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Welcome to Noclip, a podcast about the people who play and make video games. Each episode Danny O'Dwyer tells a story from inside the world of gaming. Learn about how your favorite titles were made, discover gaming communities you couldn't have imagined, and gain a deeper appreciation for the people behind the code.

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Aug 29, 2018

We talk to Bullfrog and Lionhead legends Gary Carr and Mark Webley about the design of PC cult classic Theme Hospital, and how their careers twisted and turned to see them return to create a spiritual successor.

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Hosted by @dannyodwyer
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- [Danny] Hello and welcome to Noclip, the podcast about video games and the people who make them. On today's episode, we pay a much needed visit to the video game doctor, as we celebrate the return of a PC cult classic. Bullfrog are synonymous with a wonderful period in time for games development in the United Kingdom. Producing many cult classics including Populus, Dungeon Keeper, Syndicate, and Theme Park. But to me, the jewel in Bullfrog's crown has always been their lesser-known follow up to the theme park management game. While becoming an instant classic in the UK, Theme Hospital is much lesser known here in the United States. So it was quite the surprise to me when, on a date with an American, the girl across the table from me mentioned it as one of her favorite games ever. I think that was the moment I decided I wanted to marry you, was when you mentioned you liked Theme Hospital.

- [Lindsay] Oh yeah, that's, like, an important aspect of our relationship.

- [Danny] Yeah, what do you remember about that game?

- [Lindsay] I remember all the little goofy components of it, like how the people look, and how you can pop heads, and how you can deal with a million Elvis' and the helicopter comes in and has a thousand people on it, and the fancy man comes around with his top hat.

- [Danny] Oh yeah, I forgot about the VIP.

- [Lindsay] The fancy man.

- [Danny] Yeah. And you had to make sure that he didn't, like--

- [Lindsay] See all your rats and shit, like-- So you be, like, "This way, Sir."

- [Danny] Or somebody would get sick right in front of him. He kind of looked like the Monopoly man.

- [Lindsay] Yeah, he was so fancy. And he, remember when he stopped by all the wards and looked in all the windows, he peaked in. He'd be like, "Oops, not that one, "no one works in there."

- [Danny] I wonder how much it mattered. Because when he was walking around, I always thought, oh, I better make sure that wherever he walks we have fire extinguishers.

- [Lindsay] Totally.

- [Danny] But I bet it was just, like--

- [Lindsay] It was predetermined before he even landed on his helicopter or however he got there.

- [Danny] I think this might be the first time I've ever worked on a Noclip project which is a game that you care about? Is that true? I guess Rocket League you liked.

- [Lindsay] Rocket League I liked for a few minutes. None of the other video games you've ever done a podcast on, I mean done a documentary on, I've ever even heard of.

- [Danny] Yeah. You're not a final fan of C14 fan?

- [Lindsay] I've heard of Final Fantasy. I didn't know there were 14 of them, but--

- [Danny]There's way more than 14 of them.

- [Lindsay] I've heard of it. Oh, really?

- [Danny] Yeah. And since it is the first time I've kind of worked on something that you actually have a deep knowledge of--

- [Lindsay] Oh, I'm excited.

- [Danny] If you had any questions, let me be those sort of the translator between you and the developers. What would you ask if you had any questions?

- [Lindsay] Well my big question is when they are going to make a sequel. Because as fun as it is to play that pixelly thing, they better make a sequel. My real questions are about the silly things, like how the handyman could smell cabbage or just little silly components that they put in there.

- [Danny] It's the doctors, isn't it, it smells faintly of cabbage.

- [Lindsay] It smells faintly of cabbage, yeah.

- [Danny] When you were hiring them. Oh yeah, I guess the handyman, too.

- [Lindsay] Anybody could smell like cabbage in real life. Anyone could smell like cabbage. So I had that question, and also about shooting rats. Like, what that's about and sometimes you could unlock that secret level where it was just rat shooting. And that was really cool.

- [Danny] It was kind of random, though.

- [Lindsay] Yeah yeah, it was just like--

- [Danny] Like, why does this happen?

- [Lindsay] Right, I have some experience in hospitals and I've never once shot a rat, but they thought it was important that we have that component.

- [Danny] I can answer the first question.

- [Lindsay] Oh, when the sequel's coming out?

