Surgery Tweaks

[Surrealistik]

#1: Anesthetic or pain killers (total painkiller value equal to Tramadol or better) should be necessary to prevent patient flinching which contributes to your overall surgical failure chance. As an addendum to this, give Soporific a Tramadol or better painkiller rating so it can be used for surgery without having to wait forever for the sleep component to actually set in (for balance reasons it probably should have this delay).

#2: Please get rid of randumbization for shrapnel/internal objects removal. The RNG can make surgery take needlessly excessive amounts of time, especially with multiple pieces that need to be removed.

[Guest Marlon Phoenix]

Use oxycodone. 10u lets you preform surgery after a few seconds, and they feel no pain, even if awake. 4 pills of 10u oxycodone in each OR locker makes you golden.

The randomization is a bit butts, but I would say it's more of an ideal than a detriment. Removing tiny pieces of shrapnel is hard!

[Surrealistik]

?

I think my proposal isn't being understood; what I mean is that I'd like to have a lack/absence of adequate painkillers feature the mechanical consequence of incrementing surgery step failure rates from the patient moving around due to pain (unless they're paralyzed/asleep), as is the case on say Colonial Marines. Currently I don't believe failure to apply sedative or strong painkillers has any mechanical penalty.

As the randomization goes, the sheer PITA factor definitely isn't worth the immersion; failing 10+ times in a row on a single slug is cancerous. If nothing else the number of failures should be clamped, guaranteeing success on the third try or something like that.

[Fire and Glory]

I support #1, being able to do surgery on a screaming patient with no medicine so long as they stay on the table is stupid.

I don't really back #2 as I don't think it's something that needs to be completely removed.

[Surrealistik]

I don't mind a compromise on #2 such as the one I've mentioned with a max number of attempts before guaranteed success, but something definitely needs to be done.

[Scheveningen]

?

I think my proposal isn't being understood; what I mean is that I'd like to have a lack/absence of adequate painkillers feature the mechanical consequence of incrementing surgery step failure rates from the patient moving around due to pain (unless they're paralyzed/asleep), as is the case on say Colonial Marines. Currently I don't believe failure to apply sedative or strong painkillers has any mechanical penalty.

As the randomization goes, the sheer PITA factor definitely isn't worth the immersion; failing 10+ times in a row on a single slug is cancerous. If nothing else the number of failures should be clamped, guaranteeing success on the third try or something like that.

 

Do take into consideration that tramadol and inaprovaline are not powerful enough painkillers to perform surgery. While I like the idea of surgery failures without anesthetics or painkillers, tramadol is not remotely sufficient enough for advanced kinds of treatment if you want to prevent having to outright sedate someone. Oxycodone fulfills the purpose of being a very powerful analgesic. Although oxycodone is often used for combat purposes it actually really slows down reflexes and puts the patient in a very relaxed state due to it being an opioid. But that's something for another day.

It is not easy to remove shrapnel embedded into a wound, by the way. In real life surgeons can also miss and if they drop the shrapnel back into the wound it is incredibly painful and can cause hemorrhaging if the shrapnel's shape is sharp enough to cause any grazes on its way back down to lodge back into the incision.

[Surrealistik]

I'm pretty indifferent as to the pain killer threshold. I'm not sure if it should be as high as Oxy at 200, but that's a minor consideration either way, so long as soporific is adjusted to provide most of the pain killer rating needed.

As to shrapnel extraction, again, yes, it can be difficult to remove, but there is no way removing a single piece of shrapnel should ever take as long as a complete surgical procedure (which it definitely can per the current code base). The number of attempts needs to be capped.

[Scheveningen]

The RNG could be adjusted better. Apparently it's 50-50 hit or miss but that translates very poorly given how digital chance works.

[JKJudgeX]

One thread per suggestion, this is two distinct suggestions.

1) This is a bad idea because it will just produce situations where needed surgery can't be done because a needed chemical is not available. It also would impact pretty much every surgery. How does it make the game better or more interesting? Surgery can be done now without a chemist. There's only a chemist or willing CMO half the time. Borgs who can self-trespass I guess could still perform surgery, but as someone who usually plays a human with a specific role, I'd say no thanks to this for sure.

2) Sometimes things get stuck in bodies in more deadly or hard to remove ways than other times, this is part of the simulation. As someone who just derailed another thread on the platform that you just don't want hazards to be easier to deal with, I'm not sure how you can in good conscience make this argument. This is a situation where a job is made difficult and more enriched by the difficulty involved, and a chance of failure or running out of time is introduced.

