Behind the Scenes: Theme Hospital

The article below appeared in an edition of Games magazine (Issue 113, September 2011).

"Who are those bloody idiots? Get them out of here!"

The idiots in question are Bullfrog designers Gary Carr and Mark Webley, and the angry person shouting that question is a surgeon busily sucking the fluid from an open wound as Carr excitedly watches, causing such a fuss that he distracts the surgeon from his important duties. The pair are trying to take notes as part of the research phase for their next game, Theme Hospital, but the scene before them is far more graphic than the cartoon-like and comical simulation the pair will eventually produce. "We swiftly concluded," says Carr, "that visually, there was little inspiration for us. The floor and walls and pretty much everything about hospitals were dull to look at, except, of course, some of the cool machines that they use in clinics."

So Bullfrog invented cool machines to treat strange fictional diseases - including Bloaty Head, the Uncommon Cold and Hairyitis. "That was actually Gary's idea," says Webley. "I started off using real illnesses but Gary was rightly concerned that people might find it distasteful. Using made-up illnesses gave us the opportunity to use humour, as well as being able to make up our own cures. We went with a British Ealing Comedy/Carry On kind of style - we definitely played it for laughs to try to keep it light." He credits writer James Leach, who worked on several Bullfrog titles, with bringing more humour to the writing and the receptionist's dialogue.

Some diseases did not make the cut. "Animal Magnetism would have been people walking into the hospital with animals stuck to them! We also have Saturday Night Fever, when the patient walked in wearing the white suit and black shirt, and as they did all the floor tiles would light up underneath their feet!" says Webley. Carr adds "One of the diseases turned people into Elvis impersonators. We had to get permission to use the name, and I had also done an 'uh-huh' impression of Elvis, which was deemed breach of copyright by the Elvis estate. Originally, it was called Elvis Impersonator, and we had to rename it King Syndrome. It still used the same graphic."

Theme Hospital players progressed by earning more cash and treating more patients than rival hospitals, but that was not the original design. "We had planned four time periods to the game: Medieval, Victorian, today, and future. It's fortunate that we started with the present day, because we simply ran out of time and were unable to even start the other eras," says Webley, leaving us to imagine a very different game.

Joining the team was artist Andy Bass. "Theme Hospital was the first game I worked on. I was over the moon when I got the call from Bullfrog, as they were the ones I really wanted to work for." He remembers it as a great place to work. "All the guys there were amazingly helpful; Gary was always happy to help me out. We worked very hard on Hospital, but it was always fun. Late Night Duke Nukem sessions were the norm, juggling, unicycles, people in and out of the office at all hours."

Development was far from plain sailing, however, since some corners of the studio doubted the project to the core of its premise. "Bullfrog was also working on Dungeon Keeper, Gene Wars and Syndicate Wars at the time, so Theme Hospital (who the hell was gonna buy that?) seemed like a nice safe bet for me to find my feet," says Bass. Carr agrees: "No-one understood it at first, but it lived by being a really good game. When I joined Mark on the project, I thought I was joining Dungeon Keeper, so I was really disappointed and didn't fancy it at all! Which is why we basically did some quirky things with it - there was no raw material there, and we had to make the game from nothing."

The difficulty in understanding helped devise the Dynamic Information Bar, as Carr describes. "We used to play with all the debug information displayed on the screen. Then, when we let other people outside the team play it and switched off the debug info, it became really hard because no one could tell what was going on. So, we had to enter a whole load more information so people understood it. As you point to a character, you get the information relayed back on his current state (a context-sensitive HUD), where he was going and stuff like that. That was unique at the time, but it has been used in many other games since."

One graphic stands out in Bass's memory. "We put some Kit-Kat vending machines in the game. It was a pain in the arse because we didn't have the correct colour so Gary spent ages tweaking the palette. I modelled the vending machine and rendered it to the game palette in 3D Studio before touching them up in Deluxe Paint. Our reward? A box of Kit-Kats, which arrived on a day I was on holiday, so there was nothing left upon my return." Bass describes compiling as a novelty, in hindsight. "I remember a build of the game taking about eight minutes to compile, and how we used to moan about how ridiculous that was. The game itself had to fit within an eight-megabyte footprint."

Rajan Tande was another newcomer to Bullfrog's programming team at the time. "Luckily for me I got to work on the hospital game, and it was a great first two years in the industry. There was a Thursday where I came into work and went home the next day for a shower and came straight back to work. I finally went home at about half past one in the morning on a Saturday, and I'd crashed out when about half an hour later the QA department came round in a car and drove me back to work to fix a bug! Sixteen hours later, I finally got back home and got some sleep. I still have nightmares about that knock on the door."

One snag hit late in the process, as Webley explains. "We had to take out the multiplayer near the end, where two people could compete against each other and send patients to each other's hospitals, but that got released pretty quickly as a patch." Tande remembers, "Putting that back into the first patch was actually really fun. I remember some cracking games against other team members, though games did often come down to who won the auctions for new parts of the hospital." Then there was the artwork. "The nurses had red crosses on their hats (we would have had to pay Red Cross to use it), and there was also a green cross. The box initially shipped with a green cross but they had to recall it because we'd faxed over the artwork and they thought it was in black and white - it was before we could send images by email. They looked at the fax and approved it because it was a black cross. However, we had no right to use a green cross on a white background, or vice-versa, so we have to come up with a new shape - a start. You can still buy the green cross version in a more recent format, so clearly someone forgot that had been rejected!" adds Carr.

Regular meetings in the pub tracked the game's progress. Carr says, "At one meeting we had done everything we had set out to do, and that was when Mark realised we had finished. None of us realised that we were content-complete, which was actually a bit of an anti-climax and we felt very flat. It was very odd.

"The lifetime forecast was only 50,000 units. One stroke of luck was an EA game didn't ship (X-Wing Vs. TIE Fighter) and it released some money. Paul Jackson, the UK MD of EA, said we could get ours out we would get a bit of a push. We came out around Easter, so there wasn't a lot of other stuff; we got a lot of billboard coverage including the Tube and shop fronts." Webley adds, "MDK was out at the same time and we beat it to number one - we stayed there for eight or nine weeks. It was a bit like Ultravox's 'Vienna' not getting to number one because of Joe Dolce!"

Webley remembers promoting the game. "We had to dress up as doctors and nurses for our press shot - Gary get very nervous taking his clothes off in front of a theatre nurse. In the end she became exasperated and turned her back to allow him his modesty!" Not all the press coverage was glowing. "We were mentioned in the Houses of Parliament and there was an article in The Daily Telegraph saying 'Sick computer game used by British Medical Association to train senior management'. We appeared on a couple of radio programmes to defend this."

Carr, Webley and Bass are back together working at Lionhead, but remember Theme Hospital fondly. Carr says "We all feel that it is still, out of all the things we have worked on, the one game we're most proud of. We were making Theme Hospital when EA bought Bullfrog and there was a lot of griping at all the changes that were going on. But our team had a little bubble, kept our heads down, worked hard and loved it." And Webley says, "We have been really pleased and proud of what we created. It stayed in the charts, and then in budget form, for over ten years, and it stayed relevant a lot longer than pretty much everything that came out around that time."