I had this idea, but I know I won't do anything with it, so if anyone wants to run with it, go right ahead.
You play an incredibly skilled U.S. surgeon drafted into a medical army surgical hospital during the Korean War. You have one score that says how much the Army likes you, and a sanity score. You set scenes either in surgery, or pulling pranks. A successful surgery makes the Army like you more but decreases your sanity; a successful prank makes the Army like you less but increases your sanity. If your score for how much the Army likes you bottoms out, you go to a court martial. If your sanity score bottoms out, you go crazy. As the score for how much the Army likes you increases, your competence as a surgeon suffers.