Keep Your Heart Rate Up With Flatline

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I need to talk to you about something. Something important. I don’t know how many of you out there are like me, but I feel like I need to step up for all of us and loudly declare that I am in love…with custom dice.

Let’s be clear, I love all dice. I have three fist-sized d20s and two different sets of gaming dice that are both small enough to be near unreadable. I look at the Tablebreaker and start uncontrollably drooling. But more than any of those, I love a game with a set of dice that are completely unique. Because of this, Flatline was a very easy sell for me, but if you need more than just the promise of handfuls of colorful random number generators (weirdo), then let me tell you why Flatline is one of the best games I’ve played all year. But first, just look at these dice.

Published by Renegade Game Studios, Flatline casts you in the role of futuristic emergency room doctors who have a flying ambulance full of patients to treat. To make matters worse, the building’s power supply has been damaged and if you haven’t treated all of your patients before the power goes out, the ones left untreated will die. This game is a spiritual sequel to Renegade’s other game FUSE, but you don’t have to have played that one to enjoy Flatline. All you need to know is that both games are fast-paced and involve putting dice on the right spots in order to save everyone and be a hero.

Like I said, what you’re trying to do in Flatline is save patients. You’ll have a big stack of them, but only enough space in your ER for four at a time. The wounds each patient has suffered is represented by rows of symbols. Your team of doctors will have one minute to treat your patients by placing the dice you’ve rolled onto the matching symbols. At the end of the minute, if you’ve placed enough dice to fill an entire row, you’ll cover it up. If you’ve covered all of the rows, you’ve successfully treated the patient and you bring out a new one. During that minute you’ll also place dice on cards to handle emergencies that have come up, you’ll use dice to activate power stations (giving you more rounds in the game), and you’ll only reroll your dice by placing dice in the special dice rerolling spot. Everything is dice and I absolutely love it. Dice!

No, you have a problem.


Before your minute of dice-based surgery starts a few things will happen. There’s a power tracker that counts down each turn by removing one of its power cubes (basically just featureless dice), and the number below the cube tells you how many cards to draw. These cards represent emergencies that can happen. Blue cards have nasty effects, will stick around until they’re removed during surgery, and may or may not be activated depending on the roll of the Emergency Dice (yes, more dice! Did you think we were done?!). Orange cards on the other hand need to be removed the turn they were drawn, otherwise they’ll start adding up. Let this happen enough times and you lose the game outright. Of course, if you can remove it before that happens, you’ll get to keep it as a one-time power card that’ll help you later in the game.

You’ll also have time to strategize before surgery, and this is what separates the doctors from the medical students. See, this game is extremely stressful in the moment, especially when you add more people. You’re all trying to work together but with so many dice to manage, things can get out of control really quickly. The way to counter this is to work together and come up with a solid plan. You’ll have to prioritize patients vs. emergency cards, some of which are truly horrendous. And occasionally you’ll even decide when not to treat patients. Depending on the timing, fully treating a patient can sometimes earn you either a bonus or a penalty, so it might be in your best interest to leave them on the table for just one more round before putting on the last Band-Aid.


This game does so many things right. The emergency cards provide a great challenge, overwhelming you if you let them pile up, but never letting you forget about their presence. The power track is a great way to handle what in other games would just be a boring old turn counter. Instead, because the number of cards you draw is different each turn, using the power stations to recharge (placing a cube back on the track) requires precise timing. Having only a minute to do all of these things provides such perfect tension on its own, and there’s a free app for the game with a timer/soundtrack that adds just that extra pinch of panic.

There is a minor criticism to make about Flatline in that This Is Not How Surgery Works. As much as I love these dice, and I hope I’ve impressed on you how much that is, you don’t fix a broken leg by just throwing stethoscopes and heartbeats at it. Of course, every board game is an abstraction in some way or another. Flatline chose to focus on the stress and panic of ER medicine as opposed to the mechanics of it, and in that sense I think they did a great job. That being my only real issue with the game, there’s no way I wouldn’t recommend it for gamers of all types.

Oh, did I mention that the dice are pretty good?

Looking for more games? Becca and Ivan will be delving into the world of Valerian in this week’s Game the Game on our Twitch channel this Friday. Join us there and tell us about your favorite dice games in the chat, or in the comments below. 

Image credits: Shea Parker