Medical primer from Inept to Intern

[Cnaym]

Basic concept:

Spoiler

This is a basic guide for the new doctor who wants to learn through experiencing, experimenting and roleplay. Many medical guides focus on either the chemical side or the mechanical side of our medbay. While knowledge of chemicals and surgery is super useful if someone wants to play a medical role and actually keep their job, it can be much more fun and engaging to have a couple blanks here and there, given your roleplay lives up to it. Some of my views contain a hint of contempt for people bending their characters backwards to super treat (play to win) or even go as for to salt in LOOC at the poor new guy or returning player trying to get their grip on a system that a) is unnecessary complicated through bloat and b) easy as fuck once you skim through the surface. Use ctrl + f to search for something specific or just read through it at your own pace. I may update it if people enjoy it and time permits it.

Preface:

So you got your first job in a medical field aboard a space station! Yay you! Space can be quite something... people expect the weirdest things and don't get me wrong, we get that here from time to time as well. That being said space is also full of nothing.. absolutely nothing, nada. You can spend days staring at a screen or sorting pills just to keep your hands busy and the most common cases might be drunk visitors depending on where your corporate overlords assigned you.

1. Help, I am alone and there is no doctors around.

People will die. Like. A lot. Don't blame yourself, blame budget cuts. Unless you already got a doctor title, in which case you should really get your shit together right about now. Here is my general guide to keeping people alive if all you got is a labcoat and the funny access card some higher up handed you.

Use gauze like the relay chat, gauze everyone and everything. Someone bit their tongue, gauze on it. Might feel funny but cannot make things much worse. People love gauze once they notice that it keeps their important juices on the inside and them damn germs out. If you know your salves, try to find some ointment. Most come with basic desinfection ingredients. Don't worry about the stuff, it's super cheap and nobody will yell at you for going ham with it. The slight burn will make your patient feel like you are at least doing something, and less germs means the freezer fills more slowly. This is probably the moment where you notice that you should have payed a lot more attention to the basics, like bio glue and regenerative tissues.

Speaking of those, they usually come in bundles called Advanced Trauma Kits or ATKs as the professionals often yell at interns. You might wonder right about now how much you forgot while going to that campus party a couple years back, but I swear that stuff is no science. It's made out of science, but most interns remember how to use this after the initial shellshock of actually having someone bleed all over the place. What you wanna do is slap the thin membrane on any open wound, it usually sticks to the blood which makes it a lot easier to keep it in place. Next apply the bio glue like you are preparing them for a massage. Those kits will last a lot longer once you get a feel for the dosage, but at this stage of your career it's better to go all out. Someone more qualified can probably cut away all the spare tissue later. Someone bleeding can't have too much skin if you ask me.

If your ATK is not colored green you did something wrong, the orange packages are Advanced Burn Kits or ABKs, they come with a stronger ointment and a different membrane. Don't ask me who invented these, but the stuff is super useful if your patient smells like bacon or decided to figure out if that one wire is really powered or not. Works mostly the same as the ATKs, which is probably why we all ended up confusing the two more than just once. You want to slam the ointment all over the burned skin and plop that fiber on top of it. It's a lot thinner to let air go through and won't stop blood like at all.

Basic concept to look like you know what you are doing, stop the bleeding with gauze, apply ointment and burn kits as needed, use those trauma kits if a cut is deep enough that you can see something your patient probably does not want to see like a bone or worse. Nobody is going to hate you for stopping a bleeding. In fact that is probably the most important thing you should do first, people need their blood. If you see someone dripping all over the floor, gauze away happily. If it's someone working in a dangerous field like engineering, hand them some spare gauze when they leave, that stuff is super useful.

