Trauma Center 2 is a direct follow-up to the original DS game. The story begins in Costigar, an African nation that is being torn apart by a civil war, where Derek and Angie are working as volunteers. Even though conditions are improving in the area, tensions are still high, so many of your early surgeries find you tending wartime injuries like bullet wounds as well as a few third-world diseases, one of which is under investigation by Derek's employer, Caduceus, a medical group that identifies and cures mysterious diseases.
The wartime setting for the first part of the game gives the entire storyline a much more somber tone than previous games. In the first few chapters, the small clinic is attacked by guerillas in a late-night raid, a doctor deals with the ramifications of neglect and a main character suffers life-threatening injuries as a result of an un-detonated land mine. Using sensitive, real-world issues, especially those dealing with war, is a tricky thing to pull off, but Trauma Center 2 manages to strike the right balance of commentary and humor that it never feels overly preachy or hokey.