"In young forests at the dawn of time, plants were born with the ability to kill humans. ...Such simple, perfect organisms. Do you understand the meaning of such toxic flora? They demonstrate that all creation seeks an end to mankind." -Adam
"If humans are to be won't be at the hands of other men!" -Derek Stiles
"Your old world, steeped in death, perished at the dawning of civilization!" -Naomi Kimishima

Paraskevi is the sixth strain of GUILT encountered in Under the Knife and Second Opinion. Its codename is "Arrow to the Heart."

A fibrous, worm-like pathogen, Paraskevi is extremely aggressive, as it will burrow throughout the body from organ to organ almost immediately after infection. It tries to approach the heart, at which point it will instantly kill the victim if it burrows in.



Paraskevi after being stunned with the laser.


Single section of Paraskevi, stunned.

Start with treating the few lacerations on the organ, and Paraskevi will soon emerge.

Paraskevi is invulnerable to any attack except the laser. Once struck by the laser, attack it with the scalpel, splitting it into two smaller Paraskevi. Each hit with the scalpel will cause two lacerations. Once a Paraskevi is down to a single section, it must be extracted with the forceps while stunned. There are a total of 16 Paraskevi in one full Paraskevi.

If any Paraskevi is left untouched for too long, it will burrow into the organ. If that happens, once any remaining Paraskevi are removed from the current organ, the operation view will shift to the next organ. The Paraskevi will go from the small intestine, the stomach, the liver, and finally, the heart, where any instance of Paraskevi burrowing further will instantly trigger a game over.


Attack Information
Counterattack When cut by the scalpel, Paraskevi creates two lacerations.

If used on the small intestine, stomach or liver, Paraskevi escapes the organ and moves to the next one.

If used on the heart, Paraskevi will stab into the heart and kill the host.

Paraskevi OperationsEdit

Under the KnifeEdit

Note: * refers to a location that is only played if the Paraskevi reaches it.
Episode Patient Organ(s)
5-6: Infection Cybil Myers Small intestine
6-7: Sixth Sin Unnamed girl (Sixth Sinner) Small intestine
X-6: Paraskevi Unnamed woman Small intestine

Second OpinionEdit

Note: * refers to a location that is only played if the Paraskevi reaches it.
Episode Patient Organ(s) Other GUILT Present
5-6: Infection Cybil Myers Small intestine
6-4: Second Opinion Derek Stiles Heart Immature Kyriaki
Mature Kyriaki
6-7: Fallen Heroes Unnamed man Heart None
X-6: Paraskevi Unnamed man Small intestine


  • In Under the Knife, Paraskevi always escapes to the next organ through the top of the screen. Slicing Paraskevi will force it to move slightly towards the bottom of the current organ and delay the escape, but newly-cut pieces, which cannot be stunned shortly after the cut, can still take this time to escape.
  • In Second Opinion, keep an eye on Paraskevi's tail. If it starts shaking, it means Paraskevi is about to escape the organ.
  • Sometimes, if you have trouble handling multiple Paraskevi at the same time, it is okay to let a few of them burrow into the organ, so long as you are not working on the heart. This comes in handy for the X mission where Paraskevi burrow into the organ quickly.
  • It is always best to work with the smallest possible Paraskevi. Dissecting multiple same-length sections simultaneously is extremely dangerous, as it causes massive drops in the patient's vitals and creates a swarm of Paraskevi that can prove exceedingly difficult to handle, and can cause wounds from the laser from prolonged use.


  • In Second Opinion's 6-4, the player needs to treat Paraskevi along with Kyriaki. Fortunately, the only Paraskevi that appear in this operation are the two smallest segments, allowing for quick removal.
  • Unlike Under the Knife's X-6, Second Opinion's X-6 has the patient's vitals capped at 50, in addition to all the other challenges presented with the Extreme difficulty.
    vde Trauma Center series
Games Under the KnifeSecond OpinionNew BloodUnder the Knife 2Trauma Team
Characters Derek StilesAngie ThompsonNaomi KimishimaMarkus VaughnValerie BlaylockElena SalazarCR-S01Maria TorresHank FreebirdTomoe TachibanaGabriel Cunningham
Fields SurgeryFirst ResponseOrthopedicsEndoscopyDiagnosisForensics
Organizations Caduceus InternationalDelphiEidoth PharmaceuticalsHumaniParnassusAcropolis PharmaceuticalHands of AsclepiusResurgam First CareCumberland Institute of Forensic Medicine
GUILT KyriakiDefteraTritiTetartiPemptiParaskeviSavatoBlissPGS
Stigma CheirSomaOpsOnyxBrachionCardia
Neo-GUILT NousBythosSigeAletheia
Other Rosalia Virus

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