Bullfrog Productions casts a long shadow. Longer, even, than some of its most influential contemporaries. You can make an immersive sim in 2024 without creating something obviously Deus Ex, you can make an RTS that isn’t a dolled-up Command & Conquer, but if you’re making a game where a player runs some kind of public institution and builds rooms by clicking and dragging on a square grid, it’s almost like an outside power will possess your hand to make sure the final product looks just like Theme Hospital.

Fair enough: Theme Hospital is great. Problem is, though, its epigones are never as funny as the original game. They all have cover band syndrome. So I thought, anyway, until I put my hands on Galacticare, an unabashed Theme Hospital-like tucked away in Game Pass that manages to pull off the rarest thing a videogame can do—make me actually laugh.

Care in the intergalactic community

The fundamentals are simple: Run a hospital, but in space. Aesthetic aside, none of this will be novel or hard-to-parse for anyone with even a bit of time in any other hospital sim. You build rooms by clicking and dragging, staff them up with doctors of varying talent levels, and spend no small amount of time ensuring that those rooms and their adjoining corridors are filled with enough decor, vending machines, bathrooms and benches to keep your disgusting, disgusting patients (and employees) from pitching a fit while they wait.

Wait for what? Why, your exhaustively optimised conveyor belt of wellness. Patients come in through the front door, queue at reception, queue at diagnosis, and queue at their treatment room (or rooms) before you send them on their way. Or they die. Dying is very much a possibility, and really bums out the rest of your waiting clients, who are cowards.

Like I said, nothing too unfamiliar in the gameplay loop, although there are a few bits and pieces that keep the whole thing from seeming like a total palette-swap of Bullfrog’s classic. Little touches, like special breeds of harmless pests that are attracted to your hospital like moths to flame if it’s well-run and give you rewards for finding them, that feel novel and act as the carrot to the stick of ‘patients dying and leaving’ that encourage you to keep your hospital well-run.

Though really, it’s the writing that has the whole thing stuck in my brain. It’d be bad criticism to gesture vaguely at anything like a Theme Hospital ‘vibe’ or ‘spirit’ and say Galacticare somehow ineffably captures it. But, ah, Galacticare really captures that Theme Hospital vibe and spirit, and in a way that others that try the same thing don’t.

Alright, some specifics. Galacticare truly feels like whoever sat down to write it actually gave a damn, and also like they had a lifelong dream of writing their own Mass Effect codex entries. Every species you treat in your orbiting hospital has their own lore page which, if you’re anything like me, you will swiftly and enthusiastically ignore at first sight. You shouldn’t. This stuff is genuinely quite good. The lore on humanity—they’ve only gone and plunged themself into a hellish corporate dystopia—has that same wry cynicism of Bullfrog at its best. Others, like the Ohde, who once ran a galaxy-spanning empire that no one really holds against them because they did it before any other race evolved enough to care, feel like they come straight out of Hitchhiker’s Guide to the Galaxy.

But it’s the moment-to-moment interactions that most impressed me. Characters like amoral CEO Salazon, who is somehow not voiced by Matt Berry despite sounding exactly like Matt Berry, and every single interaction between your helper-bot HEAL and the charmingly naive janitor-drones are genuinely, well, funny, with that sharp, comically cynical zing of a good Bullfrog game. It doesn’t always hit, but it does more often than not. And, well, the devs made me laugh! To myself! Alone at my desk like a madman! I’m not sure a game has managed that since Disco Elysium.

So if you fancy a Theme Hospital-like that’s actually like Theme Hospital, you could do much worse than giving Galacticare a shot. You can find it over on Game Pass, Steam, and GOG. Play it in health.