced to play, the advertisements he has to read, and casting aspersions on the intelligence of his audience.
  • Colour-Coded for Your Convenience: Hospitals and their staff are colour-coded. Doctors wear white labcoats; nurses wear dark blue scrubs; assistants wear light blue vests; janitors wear brown dust coats. Diagnostic rooms have green-trimmed walls; treatment rooms have blue trim; hybrid rooms have purple; utilities have yellow.
  • Erudite Stoner: Harrison Wolff, one of the radio DJs, is this one, with his slow speech and random ramblings.
  • Everyone Hates Mimes: The medical condition "Mime Crisis" gives patients the classic white face and stripey jumper, and they stagger around the corridors miming as if walking into a strong wind. A trip to the psychiatrist fixes them right up (or rather hopefully that'll be the case).
  • Explosive Instrumentation: Poorly-maintained medical equipment in the game will explode when shaken. The hospital itself, however, is largely earthquake-proof, though earthquakes do cause plaster debris to rain from the ceiling.
  • Failed a Spot Check: It's possible for a doctor to not be able to diagnose a patient, even if said patient has a giant lightbulb for a head in a world where having a giant lightbulb for a head is a known medical condition.
  • Freudian Couch: Used in all psychiatric therapies.
  • Gender-Blender Name: The game's name generation engine is not tied down to the NPC generation engine. This results in characters with feminine looks but a male-sounding name and vice-versa.
  • Hammerspace: It's where janitors keep their brooms, vending machine supplies, trash bags, and ghost-fighting Dustbusters.
  • Healing Hands: One of the random perks doctors and nurses can have, which causes patients' health status to increase.
  • Holiday Mode: Starting late October 2018, Halloween mode was implemented, with new spooky songs and effects like bats flying overhead and Jack-o-lanterns on the hospital premises.
    • The December 2018 update implements Christmas mode, with new Christmas-sy tunes. It also drops with the first paid DLC in the gamenote , which unlocks several new hospitals further north in the game map as well as new illnesses to cure.
  • Instant Bandages: Patients with various broken bones come in already wearing bandages and casts. The treatment is a stretch in traction, followed by removal of the bandages using a silly machine.
  • Kaiju: The disease "Metropolism" has patients who arrive at the hospital dressed as giant reptiles ("Reptile Metropolism") or robots ("Mechanical Metropolism"). The cure for both variants is to give the patient a big cardboard city to trample, snapping them out of their delusion.
  • Losing Your Head: The treatment for Lightheadedness, although it's replaced. The patient will reach for their open larynx wondering where it went.
  • Naked People Are Funny: One of the illnesses is "Emperor Complex", where patients stroll around stark naked believing themselves to be clothed. The also have a tendency to do, as the game's art director put it, "everything you wouldn’t want a naked person to do in front of you" - stretching, bending over and so on. Once cured of this delusion, they leave pretty quickly!
  • The Paranoiac: Harrison Wolff is just as likely to ramble about (hilariously) weird conspiracy theories as he would with non-sequiturs.
  • Parody Commercial: Two Point Radio would play them every now and then between songs. Keeping to the consistency of the game, there are ads for Burp Soda, Palpitation, Cheezy Gubbins and Briney Brittle, which are sold by vending machines in your hospital. There are also ads for your rivals' hospitals. Also, the game's opening cutscene is a commercial for your hospital.
  • Percussive Maintenance: How the janitors repair and upgrade machines - whacking them repeatedly with a wrench.
  • Pictorial Speech Bubble: The most urgent status of your patients and staff members is communicated by a pictorial speech bubble floating above their head (hungry, thirsty, tired, bored, needing the toilet, needing a break, health level, etc.). More detail can be discovered by clicking on the person.
  • Pixellation: Used to censor people on the toilet, undergoing surgery, or suffering from "Emperor Complex". Also the main symptom of the disease "8-Bitten".
  • Punny Name:
    • Nearly every single disease in the game.
    • The title of the game itself has a clever double meaning. Not only is it a spiritual successor to Theme Hospital, making it a kind of "Theme Hospital 2.0", but graphical advances mean that the Isometric Projection of Theme Hospital is now replaced with true 3D graphics in two-point perspective.
  • Rage Quit: An In-Universe example that, while it doesn't completely match the trope, is accurate to the patients. Patients have their own needs, and if they reach zero, they'll leave your hospital in a very furious mood, denting your reputation as a consequence. Further lampshaded when that happens - the status text when they're doing that actually reads "Rage quitting"!
