Sutures and recovery periods, and complications.

[GlitterGuts]

Im personally in favor of a harder-more realistic medical. Maybe not to the extent that patient-loss is a common thing, but to where complications and slightly more realistic wound recovery happens.

The first part of this is sutures. These would be used to close puncture and gashes permanently, as gauze really only staunches the bleeding. Sutures could also be used as a replacement for the cautery, taking a big longer to do, but leaving little or no scar behind, where the cautery can be developed at R&D, where its fast, but always leaves a scar (so people can opt out of it for cosmetic reasons in medical records). The biggest downside of sutures being that a brief period after having them done, running would have a chance to make your stitches burst, reopening the wound (except for stitches on the head).

I also think more tools should have fail chances like the bone setter and hemostat already do. Like syringes missing the vein, or tearing the skin slightly after retraction. Medical mishaps are more common than people think. I want there to be a little more suspense and urgency in the med-bay considering that once they're inside, they're pretty much guaranteed to live, because I'm sure we all know some of the lazy doctors who just use the cryo-tube for almost every patient, which can bring anyone from triple digit negative health to 100 for a minuscule amount of chems.

My last part of this suggestion is that freshly healed wounds take more pain/hallos when hit, encouraging a rest period where you are more likely to avoid a fight. Nearly every wound in the real world is pretty tender even after its healed. Patching up an officer that just had 90 brute damage on his head or chest, only to run back out in the fray without any downsides doesn't seem very RP friendly, as very few do pain RP after they're already healed.

[Carver]

I truly don't want to get killed in a critical condition because the medical doctor treating me failed an RNG check. I like the idea of encouraging a rest period and sutures sound neat, but by God keep any and all RNG away from medical.

[Mwahahahaha]

iiiii  freakin     lovEEEE being hospitalised, no joke.

A relatively similar thread has been brought up before regarding an extension of recovery times, but there are some nifty ideas going on here.

Now, I want to address recovery times first:

What I tend to do is basically extend my own characters' recovery times on the injury and it does allow me to get a bit of freedom in figuring out what would happen that the mechanics can't cover (either because they simply don't or because attempting to do so may end up inhibiting one's options). This is done purely through fluff.
Take note that this is very much an argument that could be made by one to say something like "well you can do this with fluff anyways so why force people to do this when they don't want to while the people who want to do it can do it"

However, I'd also like to point out that in my experiences, people generally kinda tend to be a lot more focused on the mechanics and this very often results in someone going "wow your are fine 100% healthy stop being a drama queen" and then they boot you out into the gutter.

Maybe the solution to that is a mechanical one, maybe the solution is sociological. It's up in the air and often debated with many different perspectives.

Okay. The other thing is that there are people, as have been argued in that other thread, who don't like "being taken out of the game for 40 minutes while [their] doctor erps with the nurse" (paraphrased).
I have my own thoughts on that but I'd be interested to hear someone else's.

I DO want to acknowledge though that you seem to be trying to introduce some alternatives or workarounds that people can take, as with the sutures vs cautery.
I think I should bring up the question as to how our cauteries actually work, considering in real life they're used in slightly different circumstances and often for kinda different functions (as I understand it right now). It's usually not a good idea to try and 'burn' your skin to seal a wound together, as, well,    it's a burn. You're actually damaging the tissue. We are evidently not made of plastic or metal which you can melt together. Burns often mean infection risk.
BUT: it is a pretty popular trope used in fiction, and rule of cool alone is often more than enough reason to include something and this is 25th century sci-fi or something so one could say 'whatever'.

In any case. Sutures.
Do you think there could be different types? Do you think staples are worth adding into the fray?
Would the differences be mostly marginal as to be considered fluff, or do you think there could be mechanics in mind?
Do they work like stacks (as with bruise packs, ointment, splints)?

