Clarify Machinist's Role In Relation To Medical Work

[EJJ]

So Surgery page says that Machinists can do Organ repair if it is mechanical. But the surgery tray in the machinist operation area does not contain the full amount of tools. This either requires a machinist to harass medical for bone gel if they cut open ribs or to ask Operations to save them a surgery kit.

And I find 99% of the time, when a Machinist asks someone for a tool they need to finish a surgery common suddenly turns into a debate on whether they should be doing it, a surgeon should or if the person with broken lungs, heart, or whatever else just needs to give up.

Current Machinist surgery tray for reference:

[Montyfatcat]

The cautery wasn't even in there initially, even that's a new addition. It kind of feels like the tray was there exclusively for borgings, which conflicts with everything else.

[Evandorf]

My personal opinion on surgery in the Machinist workshop is that it’s not sterile enough for organic surgery. It’s too open, both in terms of the mixing of air from public hallways to the lack of privacy (the new room may have tint control, I’m not sure), it doesn’t have much in the way of patient accommodation, it’s just a very dirty place to have surgery done. I would feel like I was getting my appendix out in a garage.

 

Now, IPC surgery? No problem. Borging? Cleanliness and comfort is probably not the primary concern. 

[Carver]

7 minutes ago, Evandorf said:

Now, IPC surgery? No problem. Borging? Cleanliness and comfort is probably not the primary concern. 

I have to imagine borging requires just as much cleanliness given you're sealing that brain and whatever's on it into something permanently. You don't want to introduce bacteria or anything harmful into the MMI or else you've wasted your investment. To that effect, the old Robotics Workshop on the prior map had a fairly sectioned off surgical area separate from the general workshop if I'm remembering correctly. I could imagine with some shuffling that it could be reintroduced.

[CatsinHD]

I would agree with both Evandorf and Carver. On Aurora, the machine shop had an adjacent OR with window tint, a viewing area, and I'm pretty sure door control too. This current one doesn't look near clean or sterile enough. I'm not sure how much space there is, though, to put a new OR at without making the main part of the machine shop even smaller.

I guess the alternative is giving roboticists medical and OR access, but that feels a little too far frankly.

[Boggle08]

Meddoids get weird about the machinist doing shit, because it doesn't cleanly fit into the mechanism that is medbay delegation. If medical is fully staffed, the machinist is butting into a role whose entire existence is clicking people who are on the table. If it's just physicians, they're bound to feel the same way. They're here to click people who are on the table if a surgeon can't do it. The whole delegation thing came about because medical used to fight over the traffic that comes through their doors, so seeing something that is not bound by those laws confuses and frustrates them.

It doesn't help that the Machinist exists outside of the medical department. They don't share access with medical, and at least to my vague understanding, they don't share a commline either. Because their surgery chart is so narrow, anything that isn't a simple organ fix is going to require someone from medical to be standing in the room with them, or else the patient is going to roll off the table incomplete. They can't fix bones, shrapnel, arterial, or brains. The surgical operations they can perform are extremely intrusive and grossly inappropriate depending on the severity of the injury. The machinist also has a plethora of tasks and responsibilities outside of just medicine that I haven't even brought up yet, which further divides their attention away from being a dedicated medical role.

It isn't impossible for the roboticist to be asked to help out in medical, but they have always been at the bottom of medical's queue for consultation, outside of organ printing which I don't think counts; or they shine on lowpop. If a paradigm needs to be outlined for them with respect to medical, I see this as being the one. The one thing I believe that should always be brought before the roboticist is limb installation, however. It's cooler that way.

[KingOfThePing]

The funny thing is that, according to the meme chart, a surgeon can do everything a machinist can do. So why even have them in the first place 😃

[CatsinHD]

6 hours ago, KingOfThePing said:

The funny thing is that, according to the meme chart, a surgeon can do everything a machinist can do. So why even have them in the first place 😃

Afaik, and as far as I have personally roleplayed it, the Surgeon (and CMO) can only repair organic organs. Mechanical organs either need nanopaste or consultation with the machinist. Granted, that is just me and whether the chart says this is not affected by my own opinion. I tend to follow these lines, though, because surgeons lack screwdrivers.

I do think boggle makes a good point. There is a very clear and mostly well-adhered to system of delegation and flow which a machinist breaks in the current system. It doesn't help that organ repair can either be vital to recovering a patient, or incredibly minor. Both require either moving the patient to the machine shop or yelling for the machinist to come to medical.

Without serious remapping, access change, and comms change, I don't have a feeling Machinists will be able to break into the flow of medical or have an easy time with patients who do need help when there is a lack of nanopaste.

As for limb installation? Keep that with the roboticist. Surgeons can do it in an emergency, maybe, but prosthetics and how they work and are attached is the domain of roboticist and should stay that way.

[Carver]

Generally if I'm in need of a new limb I will request a Surgeon to perform the procedure, with the Machinist producing the limb in question. If I'm not playing an IPC, I don't want a Machinist cutting me up no matter if it's in or out of their filthy workshop.

[Evandorf]

I agree, I see a machinist as medical for synthetics and should not be opening surgical sites on organic tissue. It would be interesting if cybernetics/prosthetics had deeper mechanics that required diagnostics the machinist could provide but if it’s a replacement organ that requires an organic surgery site you should be a consultant and provide scanning services or replacements as necessary. 