- [Danny] Yeah, so I decided I wanted to do this a while back, and it took a while for me to hunt down the two main dudes who worked on Theme Hospital. It turns out both of them ended up having really prolific careers and getting to the top of Lionhead Studios, who made a bunch of games.

- [Lindsay] The Movies.

- [Danny] They made The movies, I remember you love, which is so funny, you love The Movies because it's probably Lionhead's most obscure game.

- [Lindsay] The Movies was really hard. I've never made any progress at all in that game. I think I'm doing something wrong, actually.

- [Danny] And the guys who, I think both of them actually worked on The Movies as well.

- [Lindsay] Well then I have further questions for them of how you achieve anything in that game.

- [Danny] We'll have to leave that for another podcast.

- [Danny] But I ended up finding them because they're working on a spiritual successor. So after, I think it's been eight, 19 years? Around two decades, and finally you can play a new hospital management game, it's coming out really soon, so--

- [Lindsay] Yes.

- [Danny] Let me ask the questions and I'll get back to you.

- [Lindsay] Report back.

- [Danny] Like report back to you--

- [Lindsay] Thank you.

- [Danny] On the condition of our patient.

- [Lindsay] Of our fair game.

- [Danny] Yeah.

- [Mark] Yeah, I'm Mark Webley, I'm one of the founders and I guess I'm game director at Two Point Studios.

- [Gary] I'm Gary Carr, I'm also a founder and I'm creative director at Two Point Studios.

- [Mark] I kind of heard about Bullfrog, I didn't really know that much about them until I saw this EA poster, a friend of mine worked at EA, and it was a poster with all their games on, it kind of looked like interesting games. You saw this one in the middle, which is, looks incredible, I said, "What the hell was that?" And it was Populus, and I thought, wow that just looks insane, I mean, you kind of looked back at it and you might not see it, but at the time it was, in my view, whoa that looks so different and cool.

- [Gary] I think I started a couple years before Mark, I think I started in 89.

- [Mark] Yeah, you were definitely before me.

- [Gary] So I done my first game at Bullfrog was Powermonger, I was there at the back in the Populus and I did a little bit on the data disks but not very much if I'm honest. I did a little bit actually on Syndicate, but it was called Cyber Assault when I worked on it.

- [Mark] I thought it was called Quaz at one point.

- [Gary] It was called Bub as well.

- [Mark] Bub? Yeah. Just something easy to type.

- [Gary] That's the game that we could never actually decide what it was going to be. It was in production forever.

- [Danny] Back in the early 90's, the team at Bullfrog was only around eight people led by the excitable hand of a man called Peter Molyneux. The studio operated out of a makeshift office crammed into an attic above a stereo shop and a flat occupied by a chain-smoking old lady. Peter had used his charm to persuade Commodore to lend them a suite of Amiga's and it was on these computers that the team worked on games, games like Powermonger, Syndicate, Magic Carpet, Flood, and Dungeon Keeper. Gary, an artist, left for a time after they had completed the iconic Theme Park. He went to work at famed UK developers the Bitmap Brothers for a number of years before being tempted back to Bullfrog by a devilish dungeon keeper.

- [Gary] Yeah, Peter has got a great way of, kind of, sort of making people believe that these things are going to be what they want them to be and he's brilliant at that and I loved the guy for it. But I wanted to come back and do something that wasn't Theme, so I kept saying, "Could the game idea possibly be a dungeon-y game?" And he sort of said, "Could be." What he meant was it could be, but it's not. So I came back, but actually it was the best decision of my life, it really was because it was great to work with Mark. We're very different people, and we both have sort of different things we bring together and we had--

- [Mark] We argue a lot.

- [Gary] We argue a lot and we had total freedom. I mean, back then there was only about three or four people that had the luxury to sort of take an idea and own it, and we were one of those few. So it was a great time in our careers, we were at the right time, I think, to sort of build a team together and make that game. When Mark and I were probably at similar age and different types of experience, I'd had a bit more games experience at the time, Mark had had a lot more management experience at the time.

- [Mark] But I was a lot smarter.

