Purchasable Upgrade #1: Configurable Lancet 

The first in-game purchase in this game is only slightly less painful than the free item it replaces.

Game Design Background: In-App Purchasable Items

By far, today’s most successful video games offer the game for free, and make their money through virtual items sold inside the game (weapons, powerups, energy packs, etc.). 

Often the game will offer you a mediocre or entry-level weapon/tool for free with the option to upgrade for an in-app-purchase.

Often the most lucrative items in these games are referred to as ‘consumables’ - items that are used up during gameplay and therefore must be re-purchased over and over again (ammunition, lives, energy, etc.)

The hospital has an endless supply of generic lancets to do finger pricks:

They are designed to squeeze a drop of blood out of an alligator’s finger. And not just any alligator - the alligator  in “The Princess and the Frog” that also plays the trumpet and therefore has half-inch-thick-heavily-calloused-skin on his fingers.

As every good Free-to-Play game designer knows, you always want to offer the first consumable in-game upgrade for free to ‘hook’ the player. This first upgrade, the configurable lancet, is provided “for free” by the hospital - it comes with your glucose monitor. Don’t worry - you’ll need to buy another one soon enough (that next one isn’t free, of course).

The lancet is configurable, so you can adjust the depth that dastardly little bastard will go into your daughter’s tiny little finger.

Pick a number too low? You won’t break through your daughter’s skin deep enough. Poke her again! 

Pick a number too high? You just inflicted more pain on your daughter than necessary, you bad parent you!

It’s spring-action-loaded, so it gives a nice, jarring ‘pop’ when you pull the trigger. Talk about a pavlovian nightmare. 

If the pain doesn’t wake your kid up in the beginning, your kid will eventually be programmed to associate that infernal ‘pop’ with pain and wake up whenever she hears it. Maybe that pavlovian programming will come in handy in 10 years when she’s hard to wake up in the morning for high school. 

Daddy: “Come on, kiddo, wake up!”

15 year-old: “Ehhhhh. Ten more miiiinutes”

Lancet: POP!!!

15 year-old: “Dammit! I’m awake! I’m awake! Jesus. Enough with that damn thing!”