[Evandorf]

I’m not sure if artificial organ damage shows up on the full body scanners in medical but if it does I would argue it should be removed. The machinist should be consulted more by medical and making damaged synthetic organ scans their sole domain could add some cooperation.

[CatsinHD]

10 hours ago, Evandorf said:

I’m not sure if artificial organ damage shows up on the full body scanners in medical but if it does I would argue it should be removed. The machinist should be consulted more by medical and making damaged synthetic organ scans their sole domain could add some cooperation.

It does show up on a full body scan and I disagree with this suggestion. The only way I would agree that mechanical organs should be a separate scan is if machinists were integrated into medical. Even then, I'd be very cautious because of how absolutely important organs are to brainmed. Every organ, if damaged, can kill a patient. Determining if an organ is damaged shouldn't rely on a role that is as separated both departmentally, physically, and mentally as machinist with how deadly damaged organs can be. This is not mentioning that in the medical bay, including FRs, there are 7 people that can do a full scan and make a diagnosis from there (2 physicians, 2 surgeons, 2 first responders*, and 1 CMO). If they have mechanical organs, that is just 2 and in my personal experience the machinist role is not reliably filled enough to have my confidence of putting scanning mechanical organs as their SOLE domain.

*First Responders, as far as I know, are allowed to use body scanners if they are trained on how to use them. This doesn't affect the fact they cannot make advanced diagnoses, but they can use the scanner regardless.

At this point, I'd much rather looking into splitting machinist into 2 oles, or shaving down its responsibilities. It is in a limbo state between science, engineering, and medical. I am fine if surgeons are able to fix mechanical organs and machinists focus on robots, or if there is a dedicated (perhaps singular), surgeon, in medical, trained on mechanical organs, but that breaks the cardinal sin of adding a new role and makes the surgery chart even more complex. As it stands, though, it is stretched across too many responsibilities which, while under the "mechatronics" umbrella, are conflicting in their focus.

[Evandorf]

8 hours ago, William Murdoch said:

Every organ, if damaged, can kill a patient.

I might be in the minority but I don’t think the focus of medical should be efficiency, where everyone can be treated quickly and completely. I think extended treatment for niche cases should be part of the experience and when players give their characters synthetic organs they are opting-in to having a different experience than normal.

My personal medical competency is somewhat low but my understanding is that unless the organ is destroyed or extremely damaged a good doctor can still mitigate and manage the side effects and a skilled doctor would be able to get close to a correct diagnosis using the context of the patient’s condition, patient medical files, and their own experience.

[CatsinHD]

Extended treatment can work for minor damaged organs and use of weaker chemicals like peridaxon (weak as in it doesn't heal as fast as surgery or targeted regeneratives) although the medbay is not designed for it by far. Too small, not enough space, too hard to monitor in the space given (no way in hell I'm putting a damaged organ case into the recovery room). Mechanical organs can't be involved with it, though. They don't heal naturally, can't be healed with chemicals, but can still damage other organs and cause MSOF. The only treatment is surgery with nanopaste or a screwdriver. This is an instant fix. Extended care is a negative in just about every way for mechanical organs.

As for diagnosing... yeah, some organs can be diagnosed by observation. Brain and lungs are easy because of the analyzer and stethoscope. Eyes work with the penlight. Heart is harder but still possible (check their blood levels and oxygenation. If blood levels are full but BO is low, heart is not pumping). Other things, though, like the liver are difficult to spot without the body scanner. The only way I know of to diagnose the liver without a scanner is to inject inap and see if it turns into RMT, because a damaged liver iirc lets potassium enter the blood and inap+potassium= RMT. It could be done, just harder with some organs having details of their damage so small that most don't even know what to look for.

[Boggle08]

20 hours ago, Evandorf said:

I’m not sure if artificial organ damage shows up on the full body scanners in medical but if it does I would argue it should be removed. The machinist should be consulted more by medical and making damaged synthetic organ scans their sole domain could add some cooperation.

I really think we should avoid putting in any roadblocks into medical's apparatus and turning them into obligations for the roboticist to carry out. From medical's end, this will frustrate the hell out of them, from the roboticists end, this places medbay obligations upon them. And when you have medbay obligations, that means you spend most of your time hovering between service and the bay, and you drop everything you're doing and run because someone's looking bad on sensors. The roboticist is not a dedicated medical role, forcing it to be like one will screw up it's gameplay loop and priorities.

Hell, if you really want to read deep into it, if mechanical organs become too much of a byzantine contrivance, it'll become a disincentive to select them in loadout, or make established characters that have them.

If giving the roboticist some identity with their medical abilities is so important, then I would use a template I've seen before ingame: acting as impromptu physicians in scenarios where there's no medical. We could give them the ability to take out shrapnel, make it clear that they can use the GTR machines, but they gotta sit at rock bottom for delegation as they have been as a tradeoff.

[Evandorf]

I agree that adding a new dynamic will upset and frustrate those who are already comfortable in established routine but it’s a necessary evil for any large change until the new becomes the norm.

I think, as far as  pie-in-the-sky longterm goals go, we would be best served making medical treatment something that can be done from multiple areas with low transit time. Sending patient vitals/initial scan data over the network to the machinist for example. Having the machinist be able to respond and give feedback or print a compatible limb/organ. Being able to link your PDA to a roller bed monitor so that you are alerted to a patient’s state degrading, ect. QoL enhancements that make it to where deck 3 medical can be used for its intended purpose and supplementary roles like the mechanist can be more easily integrated into the process.