- [Gary] Yeah, I think so. But at this point in time, I think it was when Bullfrog was splitting up into creating teams within Bullfrog because we'd gotten a little bit bigger. So Mark kicked off what was called Pluto, believe it or not, which was the design and series team that was gonna do all the theme games and I was brought in to sort of partner with Mark on this game, we had no idea what was going to be coming and it ended up being Theme Hospital.

- [Mark] Well at that time, it was just me and you to start with, it was just, I mean, the team at its maximum size was probably about five or six. So it was pretty small teams, there's no producer, there's no designer, so I was programming, Gary as doing the art and--

- [Gary] And we were kind of making it up as we went along so that process kind of carried on for a while and I think that kind of originally it was a game about a hospital, a game about a theme park was kind of great, you got rides and exciting things and lots of fun just without even having to go outside the box.

- [Gary] Try too hard.

- [Mark] And then afterwards it was different. We kind of thought about the flow of the game the patient, the diagnosis, and the treatment of patients, but the sticking point was after. In fact, we were on the research back in Gilford, it's right next to the hospital, so we'd often spend out lunchtime walk around Dart U we'd probably get choked out now.

- [Gary] Trying to get inspiration, weren't we?

- [Mark] Yeah, just walking around the corridors, and just kind of seeing what's in the hospital. We're going to have lunch in the cafeteria and it was, it came to a point where I think you just, you said, "This is it, isn't it. "There's nothing more, it's just "boring corridors and plain walls."

- [Gary] They're all very similar, it doesn't matter if it's the US or the UK, I think hospitals share, they always have the same floor tiles. They have these slightly curved floors where obviously they're easy to wash in up corners so the floors slightly curve, they have this kind of shiny, painted up to about waist-high where I think that can be washed down as well.

- [Mark] Hosed down.

- [Gary] Hosed down. And they have a few machines with little screens on them and they all sort of makeshift beds that seems to be some sort of crash unit near it. And that's it, and we just suddenly thought, Oh my God, how does this compete with things like roller coasters, and water fluids, and all that kind of color? And we got really scared and we also spent about, and this has been said many times, but we spent about a month in different hospitals trying to do some research, trying to find a game out of all that.

- [Mark] Integrate on the street.

- [Gary] On the street, we went to Brimley and Rolsory, and we just spent time in all these hospitals and we just kind of got so weary.

- [Mark] Gary even got circumcised.

- [Gary] No, I didn't. We viewed operations, we were invited to go and look around the morgue and we went into business meetings about how one hospital could strategically beat another hospital to people that have been in injuries. And it just sounds like, oh god this is so grim.

- [Mark] We were setting up the ambulance.

- [Gary] That's right. Do you remember that?

- [Mark] Yeah yeah.

- [Gary] And then we sort of went for lunch and again in the canteen that looked very much like a real canteen, they have lots of really unhealthy food. And, uh, we just suddenly I think just landed on this idea at the same time to sort of just let's just make it up. Because we actually knew nothing about hospitals, we didn't know how they really worked.

- [Danny] Mark and Gary did their game design due diligence and visited hospitals all around the Greater London Area. They were kicked out of an operation for distracting a surgeon once, and almost visited a morgue before losing their nerve. It was these experiences that brought the boys to the conclusion that they were better off distancing themselves from the grim reality of hospitals as much as they could. They knew that the subject matter wasn't really the focus of the gameplay experience. It wasn't like people who played Theme Park all wanted to run Theme Parks, and the same could be true here. Through their experience they understood that the drive of this game came from the problems players would encounter and the ways in which they would solve them. So they didn't have to make a game about running a real hospital, they just had to make a game that was fun and challenging. It was around this time that Bullfrog was acquired by Electronic Arts. And when their new bosses turned up to see what the team was working on, they were, a bit confused.

- [Gary] And when they'd come to the studio and have a look at all the games, it's kind of like, a hospital game? No, I don't get it. It's like, oh, think about ER and things, we were trying to jazz it up. It's actually a really popular, exciting show. They'd say, "But this isn't like ER, is it."

- [Mark] I guess that's the problem. I think everybody probably would assume science fiction or fantasy--

- [Gary] Or killing or blowing up.

- [Mark] Making some sim game around that would be the best possible subject matter, but I think coming up with, if we stay in kind of reality, and relatable subject, but then you twist that into something else is, makes it way more interesting.