Spoiler

Speaking of engineers. You can stitch together a wound with wires which depending on your sewing skills may just do the trick and stop someone from bleeding out. I swear those vaurca do it all the time and then come in ranting about how their arms twitch and they cannot stop that strange green stuff growing on their... you get the idea. That is super risky and unhealthy. Probably illegal. Most likely to get you fired, cost you your license or end your internship before anyone remembers your name. Don't do that when someone is healthy enough to sue you and close enough to gauze. It looks badass in the movies, but in reality people tend to cry or pass out before throwing a fit or dying of an infection. If you got to, you got to, but make sure to treat the results of your patient abuse.

My patient is a dummy and ate something toxic! Your best friend Dylovene is here to safe the day! The stuff is anti toxins and helps with most problems in one way or another. Try it out to see how it reacts with different symptoms. It may not be able to recover your patient from taking a cyanide pill, but it helps with most other toxic substances you will encounter during your work. Monitor and talk to your patient to figure out if they have really recovered. Just because your scanner says their liver is healthy, does not mean they stopped seeing that creature at the window just yet. Make sure said creature is not real before injecting more medicine.

2. Help, I am all alone, there are no doctors around and someone fucked up seriously.

The three signs you are about to loose that nice girl who brought you coffee earlier: Gasping, itching, reacting to your warm welcome by passing out in a puddle of blood that seems to redecorate the walls around you OR some irregular bone movement / positioning / lack of bones.

Let's start with gasping. First of all, super uncool. Your patient found one of hundreds of ways to kill their lungs. If you know how to handle one of the big boy scanners, you can probably figure out just how bad it is, or you might be staring at a lung and notice that your professor really meant it when he said "This is important later down the line so please pay attention". Broken lungs are the bane of every lone intern. They kill fast and it will be painful all the way. So you probably want to start of with some painkillers if you got them handy. Most medical facilities stock up on Perconol and Mortaphenyl like it's orange juice, which from a medical viewpoint, it might as well be. Give them some, they will thank you, or at least try to, depending on how little air they got left to speak. Your patient is now very much still dying, but at least less likely to pass out before you can let them know about it. Now you really want to get some air into their lungs. If you are a surgeon, ask yourself why you are reading this instead of TREATING THE PERSON DYING IN FRONT OF YOU. If you are not, well then good luck. Air is super important to keep a brain functioning, so you want to get some of that into your patient. Some will yell for Dexalin or Pneumalin right about now, but since you are alone, the only one yelling is going to be a lawyer or relative of your soon to  be corpse. The most available way to insert that sweet sweet oxygen into your patient is a breathing mask. Make sure they wear one and got enough oxygen plugged on to it. For legal reasons, this is not fixing anything, but god knows you are just buying time at this point.

Spoiler

 

If you are absolutely unsure what to do from here on out, it is no shame to tell them to step into a cryogenic freezer and leaving a message for the next surgeon to arrive. People prefer living to dying a lot.

If you have or had a chemist who prepared you some Pneumalin inhalers or your facility comes stocked with those, grab one of them. They tend to work like scratch cards in that you only get back your money most of the time, but sometimes they hit you with that small win. It probably won't fix the entire lung, but it might just be enough for them to cough the rest of the blood out and go about their marry way without the risk of dying two steps out the front door. You may want to monitor them a little just to make sure.

 

Itching is often accompanied by a lot of bitching and for good reason. Those indicate either drug abuse, a really terrible service team, or an infection that is bound to eat your patients organs sooner or later. For the sake of this guide we will be skipping over the first two, since they are easily covered by handling the last one on that list. Your patient will probably not tell you what they smoked in that maintenance tunnel or know when exactly those alien spices went just too sour. Infections are nasty. They smell, they grow, they kill. Most of the times rather quickly. Now one might think that people develop a natural immunity but the number of germs out there is just way too high. You want to find out if your facility stocks Thetamycin and file a complaint if they didn't. Stuff comes usually in a full needle or bottled, make sure to give them plenty as we got no clue how serious the infection already is and the stuff just vaporizes if it's too little. Aim for 10-15 units and it will probably do the trick, if it does not, repeat the process. You might even want to print out a full scan. Everything odd looking on that might be an infection and just comparing two scans can let you know most of the time if at least something is happening inside your patient. Monitoring is vital here, untreated infections kill quickly and there is not much else you can offer. Wearing a mask might be a good idea at this point.

