Dem Bones: a Bone Medicine rework

[GeneralCamo]

This has been something I've been planning for over a year now. I think it's time to post it.

The idea here is to make bone medicine into something more detailed than "mandatory surgery if you chip a femur." This involves splitting the injury types and their respective cures. Minor bone injuries will only require external medicine and will no longer need surgery. Here's a quick overview of the planned types and their cures:

 

> Stress/Hairline fractures: Minor bone injury. To Fix: External: Splint + Bone Chem (If surgery, bone gel only)

> Fracture/Break: Medium bone injury. External: Splint, Anaesthetic/Painkiller, Bonesetter, Bone Chem (If surgery, see current system)

> Compound Fracture: Major Bone Injury. To fix: Surgery: ATK, Bone Gel, Bonesetter, Bone Gel

> Comminuted Fracture: Maximum bone injury. To fix: Surgery: Hemostat, ATK, Bone Gel, Bonesetter, Bone Gel

> Malalignment: Someone who is about to be fired gave bone chem without aligning the bones. We'll need to break apart the bones to then fix them. Surgery: Drill, Bonesaw, (see Comminuted Fracture)

We want the malalignment to punish people for blindly healing someone, but the rest is very open to debate. 

[Boggle08]

I think the bone chem should be in the medivends. There's no reason for it not to be plentiful when it encourages more GTR work. This could be good for medical.

[GeneralCamo]

12 minutes ago, Boggle08 said:

I think the bone chem should be in the medivends.

Considering misuse has the possibility to go -very- wrong, I see no problems with this. 

[wowzewow]

I think the bone chem should be something relatively simple - calcium.

Kind of like how Iron pills are used to restore blood.

It's intuitive, simple, and easily obtainable, relatively speaking, and something less the chemist should be worrying about - bone fractures should mainly be the surgeon's domain.

But I like the rest of the suggestion - splints are already unused most of the time.

[GeneralCamo]

2 hours ago, wowzewow said:

I think the bone chem should be something relatively simple - calcium.

This is not a good idea. This means that you can drink milk to regrow bones straight from the kitchen.

However. We can make the bone chem have calcium as a component. And if the GTR is pre-stocked with the bone chem, it shouldn't be a problem for the chemist unless there's a mass casualty incident which requires them anyway. 

2 hours ago, wowzewow said:

But I like the rest of the suggestion - splints are already unused most of the time.

The idea is that splints should be the main first treatment for bone fractures. Using your limb while it is fractured without splinting it should probably just make it worse. However, first aid procedures should be followed here: first responders should only be splinting bones, not resetting them. The physician and/or surgeon should be required to reset them. 

[wowzewow]

Thing is, the idea for calcium is that it would function similarly to iron.

However, make it so calcium in milk is found in very low amounts, similar to how iron is found in some vendor foods (just extremely sparingly.) This is mostly for ghetto surgery and whatnot - only the chemist is able to synthesize calcium in high enough concentrations to actually be effective, the botanist even less so, see messa's tears, etc.

My main opposition is just adding a entirely new chemical in general, while we already have a very convenient existing chemical to build upon.

Edited September 15, 2023 by wowzewow

[Ramke]

I love the original suggestion purely because the various severities would add a bit of complexity and depth to bone breaks, as well as giving physicians more work to do as opposed to sending everyone off to surgeons as it so frequently happens nowadays. The possibility of fucking up is pretty nice, too.

Another suggestion on the side, and no idea if this is easy to implement, should probably add "bone scarring" the same as we have organ scarring, maybe less severe but a -5 to overall bone break threshold after doing surgery would make sense, as right now after using the bone healing gel they're perfectly fine and as strong as before without giving time to heal. Maybe a dull pain while it heals? (not actually pain, just a flavour message about soreness).

The calcium suggestion I'm not so sure on, it would definitely be better to have it separate as so no one could accidentally decide to get a fortnite chug jug full of milk and get their bones to a misaligned state. If the bone healing juice is in vendors, it would be completely fine, and wouldn't invalidate the physician unless there was a pharmacist.

[Sparky_hotdog]

I'm a fan of the suggestion, because it both offers a non-surgical alternative to fix bones (thus bringing us closer to my dream of ridding us of the table once and for all) while still giving surgeons relevancy. I can particularly see this being huge during mass casualty events, where many patients can end up waiting for 15+ minutes in the GTR with nothing but a fractured rib.

On that note, I might be misunderstanding, but if it is required to splint before giving bone chem (Which I like, as splints are often underused), then ribs and skulls are still going to need surgery, as splints cannot be applied to either of those. Not sure if that is intended or not.

On the calcium suggestion, I'm not a fan of that, partially for the risk Ramke highlighted, but also just because I would rather see a sci-fi-y med used instead. Drinking a bottle of pure calcium and having your bones repair themselves seems a little silly to me.