- [Danny] EA was right. It wasn't really ER. For one, Theme Hospital didn't have any real illnesses. The people in this world suffered from conditions like Slack Tongue, Bloaty Head, Kidney Beans and Third Degree Sideburns. One condition originally called Elvitus had to be changed when Elvis' estate got wind of it. The character art, which did look a lot like Elvis, was slightly changed, and the condition was renamed King Complex. Another legal faux-pas came with the original box-art of Theme Hospital, which carried a red cross. The Red Cross wasn't too happy about that, so they changed it to a green star. The guys were starting to warm up so I figured it was probably about the time to ask Lindsay's questions. First of all, what was with all the doctors that smelled faintly of cabbage? Who wrote this stuff? And why did Theme Hospital have a rat shooting mini game?

- [Gary] One thing I think Lionhead and Bullfrog haven't probably promoted enough is the great writers who have actually made us look even, well, made us look way better than we actually are. Because it's actually, it's interesting, there wasn't that many visual illnesses in Theme Hospital, but a lot of people remember the wonderful names and they paint their own pictures.

- [Mark] Yeah, and the descriptions of how they're contracted, so.

- [Gary] So I think, but the writing was really important to us.

- [Mark] There was a guy called James Leech.

- [Gary] But James Leech did the original, but James also worked with a guy called Mark Hill throughout, on and off through the Lionhead days, and that was something we wanted to bring, keep that consistency of writing. So, it was probably Mark, probably is, he's really strong.

- [Mark] Yeah, if you've got enough, if you've shot enough rats in a level, you could unlock a secret in between levels, you rat shoot. And it was basically just a lot of rats. You had a certain amount of time to kill as many as you can, and if you kind of chain them together, if you've got enough, if you've got a streak as it were, you could level up your weapons.

- [Gary] That's right.

- [Mark] And they were really difficult, I think the rat was two by one pixels, you know it was some of my best work, and you had to get a headshot. So you literally had to be almost pixel perfect, certainly in the harder levels.

- [Gary] It was hard, yeah.

- [Mark] And it's weird, things like that used to happen because we didn't have design documents. We didn't have, you know, we weren't scheduled to do, this week we're on this, next week we're on that. So, you know, this is just when developers just start dicking about really.

- [Voiceover] Could people please try not to be sick in the corridors.

- [Danny] Theme Hospital was a critical and commercial success, but once they were done post-acquisition Bullfrog saw an exodus of developers as Peter Molyneux left to form a new studio, Lionhead. Mark followed his old boss to Lionhead while Gary was part of another group that founded the studio Mucky Foot. There, he worked on the art for Urban Chaos, Startopia, and Blade 2, and left once the studio closed in 2003 whereupon he joined Lionhead to work on The Movies. By this stage the two friends found themselves in lead positions at the company. They shepherded many games through the studio during this time including Black and White, Fable, Kinect Sports, and unreleased projects such as Project Milo and "BC". They worked together at Lionhead for a decade, but as time passed the job became less like the good old days. Microsoft had acquired Lionhead in 2006 and the now 200 person studio had run into financial difficulty. So as the years wore on, the influence of their parent company was having an erosive effect on the team's creativity. Gary found it especially difficult to get his ideas to gain traction, and so he decided to leave.

- [Gary] I guess the thing I enjoyed most of the Bullfrog era was definitely Theme Hospital. It just was, because it was a point when I was ready to do more than just the artwork on a game. So I felt I was much more stepping into being a kind of a co-creating role rather than just making things look as pretty as I could. Then, I enjoyed my period with Mucky Foot, which was a company I sort of helped formulate, and we had some great years there. Lionhead, I guess the challenges were always working with Peter on such ambitious ideas because Peter would, I was in a team that wasn't Fable, so my part of that was Peter would throw some incredibly outlandish ideas around and it was kind of my job to get a little group of people together to try and realize that ambition. And it was really exciting, I mean, we literally went from making things on Kinect or things like Milo and Cabige, which was a bit nice for a while, it was just weird and wonderful opportunities to try and make a difference and do something strange and interesting, so I enjoyed that, too.

- [Danny] By the time Mark's tenure was coming to a close, Peter Molyneux had long left the company and Mark was creative director of Lionhead. His final act at the studio was to help get Fable: Anniversary out the door, and it was then that he stepped away from a job where he'd spent most of his adult life.