Spoiler

 

If your patient is not improving at all, let central know that there might be something new or immune on your station! (this means ahelping to find out if Theta is broken again, it happens a lot more than you might expect and the admin will usually let you know if it's something else)

If you are certain your patient is going to die from this and you are not seeing any improvement, their immune system might just be shit from living of vendor food for the last two years. They should find a cryogenic freezer at this point and only be popped out once a qualified doctor arrives to handle this... or a biohazard team if things got too weird.

My patient is just bitching louder and pucking all over the place but the itching has stopped and the scan looks pretty normal or is no longer changing every time I do one. Congratulations! Your patient is healthy and most likely an idiot since the itching could have been from drugs or food gone bad and they just "forgot" to mention that. They will vomit out the Thetamycin. FYI they will always do that, the stuff is nasty and disgusting. If you like your patient and are able to perform the blood filtering thing on them... diaysis or something, don't ask me.

 

The ceiling needs a janitor as well, oh my good their is blood everywhere! That is what we call internal bleeding. Build up inside the patient, burst out like an overcharged squirt gun, your patient is usually in a hell of pain right now, so the heart beat is up like crazy and that is not helping either...  at all. Now that is where things get really ugly, you can consider the prior two cases as minor inconvenience compared to this stuff. A surgeon could cut them open and stitch that up in no time, but we are not having one of these. Your facility better is stocked up on Bicaridine or body bags. Honestly if you need to organize that stuff about now your best bet is a scientist or an ambitious gardener who knows their plants and has prepared a lot more than you did. Keep the patient filled with some Inaprovaline, around 10 units is where you wanna keep it steady at. The stuff will help with the pain and the heart rate, in turn also regulating the blood flow somewhat. If you are able to you want to get them hooked up to an IV drip as well, they will keep loosing blood at a scary rate, so you are just buying time, but time is always a good thing to have. Sadly an internal bleeding WILL NOT GET BETTER ON ITS OWN! If your patient is not dead by the time you organized that Bicaridine you want to overdose them on that, put in 35 to 40 units and pray that the bleeding stops. If it does not, keep the dose up. It's the only chance your patient has to survive this right now, but nobody will blame you if your company simply did not supply you with that.

Spoiler

The terrible side effects of loosing so much blood are brain damage and other organ related failures, warn them of that, keep them monitored and provide aid as best as you can. Communication is key here to figure out if your patient is able to walk through an airlock without collapsing. My favorite telltale of a roughed up brain is a problem with colors and tastes, memory loss can also occur but you usually don't remember to tell your doctor something you already forgot.

I am fairly sure only skrell are supposed to bend their legs or arms like that or what is that white thing pocking out of my chest? Congratulations you found a broken bone! Those are mildly annoying to fairly lethal depending on which one it is and how much you plan to move around with it. If it's a rib getting romantically close to the lungs you probably want them on a stretcher until someone fixes that, if it's a leg or an arm, maybe just one of the less important fingers, you might just be able to stabilize that with a splint. In any case you want to throw carefully place your patient in the scanner and print a nice snapshot of their new bone structure for the surgeon arriving next week. Hard work is right out at this point as any further stress to the bone will just make things worse from here on out.