[Surrealistik]

1) This is a bad idea because it will just produce situations where needed surgery can't be done because a needed chemical is not available. It also would impact pretty much every surgery. How does it make the game better or more interesting? Surgery can be done now without a chemist. There's only a chemist or willing CMO half the time. Borgs who can self-trespass I guess could still perform surgery, but as someone who usually plays a human with a specific role, I'd say no thanks to this for sure.

 

Surgery can still be done without chemicals, or a chemist; the anesthetic tanks aren't going anywhere. This makes emergency/improvised/rush/speed/ghetto surgery more dangerous though if you don't or can't attempt to apply any anesthetic whatsoever, even something as improvised as choking/knocking your patient unconscious. Yes, on an RP server, surgery without proper anesthetic is going to be corner case, but less so than straight up ghetto surgery with tools as surgical implements, and those all increment failure chance. Further, that failing to apply proper anesthetic, or to otherwise render your patient insensible to pain results in no mechanical consequences makes even less sense from a verisimilitude/immersion perspective than a single bullet extraction taking longer than heart surgery which you apparently support as below.

 

2) Sometimes things get stuck in bodies in more deadly or hard to remove ways than other times, this is part of the simulation. As someone who just derailed another thread on the platform that you just don't want hazards to be easier to deal with, I'm not sure how you can in good conscience make this argument. This is a situation where a job is made difficult and more enriched by the difficulty involved, and a chance of failure or running out of time is introduced.

 

This is one of those situations where gameplay > verisimilitude. But my argument also stems from verisimilitude and internal consistency because other surgical steps can also be prone to difficulties and complications yet they aren't. For the sake of internal consistency and 'realism' would you approve of expanding a base failure chance to all steps? Furthermore, it is entirely possible that extracting one or two slugs alone will take longer than an entire surgical procedure which is pretty silly.

[JKJudgeX]

Let's simplify:

1) Generally makes many surgeries more difficult. I'm not a fan of big changes like this.

2) Flattens a type of surgery that has variable difficulty. I'm not a fan of just making things easier without a rational justification. I like a balance of simulation and gameplay, myself, but making all extractions a rote, identical surgery seems heavy handed, too.

[Surrealistik]

Let's simplify:

1) Generally makes many surgeries more difficult. I'm not a fan of big changes like this.

2) Flattens a type of surgery that has variable difficulty. I'm not a fan of just making things easier without a rational justification. I like a balance of simulation and gameplay, myself, but making all extractions a rote, identical surgery seems heavy handed, too.

 

1) It's not really a big change; it affects corner case emergency/improvised/ghetto surgeries which are a definitive minority of surgeries.

2) It doesn't actually make slug removal easier or more difficult; just less time intensive, while making it consistent with every other surgery step in the game. What is rational is either having random failure chance for all steps (barring ones you can't possibly fuck up), or random failure chance for no steps, rather than a snowflaked RNG failure chance for one (1) specific surgery step that can end up making it take longer than whole procedures which is also silly, irrational and inconsistent.

[JKJudgeX]

1) I understand this. Thinking from an antag perspective, the tools of medbay and medicines may not be available. There is already a much higher chance of failure in this kind of surgery to begin with, why make it further difficult or impossible without a chemical that may not be had? The way it's described in the OP, not having tramadol/etc on hand would make something like removing a bullet in the field pretty much impossible, which it shouldn't be, and it's already difficult in-game as is. Just seems like arbitrarily ranking up a difficulty of something that's already a 6 or 7 to an 8 or 9, when no one is really complaining that ghetto surgery is too easily done.

2) Time is often a measure of difficulty, it makes removal take fewer steps... the game simulation seems pretty decent to me here... sometimes you get shot and it *is* an easy extraction in real life... other times, complications come in or the bullet is harder to find... I wouldn't want to diminish that. In other words, though the game doesn't simulate a bone shattering into 42 fragments, or your stomach contents leaking into your abdomen, which are things that might happen from a real gunshot, it can provide randomized complications that in a way simulate this being the case. I appreciate that.

This is why there should really be one idea or concept per post, though, because here, I really disagree with #1, but #2 I'm not completely dead-set against some kind of change. I think both are things that should have been suggested in some capacity, though I don't really like the approaches given for each.