- [Mark] Yeah, I mean, I was there from the beginning, and my tenure was 15 to 16 years.

- [Gary] It was 16 nearly, I think.

- [Mark] Yeah, I left in the beginning of 2013. But it was a long and anxious period that I was kind of working through. I mean things had changed, obviously Peter had gone, and the kind of vision for Lionhead was, well, a vision for the Europe Microsoft was free to play console stuff and it wasn't really, I wasn't really enjoying it anymore. I think that's the best thing to say. You know, I kind of, if I was going to do it again, I wanted to fall back in love with making games and--

- [Gary] You're quite an emotional person, if you don't like something, you let people know about it.

- [Mark] And I sulk about it.

- [Danny] Mark and Gary were free agents and worked odd jobs here and there for old friends. They enjoyed the easier workload after years of grind at the top of one of the UK's largest developers. Perhaps it was then, given the benefit of hindsight, that the two remembered just how much fun they had had working on those old games together. So it was then, one evening, when Mark was picking up pizza, Gary pitched him an idea about starting a small, independent studio, and working on games sort of like they used to, in a cramped old flat stuck above a stereo shop and a chain-smoking old lady.

- [Gary] Yeah, I kind of didn't think. I thought, well who'd be interested in, you know, revisiting--

- [Mark] Two old farts you know, making old games, who's interested in it? And I think that was kind of--

- [Gary] We had to go on a journey of discovery. And actually it was when we started sort of talking to some people when we were still trying to find a partner to make this, we certainly realized there was a lot of interest.

- [Mark] We did a tour, didn't we?

- [Gary] We did a tour, we sort of went on the roads, and met up with a bunch of either, we were looking to either sell publish, initially, maybe do a kickstarter, or partner with a small publisher. We didn't know, you know, who would go for this. So we just sort of started looking into it. And we just literally got in the car, booked into a sort of cheap hotel, motel-type places, and just knocked on doors and that's how we started. Which was great fun because this was a couple of 50 year old guys, basically in a band back together again.

- [Mark] And going on tour, so we just, our wives probably thought, look at them, they're pathetic. What do they think right now?

- [Danny] Mark and Gary thought there might still be a thirst for their old sim games. The classic Bullfrog titles were still selling well over on GOG and new games like Prison Architect and City Skylines were creating a whole new generation of fans. They had considered crowdfunding the project at one point, but they were warned away by some of the developers they talked to during their road-trip. So, they wrote a pitch for a new hospital game that would evolve the ideas of a game they had made almost two decades earlier. They knew they needed financial help. The guys were experienced and understood the type of game they wanted to create would require more money and time than they personally had. They shot the pitch around to publishers, and while some were receptive, there was one in particular that seemed very keen: SEGA. They negotiated terms with SEGA from the end of 2015 right up to the summer of 2016. And as it happens, right as the deal was signed, news broke that Microsoft would be closing Lionhead Studios. So, somewhat ahead of schedule, Gary and Mark rushed to hire their new team.

- [Gary] We kind of imagined we'd take them over a period of time, but Lionhead closed, and it was suddenly these brilliant people were out of work.

- [Mark] Tons of brilliant people.

- [Gary] And they weren't around for long.

- [Mark] No, we were going to lose them.

- [Gary] Companies were coming to Gilford doing presentations just going, "You should come work for us." And we, you know, we had to kind of promise--

- [Mark] That was a risky thing to do. Because obviously we had to sort of lay out a huge amount of our expenditure earlier than we would ordinarily do it, but the point thing is we made a huge advancement in the development in the game and also this team, I wouldn't swap them for the world. They're amazing bunch of people.

- [Gary] Some of them have worked with us for over twenty years. But Alan, who's sat behind Mark right now, I think he was your best mate at school, wasn't he?

- [Mark] Pretty much. I mean Pram, Pram reminds me of Chris. Pram literally knocked on the door, and one of the guys we've worked with for over twenty years, I hired him out of college. And now he's absolutely integral to this team. So that's the kind of things we like to do. It's to build those relationships.

