The power of accurate observation is frequently called cynicism by those who don't have it.

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The golden rule when it comes to XSing this game is practice, practice, practice. This guide aims to help you in this endeavor, but like most action games, no amount of tips and no amount of knowledge can ever substitute actual experience. So get in there and do stuff. Get comfortable with the tools, with the wiimote, with the nuances of the game. You should be so used to it that you can switch between tools without even thinking.

Generally speaking, I recommend using the B button in favor of the A button. In fact, you should never press the A button unless you're using the forceps. Do not use the wiimote jacket or any other accessory of that kind. If you're doing something that requires precision, hold the wiimote near the top part rather than the bottom, place your thumb around the area to the left, slightly bottom-left of the d-pad and upper left of the A button and grip firmly with it. In my experience this affords greater control. You should grip with the tip of your thumb so that you're not actually pressing the A button, but if you have to, you can simply bring the rest of it down and easily press it with the joint between the proximal and distal phalanges while still maintaining the grip.

When using tools, sometimes it's a good idea to keep the control stick HELD DOWN in the position you want. This not only makes it so that you switch to that tool instantly as soon as people are done talking/a transition ends, but it also makes it less likely that it slips when moving back to the neutral position. Obviously this shouldn't be done if you're going to use a certain tool for an extended period of time, but it certainly helps when you're quickly switching between different ones.

If this is your first Trauma Center, XSing this game will not be an easy task. While this guide should make things easier for you than if you had to figure everything out, don't expect a smooth ride all around. Expect to be challenged. Sometimes, a new operation might seem so difficult that you can't imagine being able to XS it. But don't despair. I can guarantee that each and every single operation is not only possible but also balanced, reasonable, and fair. Once you've mastered them and go back, you'll see that you can XS them consistently and almost effortlessly. Always the mark of a good action game.

One of the beautiful things about this game is that very few things are out of your control. Whereas in more traditional action games there are a lot of things happening, not all of which you might see, such as the classic fireball of doom from offscreen, in Second Opinion everything happens onscreen. You can see everything. When you fail, try to see what you did wrong. Try to see where it is that you can improve. Look at my videos and try to see what you're doing differently and how this can affect the outcome.

Always try your best to stay calm. This is the most beneficial state in which you can play the game. Getting agigated or angry will only lower your skill. The problem is that adrenaline, or epinephrine, is a fight or flight hormone. Basically it prepares the entire body including the muscles for emergency actions such as running or fighting. But it does not prepare the muscles for precision work of the kind you need to succeed in this game. Quite the opposite. It gives you what I call the jitters.

This is why keeping a calm mind is so important. There are many methods you can use to help calm you. When you feel overwhelmed, take a small break, just a few minutes is fine, stand up, walk around a little, stare out the window. Surf the net, read a little. The benefits of doing this are actually two-fold: not only does it help calm your mind, but also your wrist. It's no secret that prolonged use of the wiimote causes quite a bit of wrist pain. Even more if you suffer from carpal tunnel syndrome. Resting for a few minutes in between retries does wonders to help prepare you for the next operation. In a related note, it's also possible that your hands can get deathly cold while playing the game, especially if you live in a cold place. This can hamper you a little, so I recommend washing them in hot water every now and then. This might only be a temporary solution but it helps and gives you an excuse to take a quick break.

Sometimes there are some operations that are so long that your wrist can get very tired before they're over. In these situations, pausing the game and resting for a few seconds or minutes isn't a bad idea.

If you are very tired or need sleep, it's probably also a good idea to do so, as it can negatively affect your performance. You want to be calm, but you also want to be alert. You don't want to lean too far to either side.

When you fail, try not to blame outside forces. This is a psychological defense mechanism that manifests in a surprising amount of people. It might make you feel better, but it tends to hinder improvement. As I said before, I can guarantee that everything in this game is fair, balanced, and reasonable. So don't blame your failures on the game. Don't say "The hit detection is off," or "It's random," or "The wiimote isn't good enough". Instead say "My hand slipped," "I wasn't fast enough," or "I haven't practiced enough". Only by accepting responsibility can you strive to change what has gone wrong before.