  • Real-Time with Pause: Though this is a real-time strategy game, you are able to slow down and pause the game to build rooms, move around staff and perform other activities. Some actions, such as building on a new plot of land or upgrading a machine still have to take place in real-time.
  • Room 101: The treatment for Jest Infection, disguised as a circus tent.
  • Sandbox Mode: Introduced along with the Halloween update. You get to run a hospital for as long as you wish, with no possibility of losing the game.
  • The Scrappy: In game example - the radio DJ Nigel Bickleworth is hated by both his colleagues Harrison Wolff and Ricky Hawthorn.
  • Screen Shake: During the frequent, powerful earthquakes and volcanic eruptions of England.
  • Screw This, I'm Outta Here!: Keep your patients waiting too long, or deprive them of food, drink, warmth and entertainment while they wait, and they'll storm out in anger, denting your reputation in the process.
  • Shout-Out:
    • The title of the game itself doubles as a shout-out to Twin Peaks.
    • The illnesses and clinics, as well as having Punny Names, also have shout-outs to various media:
      • "Mock Star" patients dress and behave like Freddie Mercury in his iconic 80s-era yellow jacket. The Flavor Text describes sufferers as "sadly ga-ga".
      • "Night Fever" patients dress and behave like John Travolta in Saturday Night Fever.
      • Patients coming in with a saucepan stuck on their head ("Pandemic") have it removed in the "Pans Lab".
      • "Bogwarts". The Flavor Text suggests that as well as being cured by a visit to the pharmacy, it could also be cured "by witchcraft".
      • "Spinal Bap" references the band "Spinal Tap", itself being a functional band in the movie This Is Spın̈al Tap.
      • "Mime Crisis" is very closely named to Time Crisis, although the two are vastly different.
      • The illness "Mucky Feet" is named in tribute to Mucky Foot, the studio that was set up by former Bullfrog employees and which developed Startopia, another Space-Management Game.
      • A disease that drains the patient entirely of colour, leaving them monochrome, is called "Grey Anatomy". The show's name itself is a shout out to the 1858 textbook "Gray's Anatomy", which is about the human anatomy. That makes the disease a shout out to a shout out.
      • A special freeplay weekend introduced patients coming in with head crabs from the Half-Life series.
      • The treatment for "Wanderust", a disease that makes patients crave for excitement by putting themselves in dangerous situations, is a trip through the "Counterfeat", a machine that simulates an Indiana Jones-style ancient temple full of booby traps. Naturally, these include spikes popping out of the walls, a collapsing floor, and the iconic giant rolling boulder.
    • Staff character names include Longbottom, Lovecraft, Dynamite, Kilmister, McBoatface, Gamgee and Tobias Funkle.
    • The tutorial for janitorial work is titled "Charlie Work".
    • The guest trainer in diagnostic medicine is named "Dr. Gregory Mouse".
    • The arcade machine, one of the unlockable items of furniture, is clearly playing a game of Sonic Mania - the title screen music plays faintly when the machine is in use, and the screen shows Sonic running through the Flying Battery Zone. Being published by Sega allowed for this little easter egg.
    • Swindles Bank (one of three banks that provide loans to cash-strapped hospitals) has a two-headed griffon in a ring of circular dots as its logo, a clear parody of the now-defunct Midland Bank. This also counts as a shout-out to Theme Park, the UK edition of which was sponsored by Midland Bank and prominently featured the logo.
    • One of Sir Nigel Bickleworth's radio interludes has him complaining about the terrible writing of a frozen peas advertisement he is forced to read out, parodying the famous Orson Welles outtakes for a series of 1970 Findus frozen foods advertisements.
      • Sir Nigel Bickleworth's personality itself is also a Call-Back to a particular William McDuff from The Movies, right down to his thespian background. Unsurprisingly, said game was by Lionhead Studios.
    • Occasionally, the hospital announcer will call for "Doc Brown to the roof please, that's Doc Brown to the roof."
    • One of the later areas you can run your hospital in is called Sweaty Palms. This is a call back to the disease in the original Theme Hospital.
    • One of the punchlines in the opening blurb of the Rotting Hill hospital (which could be a shout-out to the film, Notting Hill, or simply the district of London from which the film took its name) is that the hospital "smells vaguely of cabbage", one of the random attributes that were included in staff descriptions in Theme Hospital.
    • Another shout-out to Theme Hospital comes in the Bigfoot DLC pack, which adds the illness "Bloaty Dread", a reference to the "Bloaty Head" illness in its predecessor.