- [Danny] Mark and Gary founded Two Point Studios, and over the coming years built a team of 16 people to help make this game. Some were old friends and colleagues, others new kids on the block. Their game was going to be called Two Point Hospital. The spiritual successor to a Bullfrog classic. But it wouldn't be enough to simply re-make an old game. For one, Theme Hospital was a 2D game. When Edge Magazine came to visit the studio in the mid 90's, they barely took notice of it, as gamers were far more interested in 3D screenshots of games like Dungeon Keeper. But time would prove to be kinder to Theme Hospital. While those early 3D games aged quickly as 3D technology improved, 2D games have a sort of timeless, inviting quality to them. Plus, to create these sophisticated sandbox they were aiming for, Two Point Hospital would have to be in 3D.

- [Gary] We knew how Theme Hospital had done better over 20 years and some of it's contemporary.

- [Mark] So we needed to come up with a style which incorporated something that felt like it was fresh and up-to-date, but we felt if the game does have legs, if people do love this game and we can keep it around for long enough, won't look out of sorts in two, three, four years time. So, we went for something quite organic feeling, it doesn't feel like it's rendered, it feels more like it's made of clay or plasticine, and it feels drawn rather than engineered,

- [Gary] And I think also that that art style back then was, with was certainly Theme Park and Theme Hospital had, we had quite a big proportion of female players, which back then was certainly unheard of for our types of games. Obviously something like the sims, which came later, it just blew their market wide open. But I think we didn't have an art style that was--

- [Mark] Exact not footing.

- [Gary] Yeah, it kind of, it was accessible, I'm not going to be patronizing and suggest that, you know, we made something that was appealing to girls, Because I wouldn't even have a clue how that would, you know--

- [Mark] I think it felt accessible, it felt like it wasn't aimed at any particular type of gamer.

- [Gary] Because you're looking at the game not from a fixed angle, you could be above or sort of, like, low down, you could kind of twist the camera. So a lot of these kind of considerations were kind of worked through and then,

- [Mark] And then the US, is it Where's Wilbur in the US? Where's Wally?

- [Danny] Oh yeah, Waldo they say over here.

- [Gary] Waldo, that's it. And we, you know, to make something readable when you've got so much on screen, and I don't know if you need a screenshot with some of the later levels where you've got absolutely vast marks with hundreds of people on screen. To get a clean read and not get it to look noisy and kind of, I don't know, slightly put you on edge because everything's moving and they've been shimmering because everything's trying to fight for your attention was a real consideration for us. In fact, I've seen some footage that's just gone out last night, and the guy's captured all his footage top down.

- [Danny] Right.

- [Gary] Imagine being a designer or an artist trying to design a game that looks good from anything possible conceivable angle. It's really difficult.

- [Danny] Theme Hospital was accessible, not just with both men and women, but with gamers and non-gamers, and young and old too. It was one of those games that was effortless to pick up. But after the first few missions, Theme Hospital's rough edges began to show. First of all the game got rather hard really quickly. And secondly, there just wasn't any interesting progression. Each level in Theme Hospital was almost identical to the previous one. So to combat this, the team created a world where each hospital takes places in a unique region with its own biome and its own unique needs.

- [Gary] Because the regions are very different, the people in that area are very different, some are rich, some are poor regions, and some of the challenges are different. In some cases, you may be running a hospital that's actually funded rather than you get paid for curing people from the individuals, they don't pay, you just get a budget at the beginning of the level. And that just makes the plagues spin completely different, so we wanted to kind of make it stay fresh as much as possible. And also give people the opportunity to circle back and go back and do things that they probably struggled earlier on and keep that fresh by putting new challenges in there.

- [Mark] And you have the ability to progress through the county reasonably easy. But if you really want to max out the game, you can kind of return to earlier hospitals, you can unlock things in later levels, you can do research, maybe unlock certain qualifications, come back to one of the earlier hospitals and train the staff in those things, upgrade those machines.

- [Gary] So the game doesn't have that pinch point, which the original game had where it just got too hard for me, I think I got to about level seven and would find it a real struggle. And we didn't want to do that again.

- [Danny] When I ask the guys about the features that excite them most, there's one that immediately stands out. Two Point Hospital features characters with a variety of personality traits that are not only affected by the world around them, but also by the people around them. They want you to care a lot more about your employees in this game, but more than that, this system has the ability to create wonderful emergent moments as doctors and patients clash with both each other, and the rules of the world. M This is what's real new cutting edge stuff is we've got this, the brains the little people now, is they've got these traits and of course they also have the conditions they're under combined to make quite unique animation blends, which means they do things, they react almost uniquely. It doesn't feel like it's pre-canned. You see somebody walk up to somebody and they'll respond completely different to the next person based on how those two people feel about each other.