Do keep in mind as well that often, the server sees on average somewhere between 2–3 hours worth of round time. That's actually a pretty nice lengthy time but to many, that's probably not very long at all. I personally don't mind being a 'useless wounded person who's being dramatic' for the rest of the shift if it means I can drive something and I'd love to know if that somehow benefits someone else's experience — but I know that others would probably be in for a rush to try and get things done before the round's end. Indeed, there's always next round to keep doing stuff, but to that I imagine people would say that some don't have enough time to play more than one round on that day.
This, weighed up with the fact that said person was literally shot like 8 times with a .700 Nitro Express or something      exploding bullets       in the face. or something.
Or you know, just getting shot 10 times in the chest with any penetrating projectile period. Whatever.

One may also bring up as an argument that, again, it's the 25th century and woah advanced medical technology we're so    everyone can get back on their feet in 10 seconds as fit as a cute baby piglet.
Personally though I feel like this might inhibit some room for creativity there, but that's all subjective.

I'd be interested to understand what you have in mind in response, if that's all right.

[Guest Marlon Phoenix]

Staying inside medical under supervision due to complications would bore me to tears and id have to afk during the process.

Having to supervise people as an MD would bore me to tears and I'd job hop away into another department.

 

Hospital rp is an incredibly niche genre that only a select few people enjoy enough to get into it.

 

-1

Edited July 31, 2019 by Marlon Phoenix

[Mwahahahaha]

 

I personally find it a little bit of a small shame whenever someone would rather not, if only because I feel like it’s a good opportunity to get creative and perhaps even to learn something.

But, of course, there’s the question of even enforcing this as a mechanic rather than its current “fluff form” (bearing in mind my earlier points regarding current attitudes towards this).

I do want to raise the question though as to what different people find fun. I just want to pose for consideration: have you ever tried it a little more with some elements added in such as, again, recovery time, pain, side effects of certain substances or injuries? An alternative would be to go back to doing what you effectively always get to do every single round. It might be an opportunity to try something new — but I’m not saying it’s a must.

@Marlon Phoenix

What are your thoughts on sutures and surgery mishaps, if I might ask? Notwithstanding their contributions to recovery time.

[Guest Marlon Phoenix]

Having persistent (for a round) lil scars or stitches caused by surgeries (using only 1 extra surgery step please) could be neat.  Running around with a bunch of scars on my examine.

Mishaps idk. Surgery is really stressful as is. Im not fully persuaded that more punishment around it would be ideal

[Resilynn]

Add a scar to your flavor text and tell your doctor to switch hands to injure you in looc?

Almost no one likes sitting unconscious through surgery, especially for longer than they have to. It’s literally staring at a blank screen for up to 20 minutes if your surgeon is new. 

Very few people enjoy hanging out in medical and most will just take off the moment we say they’re improving.  

RNG fail chances is artificial difficulty. Artificial difficulty is bad game design. 

[Mwahahahaha]

The suggestion with sutures isn't just about scars and recovery times.

What do we think about having alterations with gauzes (bruise packs?) and distinction between gauzes and sutures?

What about as a replacement for the cautery, with the cautery going to R&D?

Your responses about scars: were they to do with sutures, or the cautery scars as mentioned in OP?

What about the proposed mechanic regarding stitches/scars reopening if they sprint? I presume this could be under the circumstances where the patient has already been discharged?

[Sheeplets]

Tender wounds and recovery periods could be a neat mechanic so long as you can do them without being glued to a bed, in pain-crit. Like Jackboot said, it isn't fun and Medical is, as a whole, already notorious for completely neglecting patients as it is. I've lost count of the number of times I've been sedated by idiot surgeons (mostly CMOs) and abandoned in the recovery ward for upwards of half an hour while my body processed the gallon of soporific that I'd been injected with. I'd rather not get shot once and have to deal with anything similar. On the other hand, I'm equally as sick of seeing Chad Thundercock, Warden Extraordinaire with at least three rifles on his person eat buckshot and be back to securing valids in less than five minutes.