[Surrealistik]

1) I understand this. Thinking from an antag perspective, the tools of medbay and medicines may not be available. There is already a much higher chance of failure in this kind of surgery to begin with, why make it further difficult or impossible without a chemical that may not be had? The way it's described in the OP, not having tramadol/etc on hand would make something like removing a bullet in the field pretty much impossible, which it shouldn't be, and it's already difficult in-game as is. Just seems like arbitrarily ranking up a difficulty of something that's already a 6 or 7 to an 8 or 9, when no one is really complaining that ghetto surgery is too easily done.

 

There are alternate methods of anesthetizing patients like choking and KOing. As long as they're paralyzed or unconscious, you're not eating penalties. Beyond that, strong alcohol (or better yet, alcohol that KOs someone) can also reduce failure chances.

 

2) Time is often a measure of difficulty, it makes removal take fewer steps... the game simulation seems pretty decent to me here... sometimes you get shot and it *is* an easy extraction in real life... other times, complications come in or the bullet is harder to find... I wouldn't want to diminish that. In other words, though the game doesn't simulate a bone shattering into 42 fragments, or your stomach contents leaking into your abdomen, which are things that might happen from a real gunshot, it can provide randomized complications that in a way simulate this being the case. I appreciate that.

This is why there should really be one idea or concept per post, though, because here, I really disagree with #1, but #2 I'm not completely dead-set against some kind of change. I think both are things that should have been suggested in some capacity, though I don't really like the approaches given for each.

 

Surgery at present is nothing like real life except for the generalities of the steps. Again, that one step has a failure chance and the others don't is a glaring inconsistency; either every step should have a failure chance (barring stuff that's impossible to fuck up), or none of them should. Further, time isn't really a measure of difficulty here; there is no increment of actual difficulty or challenge in completing the procedure.

Overall I have to note there's a certain inconsistency in supporting the status quo in #1's case for gameplay reasons and supporting it in #2's case for verisimilitude/simulationist reasons, when #1's status quo is far more egregious a violation of simulationism than the changes proposed to #2 (effectively ignoring the consequences of trying to operate on a fully conscious and unmedicated patient vs taking less time to do a single surgery step), while having less of an actual gameplay impact. This is to say nothing of the fact that #2's status quo is internally inconsistent and silly in the first place: again slug extraction taking potentially longer than heart or brain surgery (which can also have serious complications), with only one step out of the many, including more complex ones, having a base failure chance.

[icy_dew]

actually setting a bone has a chance to fail too

[Faris]

actually setting a bone has a chance to fail too

 

It's heavily reliant on brute damage to the limb.

[Scheveningen]

Setting a bone that isn't broken will break it.

[Scheveningen]

Let's simplify:

1) Generally makes many surgeries more difficult. I'm not a fan of big changes like this.

2) Flattens a type of surgery that has variable difficulty. I'm not a fan of just making things easier without a rational justification. I like a balance of simulation and gameplay, myself, but making all extractions a rote, identical surgery seems heavy handed, too.

 

1.) People will use anesthetic or oxycodone regardless as they have been doing. Absolutely nothing changes beyond massively punishing anyone that tries to operate without anesthetic or powerful painkillers.

2.) There is no difficulty to the surgery beyond RNG gating whether you succeed or fail, it has nothing to do with mechanical skill whatsoever, but whether a random number generator decides if you're going to succeed on your attempt of operation. It is not "immersive" leaving such a thing to chance when surgeons have spent years up to decades honing their craft, pardon me for using such a dumb term.

[JKJudgeX]

1.) People will use anesthetic or oxycodone regardless as they have been doing. Absolutely nothing changes beyond massively punishing anyone that tries to operate without anesthetic or powerful painkillers.

2.) There is no difficulty to the surgery beyond RNG gating whether you succeed or fail, it has nothing to do with mechanical skill whatsoever, but whether a random number generator decides if you're going to succeed on your attempt of operation. It is not "immersive" leaving such a thing to chance when surgeons have spent years up to decades honing their craft, pardon me for using such a dumb term.

 

1) Again, unnecessary. Many surgeries can be successfully completed without anesthetic IRL. Surgery was invented a long time before anesthetic, and the ghetto surgery already has a large risk of failure... so this is already factored in enough without the need to make it even more difficult without extra preparation. Makes perfect sense the way it is.