- [Danny] Could you give an example? Like is it, if two doctors don't like each other, or if they have a tough patient, or how does that sort of manifest?

- [Gary] It's just patient is a good example, I mean, they as well as the personality traits, the things that are going on, if doctors has just treated a patient and they die, that has an effect on their happiness, they go on a break to the staff room, and that could end up in an argument with another doctor, and then just that argument could just--

- [Mark] And it's not all emotional, sometimes it's just that the habitual things, like you have a fantastic doctor who may just never wash his hands when he goes to the toilet.

- [Gary] Right, now that has an impact on the game. It's not just funny, it actually has an impact and in fact, there was somebody who was showing the game to in San Francisco the other week, and this person has an amazing hospital, doing really well, but when you put the filter on to look at hygiene, the hospital is really clean, but all the staff are really filthy, and I mean you couldn't work it out, and she'd built this massive facility with a toilet which only had two cubicles and she put no sinks in it and no hand dryers and put no sanitizer units anywhere in the hospital. So all these doctors were working on all these patients, filthy. And we put this kind of filter over it and showed her all the instants of filth trails in the game, and Mark just went, I can see your problem. He said, "Do you ever wash your hands "when you go to the toilet?" And this girl was just so embarrassed and immediately went and put this bathroom, a sink into the bathroom, to the toilet. And all the staff just ran to cure, to wash their hands, it's that stuff.

- [Mark] Everything in the game affects something else so the people, the machines, the way and the sick, and everything in your world is important.

- [Gary] If you have a brilliant surgeon but he's an angry man or woman, right, your job is to try and work out how to diffuse that situation to get them to do even better. And that's kind of the fun depth that the game has. Maybe this person just needs more caffeine in their life. Maybe this person needs more weird executive toys in the office. Those kind of things, it's just you getting that extra ten percent out of their performance which is the real depth I think this game supports.

- [Danny] As Gary just said in Two Point Hospital you can have an angry surgeon, man or woman. Another evolution from games past that shows not only just how far games have come in terms of representation, but also in terms of technology. If there's one thing I keep hearing when I interview designers today, it's that technology provides, it provides answers. Many design problems that used to exist in the past have been rendered moot by the advancement of technology. And Two Point's character variety is a perfect example of this. The original Theme Hospital had four main character types: A nurse who was a women, a doctor who was a man, a receptionist who was a woman, and a janitor who was a dusty-looking old man. So I asked Mike and Gary, why?

- [Mark] It covered respective times people have said that we made a sexist game, but we had to make the game run in four megabytes. I mean, it was a time and memory, and it wasn't a question of, like, well doctors are just men and nurses are just women, it was just a question of like, we had to make a call with it, and I think you had new, you had different heads, but it was pretty much the same body, different jackets and stuff, and we couldn't have made--

- [Gary] I was really keen on skin tone was important. I did not want to have a particular skin tone, but we just did not have the time or the memory, mainly the memory.

- [Mark] The character variation was important to us back then, and it was only 21 years ago but you very rarely got very different clothing variations and we did manage to get an element of that in. But the basic model of the man and the woman, that was the huge memory part of this. You know, so rightly or wrongly, I could have made a male nurse and a female doctor, I could have made a young janitor, I could have made a male reception administration staff. All of those things are absolutely true. You know, 20 odd years down the line it just seems critically incorrect but it wasn't our intention, I'd like to think we're quite right on. But the decision was made that the doctors were male and the nurses were female, rightly or wrongly, it was a call I made but I certainly didn't mean the offend anybody.

- [Danny] But it sounds like that's something that's been changed for Two Point?

- [Mark] Totally.

- [Gary] Absolutely. I mean, you know, that would have, that's absolutely goes without saying, he's not trying to correct anything, it's just that we had no choice back then to make a decision, rightly or wrongly, but it was just never going to be a situation. I mean, we've got so many more other types now of staff anyway, and what they do is very different. I mean, and thank God our initiative stuff in this game do all sorts of things, they're not just manning, I mean the little bit of footage you've probably seen, it may look like, oh look, there's somebody on the reception desk again. They do all sorts of different roles.