[GeneralCamo]

1 hour ago, Sparky_hotdog said:

then ribs and skulls are still going to need surgery, as splints cannot be applied to either of those

Being that the skull is one huge bone, we can make it a little special and not require splinting for hairline fractures. Breaks would mandate surgery however just due to the impossibility of externally setting that.

I'm not sure what to do with the ribs. I'm open to thoughts. 

[wowzewow]

I think ribs can withstand the same treatment as the skull, since it's one of the more hardier bones in the human body. Would be less punishing for CPR bone breaks too.

 

To elaborate on calcium as well, it should work very slowly, however, it will *never* cause misalignment. Again, enough that people won't be running to get milk to repair their bones, but at least have it as a viable alternative. Ghetto surgery is *extremely* neglected, and I hate to see it getting shot down again.

Anyway, I'm retracting my thoughts on having a dedicated bone chem, but please have the name be something painfully obvious.

Edited September 15, 2023 by wowzewow

[GeneralCamo]

36 minutes ago, wowzewow said:

it will *never* cause misalignment

Absolutely not. The whole point of the system I made is to punish blind healing. Otherwise it turns into a routine assembly line of giving chems. 

 

36 minutes ago, wowzewow said:

Ghetto surgery is *extremely* neglected, and I hate to see it getting shot down again.

Oh don't worry. I'm sure we can add some system for people to set bones without the proper tools. I was thinking a relatively simple recipe for BoneGro so a random traitor can make it in maintenance. No Phoron or similar required. 

[Roostercat]

As a surgeon main, I really like this idea because it actually gives the poor physicians something to do instead of having to throw bone patients at the OR at mach ten by requirement, and past that it adds some much needed variation to injuries to switch the medical assembly line up a bit. I think adding a specific bonechem (throwing Osteodine as a name out) is better than using calcium, as I think a simple electrolyte growing bones however slowly is really goofy. On that note, I think having calcium be a component of a chem that makes bone injuries less likely could be cool as a preventative supplement. 

 

Another concern I have is how complicated the bone surgeries/fixing can get.

20 hours ago, GeneralCamo said:

 

> Stress/Hairline fractures: Minor bone injury. To Fix: External: Splint + Bone Chem (If surgery, bone gel only)

> Fracture/Break: Medium bone injury. External: Splint, Anaesthetic/Painkiller, Bonesetter, Bone Chem (If surgery, see current system)

> Compound Fracture: Major Bone Injury. To fix: Surgery: ATK, Bone Gel, Bonesetter, Bone Gel

> Comminuted Fracture: Maximum bone injury. To fix: Surgery: Hemostat, ATK, Bone Gel, Bonesetter, Bone Gel

> Malalignment: Someone who is about to be fired gave bone chem without aligning the bones. We'll need to break apart the bones to then fix them. Surgery: Drill, Bonesaw, (see Comminuted Fracture)

 

Firstly, I think Stress/Hairline should be renamed to Stress/Bruise. Secondly, I think the requirement for bone chem on this one should be gone just to give solo physicians and whatnot better usefulness (even if the medbay has it at roundstart). 

Thirdly, I think it would be neat if Comminuted Fracture caused blood loss to simulate losing bone marrow. Maybe replace the Hemostat step with the vascular recoupler.

[CatsinHD]

I am for this, as I am with most things that add some complexity to areas of med that could use it, especially as it gives Physicians a way out of the GTR clogging "awaiting bone surgery" scourge. I would like to see maybe some ideas on how fast the bone chem works since I feel like would end up being the deciding factor between bone surgeries disappearing except low-pop and having a semi-regular discussion on which treatment would be the better option. Ideally, it would be slow enough where surgery is the faster option, but not so ungodly slow that it nukes itself into uselessness. That way surgery is still useful when there is room in the ORs, but the physicians are left out to dry when John Sol rushed the mercs and got their bones giga-blasted. Obviously this should be discussed, though, as I imagine some people disagree.

 

Regardless, love the idea and also agree with what Rooster said (especially the name). +1

[GeneralCamo]

36 minutes ago, William Murdoch said:

bone surgeries disappearing

Heavy injuries still require bone surgery. Thresholds are up for discussion, but if you got blasted by a rocket launcher you're not going to get away with just some bone juice to the bones that are closer to the consistency of popcorn. This is primarily meant to remove the need for surgery for minor injuries, not serious injuries. 

4 hours ago, Roostercat said:

Firstly, I think Stress/Hairline should be renamed to Stress/Bruise.

It was going to be called either stress or hairline. The idea being it's a crack in the bone, that just needs some patching, as opposed to a larger break. We could add bruise as a new threshold though, for extremely minor injuries. 

4 hours ago, Roostercat said:

Thirdly, I think it would be neat if Comminuted Fracture caused blood loss to simulate losing bone marrow. Maybe replace the Hemostat step with the vascular recoupler.

The idea is that it needs rebuilding from pieces, though I would like to kill blood generation perhaps in that organ/limb. Steps are up for discussion definitely though.