2) I already acknowledged this. Every bullet wound isn't the same. The RNG failure could be there to represent that one bullet/shrapnel wound was exceptionally bad, while the other was not without adding extra mechanical steps. Flattening this would make it seem like every bullet wound was exactly the same. I don't care how great a person is at surgery, some bullets/shrapnel penetrate more deeply or in more complicated ways. Makes perfect sense the way it is.

[icy_dew]

actually setting a bone has a chance to fail too

 

It's heavily reliant on brute damage to the limb.

actually when you have too much brute damage you hear it crack, and have to redo it.

there's just a general chance you'll "set the bone in the WRONG PLACE"

[Surrealistik]

1) Again, unnecessary. Many surgeries can be successfully completed without anesthetic IRL. Surgery was invented a long time before anesthetic, and the ghetto surgery already has a large risk of failure... so this is already factored in enough without the need to make it even more difficult without extra preparation. Makes perfect sense the way it is.

 

And the failure rate of surgery pre-anesthetic was considerably higher for obvious reasons.

Again, ghetto surgery remains just as viable with a little more prep; choking your patient into unconsciousness works just fine (assuming he's not in hard crit already).

 

2) I already acknowledged this. Every bullet wound isn't the same. The RNG failure could be there to represent that one bullet/shrapnel wound was exceptionally bad, while the other was not without adding extra mechanical steps. Flattening this would make it seem like every bullet wound was exactly the same. I don't care how great a person is at surgery, some bullets/shrapnel penetrate more deeply or in more complicated ways. Makes perfect sense the way it is.

 

Again, either all surgery steps, particularly ones more complicated than shrapnel removal should have a failure chance, or none of them should.

[JKJudgeX]

There's a 1/3 per step chance when doing ghetto surgery to injure the patient. This is because you don't have good tools/anesthetic. From the bay wiki: "you have a 1/3 chance per step to make a mistake and injure the patient rather than advancing the procedure". There's no need to make this any more difficult or punishing.

What's a better story? "Steve died because we didn't have enough pain medicine because nobody was playing chemist. That's why the round ended." or "We rescued Steve using what few tools we had, though it was a bloody procedure! Then the round was good." ... I generally prefer the latter.

The "chance" of failure on a normal surgery step would indicate something out of the ordinary happening. A piece of metal randomly inserted into the body makes a lot of sense to cause this, right? "Yep, boomerang tangled up in the intestines this time" or "142 paperclips in the lungs, this might take a while" as opposed to "Oops, I killed him because I accidentally forgot how to replace a heart this time for no discernible reason. "

I dunno, just saying, mechanically, it makes sense and seems to have accommodated for ghetto surgery being fail-tastic, as well as regular surgery having complications with randomly inserted objects. No change needed.

[Surrealistik]

There's a 1/3 per step chance when doing ghetto surgery to injure the patient. This is because you don't have good tools/anesthetic. From the bay wiki: "you have a 1/3 chance per step to make a mistake and injure the patient rather than advancing the procedure". There's no need to make this any more difficult or punishing.

What's a better story? "Steve died because we didn't have enough pain medicine because nobody was playing chemist. That's why the round ended." or "We rescued Steve using what few tools we had, though it was a bloody procedure! Then the round was good." ... I generally prefer the latter.

 

Steve would have died in the former case because no one was intelligent enough to KO or choke him out.

Keep in mind that when you're in hard crit, you're already KOed, so ghetto surgery then wouldn't be affected by the increment in failure chance.

 

The "chance" of failure on a normal surgery step would indicate something out of the ordinary happening. A piece of metal randomly inserted into the body makes a lot of sense to cause this, right? "Yep, boomerang tangled up in the intestines this time" or "142 paperclips in the lungs, this might take a while" as opposed to "Oops, I killed him because I accidentally forgot how to replace a heart this time for no discernible reason. "

 

It's not that you forget how to replace the heart, it's that you fucked up when applying the biogel, you went half an inch too far or too short; you put an iota too much stress on the artery while clamping and threading it with the Fix-O-Vein; vital organs and indeed most internals of the body are tremendously sensitive things, and manipulating them is both a complex and delicate task; certainly more so in many cases than pulling out a slug or piece of shrapnel. There is simply no consistency on this point in the current system.

 

I dunno, just saying, mechanically, it makes sense and seems to have accommodated for ghetto surgery being fail-tastic, as well as regular surgery having complications with randomly inserted objects. No change needed.

 

In terms of mechanics and versimilitude the status quo on these points doesn't make any sense at all; that's precisely the problem, so change seems pretty desirable.