- [Mark] Yeah so we've got a marketing department which you open up later in the game, so the assistants can work, if they have the qualification, they can work in marketing,

- [Gary] They're kind of civil-servant-y type people, aren't they. They do a cross of different things, but the other things is we've taken a variation to a ridiculous level now. You can have hundreds of people, in fact, somebody took a fantastic screenshot within the studio, it's on our Twitter feed, and it's just about three hundred people just jammed into section and no two, they're all completely different characters. We've got this amazing modular system which puts on things such as steam goggles if it wants to, you know, boots, every component can be different and it just randomly generates them. So you really are lucky if you see two characters that look vaguely similar. Certainly more similar people in Yorkshire than there are in our game.

- [Danny] What excites me most about Two Point Hospital isn't replaying a style of game that I enjoyed in my youth, it's that this game seems to be free of the technological restrictions of its predecessor. It's full of neat little features like teaching janitors to vacuum up gDannys. So even that old dog has a new trick. The guys are busy finalizing the game so I didn't want to take too much more of their time. But before they left, I had to ask them the most important question: What new illnesses could we look forward to treating in Two Point Hospital?

- [Mark] Turtle Head is an affliction where the head shrinks down to a very small and it has to be a, I'm only saying that because I know it's on our website.

- [Gary] There's another one where the guy's foot is like a camel's foot and it's called Camel Toe and that has to be, that's not in there, it's just hardly been--

- [Mark] That was one of my favorites ones. I thought you liked it.

- [Gary] Mark, he's trying to get that in the game. I have to say as well--

- [Mark] I say we've talked about it now in the press, so we have to put it in.

- [Danny] Lads, you sound like you're having a great laugh. This sounds like a very professionally exciting period in your lives. Is that fair to say?

- [Mark] I mean, 21 years ago, releasing Theme Hospital, that was an amazing time. We had such good time, and just kind of starting a studio and going "Wouldn't it be cool to be able to "recapture some of that kind of--"

- [Gary] Actually we started our families. I mean, we both got married, you might have been before me. Side having your family at the beginning, I think--

- [Mark] Yeah, I hear you, Sam was born just as we started.

- [Gary] There's a story: Sam actually worked with us here. Sam's Mark's firstborn, was born right at the beginning.

- [Mark] Pretty much as we started.

- [Gary] As we started, and he's one of the engineers and creatives on this, it's very odd, it's very strange, but that's what makes it fun, right, because we got to a stage in our careers where we just want to actually enjoy coming into work, not have to be some, the problem with games is you get promoted, that's the problem with games. And when you get promoted, you stop making games. You start becoming that person nobody likes. You have to get a game done, and it has to be done like this, and nobody likes people telling people what to do. So we've basically set up this company so nobody, we don't have to tell people what to do and no one tells us what to do and yeah, it's great fun coming into work everyday. I don't think we've had one day where I haven't felt this is the best thing I've done in my life.

- [Danny] Two Point Hospital should be available to purchase on PC, Mac, and Linux around the time you hear this podcast. You can learn more about the game at If you're interested in playing the original Theme Hospital and you should be, it's really good, it's available on If fact, if you're a fan of GOG, you should check out our documentary on the company and their game preservation efforts over on our YouTube channel: I'd also like to recommend a patch for that game: Corsix TH. It's a tremendous community-created wrapper that updates the GOG version of Theme Hospital to work with modern resolutions with sharper graphics and updated menus. A wonderful testament to the fan passion that has surrounded this game for 19 years. As ever thanks to our Patrons for supporting our work. You can support our documentaries, this podcast, and more by joining up at You'll also get access to this podcast early via a special RSS feed. Thanks so much to Gary and Mark for their time, Lauran Carter over at SEGA for setting the whole thing up, and my wonderful wife for chatting to me about one of our favorite games. Sorry for the delay in getting this episode number two out. It was supposed to be up about six weeks ago, But then my baby girl decided to come a couple of weeks early. So we've been rather busy here in the O'Dwyer household. We have a bunch of fun podcasts planned for between now and the end of the year, so of course, keep this feed running. Until then, play some games. We'll talk again soon.