[SatinsPristOTD]

Why would a cautery go to R&D? We use cauteries in TODAY's surgery. Sutures would be fine, but the cautery should remain in the surgical procedure. THE CAUTERY PROCEDURE IS NOT AN UNCOMMON ENOUGH THING TO BE DEVELOPED IN RESEARCH AND DEVELOPMENT. I CAN REPEAT THAT IF NEED BE.

On the topic of "healing times", as mentioned in a previous discussion for this: rounds are 2 hours long (sometimes less, sometimes more but this is the average.) No one wants to sit there for 30-40 mins in pain crit, or expecting Medical to RP with them while the Ninja is ripping limbs off in one hit crits. Medical can be slow, but those rounds aren't as common as you think. Once the antag hits, we can barely keep our head out of the dirt. ss13, whether you admit this to yourself or not, is face paced when the antag hits.

We can sit there and RP your pain levels, but as someone who has undergone some serious surgeries AND had to pain manage in a hospital... your nurse isn't sitting there holding your hand. "The wound is tender" RP outside of the medical wing will just have people demanding tramadol or Oxy simply because there's some lunatic with an axe decapping your friends.

I'm all for Sutures. In all honesty, I'm all for a better surgery in general. Right now it's "click, wait, click, wait, click wait." We have no life support system. We have no defibs. We have nothing logical.

RNG for my surgical skills is a big no no. Do not let my characters skill be based on RNG. It's my decision if Asclepius is good or not.

Edited August 1, 2019 by SatinsPristOTD

[Doxxmedearly]

I agree with what most of what's been said, especially by Jo and Satins.

I do, though, think that after a procedure, there should be some recovery period where you're in a state of minor pain and serious physical activity (Sprinting, fighting, climbing, etc) could cause complications (Such as a suture splitting, as suggested, and causing you to bleed/more pain), but otherwise you're able to interact. This way you're still not 100% for a bit after a procedure (like 5-10 minutes?) but you're not forced to lay in a bed in a stupor while medical handles the fallout from manhack the main hall gimmick #17. They can send you off with some paracetamol/tramadol. 

5-10 Minutes is my initial thought because, as said, we're operating on typically 2 hour rounds. Spending 30-40 minutes in medical is just... not enjoyable for most. So it's something to slow your roll after you've had a surgery- which should be expected- but not enough to keep you away from RP you want to do. Yeah, people might demand high-level painkillers to get back to securing valids, but I think overall it's a net positive to have some period after surgery where you're not in tip-top shape.

49 minutes ago, UncleJo said:

On the other hand, I'm equally as sick of seeing Chad Thundercock, Warden Extraordinaire with at least three rifles on his person eat buckshot and be back to securing valids in less than five minutes.

If you have a problem with my self-insert say it to my face Jo. 

Edited August 1, 2019 by Doxxmedearly

[Guest Marlon Phoenix]

The additional difficulty from sutures and gauze being split apart is not something I'm a fan of. However having an additional type of cautery for incisions would be cool. 

 

At the same time it feels a a bit primitive to still have to worry about sutures and wounds opening in 400 years into a scifi future.

[TrickingTrapster]

I think personally it would be much easier to try and have a rule about it instated, or have some lingering pain messages after surgery or something so you know what's up. You need to keep in mind the whole realism vs fun thing, which is what I'm seeing here. Fun will always take precedence over realism. (This is why we don't have to unscrew every individual bolt as an engineer and this is why we don't have 500 surgical steps, for example.) I'm fine with having some arbitrary means of telling people that recovering from surgery isn't done in 5 seconds, but I don't think we should rewrite half of medical for it.

[Scheveningen]

Keep in mind anything that affects the crew on the medical side will also affect antagonists that will get hit in combat.

Proposed changes are also unfeasible in terms of balance, considering that this would motivate people to just play IPC, speedrun the ions and throw it out the airlock.