Spoiler

If you got send to some backwater truckstop station without a modern scanner identifying the exact bone becomes a lot more complicated, but it's still possible if you payed attention to your anatomy books. First of all ask the patient to move around each and every part of their body, they will usually let you know where exactly it hurts the most or you might just be able to guess it from their face going all "urgh" on you. Unathi are usually not doing that, but they also usually do not break bones so they got that going for them. One your patient is done with their self inspection (help intent, clicking yourself with an empty hand) you should take a closer look. You are the expert after all! Grab your patients and carefully check the spot for anything moving more than it should be. Depending on how well you know your bones you might be as precise as any scanner those hightech stations get. (grab a patient on grab intent, aim for the limb in question on the funny little health doll, switch to help intent and click on the patient while having them in your grab. This is a super useful technique to figure out issues when medical has blown up your scanners are out of power)

3. Help! I am not alone, but it seems super busy and I kinda wanna be useful.

So your hopes of someone holding your hands got crushed by a meteor storm? Here is what you need to know to be the best intern that ever got not thrown out. Just remember that you may still get yelled at... lots and lots and lots and lots.

As an intern you want to focus on what you can best, that means, not much. Really be a helping hand to shine here, talk to the patients to figure out any untended issues that a doctor should know about, print out scans of everyone and hand them to someone who can read them together with the right patient, clean all the blood in the lobby and maybe even stop someone's bleeding to keep your cleaning supplies and patients from running dry. Doctors will usually yell for specific medicine as well, let them know that you can read and got working legs, so practice your sprint to the fridge and bring them what they ask for. Who knows, you even might get an explanation of why the needed it and learn something along the way. The sky's the limit here. I have seen interns handling the door buzzer and keeping an eye on the lobby and even that can be super useful if done right. In general you are the doctors third hand and most often they decide how useful they want you to be. Some may even trust you with your own patients or monitoring a drunk while they do some heart surgery. If things become stressful pull through and and find some quiet place to smoke later or do the peer review thing to improve. This is not the time to argue but to act, everything else can be sorted out later, possibly by lawyers if someone is really unhappy. Don't feel like a snitch for filing an IR as well, but keep in mind that talking to your local superior can usually fix things without causing more irritations.

Here is the super comprehensive list of what the others are supposed to be doing during your emergencies:

1. Paramedics and EMTs, sometimes called First Responders. They will be running all over the place, their mind is super focused on keeping people stable enough for a doctor to take over. Those guys will often tell you to monitor someone and administer a specific medicine if something happens. Those are real gauze wizzards and will usually be easy to talk to and happy to teach, since they are no doctors and got not much else to do when nobody is screaming for help on the radio. If you want to learn how to bandage someone in zero G, those are your guys to go to.

2. Physicians and general doctors. Probably your designated person to shadow for a shift or week or year. They are not really specialized and as result got to stay updated on almost anything related to keeping people alive and comfy. You may not see them do brain surgery, but a good one of those will handle ten patients at the same time without breaking a sweat. Most often works and lives in a general treatment room or GTR They are also usually fairly well connected with the crew since everyone needs a doctor sooner or later. Think of them as your professor in their wild years. They also make for some of the best story tellers.

3. Surgeons. The infamous gods in white. If your patient needs one they probably got roughed up badly. A good surgeon will be able to repair organs in the time you take for your smoke break. Most of them prefer a stable patient with a printed scan, but don't think that means they cannot be incredibly useful in an emergency. Range from butcher to artist and are usually happy to teach their craft during slow shifts. Just don't ask about their odd obsession with slaughtering monkeys. They are usually OR dwellers unless the general treatment is left unattended since they are also doctors from a legal perspective.

4. Chemists. Your best buddies. Full stop. You get everything useful from them and then some. They not only know how to make medicine but also studied the most obscure scenarios involving those. So if you are unsure what to pump your patient full with, asking a chemist will do the trick. Tend to keep their fridges filled if you let them know when something is about to run out. Get them some coffee and they will become your buddy in no time. Some of them may be doctors while others might just have an odd obsession with chemicals. Just ask them before letting them tend to a patient, that's not considered rude but rather important for legal reasons.