    • The first DLC pack, "Bigfoot", adds several new locations to build hospitals, including a snowbound mountain-top hotel called "The Underlook Hotel". You can also hear it being mentioned on Two Point Radio at times.
    • When Christmas Mode is active, one of the seasonal songs the radio plays is called Aurora the Explorer. Thankfully it's really good and is not repetitive to the point of driving the player mad.
  • The Shrink: Psychiatry is one of the specialisms that doctors can have. The patient lies on a Freudian Couch as they get diagnosed or treated by them.
  • Sliding Scale of Gender Inequality: While Theme Hospital had only male doctors and handymen, and only female nurses and receptionists, Two Point Hospital redresses the balance with male and female staff members in every role.
  • Spiritual Successor: To 1997's Theme Hospital; several senior members of the development team worked on the original game, while much of the junior members of the staff have confessed to be fanboys of the original. Two Point Hospital has a lot of the same mechanics, but expands and improves on them in numerous ways, such as being able to train all members of staff and not just doctors, and being able to go back to previous hospitals to continue running and expanding them.
  • Stealth Pun: Janitors capture ghosts with handheld vacuums, like Dustbusters. Making them... Ghostbusters.
  • Stuff Blowing Up: Earthquakes can damage your equipment, and they can explode, in which at that point, you have to replace them.
  • Stylistic Suck: Cleverly done with patients suffering from "8-Bitten", a disease that causes them to appear pixellated. Far from just being a mosaic filter, patients even get downgraded walk cycles (with fewer frames than other people) and only 8 viewing angles - watch an 8-Bitten patient while turning the camera around and notice they will "snap" to a new angle every 45 degrees, exactly like in isometric games where the sprites are only drawn from a few specific angles. When treatment is unsuccessful, patients will still exhibit some of the symptoms, losing the blocky appearance but keeping the jerky walk cycle.
  • Timed Mission: A couple of varieties. You will occasionally get emergency cases, where multiple patients all suffering the same malady arrive at once, and must be treated within a certain time period (thankfully they don't need to go through the diagnostic process, and you only need to cure more than half to succeed). At other times, you will receive a timed challenge from a staff member to improve something about the hospital, such as curing a certain number of patients, avoiding any deaths, or increasing the attractiveness of the hospital or a particular room. Thankfully, both emergencies and staff missions are optional.
  • The Pig Pen: Jumbo McNally, CEO of a rival hospital, will occasionally visit and drop litter everywhere he goes.
  • Toilet Humor: When the, ahem, call of nature gets too urgent for a character, they will usually dash towards the nearest bathroom with their hands clutching their... pertinent areas. Leave it too late, and your janitors will be mopping up yellow puddles.
  • Video Game Cruelty Potential: While your goal might be to cure patients, it's entirely possible to torture them instead. Want to give the entire hospital a single toilet so you can watch hordes of people queue up until they wet themselves? You can do that. Want to block patients in until they starve, dehydrate or die of their illness? You can do that. Want to send them for treatment when the doctors have only the vaguest idea what's wrong with them? Well, it'll get them out of the door quicker, one way or another...
  • Video Game Cruelty Punishment: However, every patient death, failed cure and rage-quit will take a notch off your reputation. Do that for too long, and you won't attract patients, you won't be able to pay your bills, and your hospital will fail.
  • Video Game Time: The in-game clock passes pretty quickly, with each day lasting about 7 seconds on normal speed, yet the staff and patients move around at a normal walking pace. This means that patients often spend over a hundred "days" in the hospital, from checking in to checking out (either literally or figuratively). However, rooms are constructed instantaneously, and putting up a new building takes a couple of in-game weeks (a couple of minutes of real-world time).
  • Visual Pun: some of the diseases.
    • Animal Magnetism: the patient has little critters stuck to him.
    • Light Headed: the patient's head has turned into a giant incandescent light bulb.
    • Litter Bug: an infection that causes the patient to randomly drop garbage.
    • Rock Bottom: the patient's butt has petrified.
  • Weapons That Suck: Patients who die in your hospitals come back as ghosts that spook other patients and staff. Getting rid of them requires a janitor with the ghost-catching skill; they remove the annoying spectres with a hand-held vacuum cleaner.
  • Who's on First?: A easily missed joke on the radio- occasionally, the radio would play a song called "Come On Over"- by a group called "What? Where?"
  • X-Ray Sparks: Patients suffering from "Shock Horror" randomly emit bursts of electricity, causing them to appear momentarily as glowing skeletons.


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