5. Chief medical officers a.k.a. CMOs and other higher ups. Listen to them, even if they are stupid. We all had that boss who knew jack shit, but even if they suck at talking to a patient, they did something right to get that postion. Usually know their way around legal issues, can organize you specific training sessions and so on. You will have good ones and terrible versions, just keep in mind that they got a little bit more pressure than just the couple of gasping miners in the hallway. Most of them love to stay up to date, so giving frequent updates about the current situation can make those your friends in no time. (Those are whitelisted players, they are meant to help out new folks and organize departments. If they don't ask them in looc and figure out if it's an IC issue. If it's an obvious OOC issue you should let staff know via ahelp, they will investigate further. Some of them also feel responsible for reporting obvious abuse, so if you decide to test out that super cool syringe gun on an unwilling test subject while the CMO is staring at you, be ready to explain to an admin how exactly your character came up with that idea. That being said they are usually chill and friendly, since command players tend to be far more experienced with the mechanics and community)

Some general OOC guidelines to improve your medical experience:

Spoiler

 

Keep patient filled with blood, put chemicals and air in blood, make sure brain has said air.

Keep your chemistry page open and use ctrl+ f to quickly find the right medicine. You can even search for stuff like "toxins" or "trauma" and it will usually send you in the right direction. Better yet, note down what your medbay starts out with and what it does, then add notes to your personal document of stuff you learned about and used, this will make it easier to return to a medical role later down the line and by writing stuff down in your own words you will remember it way better than just reading a giant wiki list or guide.

Roleplay roleplay roleplay. Your patient is another player who usually knows exactly what they are dying from. Talking to patients does not only provide you vital information but also fun RP for both involved. In general avoid wordlessly injecting people or throwing them on a stretcher and running off with them. If someone salts at you in LooC let them know you are new, if they keep going let staff know via an ahelp.

Read up on more specialized guides if you want to move towards another direction, the surgery page on the wiki and chemistry guides on the forums are usually super informative but overwhelming for new players. The easiest way to learn is ICly, don't be afraid to mess up, people die all the time in this game. You will usually get an explanation for what you are doing, why you are doing it and how can do it from a senior doctor. LooC can be used for neat OOC tips like hotkeys or ways to make your life easier as a player. The medical lobby is where medical meets and you can usually find someone there who is able to explain the most obscure of situations to you via LooC.

Keep IC and OOC apart. People can be ICly mad at their characters dead friend, but OOCly laughing about that hilarious explosion that caused it. You might know a ton about surgery, but that still does not mean your intern should do any without supervision and studying for that specific field of medical. Same goes for chemistry, most recipes are easy but you may be breaking server rules by going out of your way to "win" at the medical system.

Take people boasting about their medical knowledge with a grain of salt. The best doctors we got know that even when everything is done right, the code will still decide to end someone from time to time. Being humble is usually a good sign of understanding that this is a game and none of us are real doctors. Except for the guys screeching about chemical names, those are probably real doctors, which still does not mean much when it comes to playing one. If your character hears a voice in their head to check out the morgue it usually means an admin stepped in and revived someone who now woke up in a morgue tray. If that voice comes over the radio instead, head down anyway! Who knows what kind of situation you may find down there.

If your patient just coughed out a giant cloud of yellow smoke he is dead, and so are you. That stuff is called K'ois and once breathed in has a persistent chance to not only end you, but have you spreading those spores before you die. Laugh at it OOCly, despair at it ICly... You need a good surgeon to even have a chance at surviving that and the clocks running fast once it is inhaled.

Forensics prefers to do autopsies for multiple reasons. Let them do it if they are available. They will thank you for it. Just cause your funny scanner says "shot to the face" does not mean you should handle the corpse when there is someone willing to file multiple folders full with roleplay details.

If you want to skip the intern phase, play a physician who is a bit out of the loop or just panics during stress. It provides fun RP and allows you to know far less than you should while searching the wiki for answers or ahelping for a staff member to walk you through something. Just be ready to move on towards a more stable character once you figured out the medical systems and want to stick to a more professional character as people tend to keep it in memory if a certain doctor kept messing up big time some weeks ago.

 

 

[StationCrab]

I love this guide so much.

[Kryostro]

Instructions unclear, sawed an Unathi in half.