Doctoring

Medical doctors have a bad reputation for never being around and being useless. Can you do better?

The Health System

All crew members spawn with 100% health, and with 4 categories of damage: suffocation, toxin, burn, and brute. Any damage taken will add to its corresponding category and subtract from total health. There is also brain and bleeding damage, which work differently from the others. As one's health declines, they will find it harder to move around. At 0% health, the patient enters critical health. They will stumble around, fall in and out of consciousness, begin to slowly take suffocation as well as brain damage and have an ever-increasing chance to develop shock and cardiac failure. If left untreated, they will eventually reach a certain amount of damage (overall, around 600) and die. Generally speaking, people are unlikely to survive 200 (-100% health) or more total damage.

Drugs

Medical doctors have access to some of these in medbay, and others can be created by botanists (though you'll really have to nag them for it). The quartermaster can also provide a medical resupply kit. Advanced drugs can be created by the scientists, assuming they haven't already burned themselves to death. Medbots synthesize a number of different medicines, which are indicated in the table below.

For a more complete list of medical chemicals, how to make them, and what they do, see Chemistry.

Basic

Drug	Use	Advanced version
Ephedrine	Stabilizes critical patients, but less effectively than epinephrine. Reduces stun/knockdown effects. Addictive.	Epinephrine
Epinephrine	Stops suffocation, stabilizes critical patients. Treats cardiac problems and allergic reactions. Reduces stun/knockdown effects. Causes sickness on overdose (20+ units).	Atropine
Salbutamol	Treats suffocation damage. Part of the standard medbot injection set.	Perfluorodecalin
Styptic Powder	Slows down the health loss from bleeding and heals brute damage. Only apply topically (patch, dropper etc)!	Synthflesh
Silver Sulfadiazine	Heals burn damage. Only apply topically (patch, dropper etc)!	Synthflesh
Saline-glucose Solution	Slowly heals brute and burn damage, handles circulatory shock, increases the body's natural regeneration rate of blood. Part of the standard medbot injection set.
Charcoal	Treats toxin damage, absorbs other reagents in the body. Part of the standard medbot injection set.	Pentetic Acid
Calomel	Rapidly flushes chemicals out of people's bloodstreams, but causes toxin damage in the process.	Pentetic Acid
Potassium Iodide	Basic anti-radiation medicine.	Pentetic Acid
Cryoxodone	Heals most damage types; used in cryo chambers. Only works at low temperatures!	Omnizine
Salicylic Acid	Basic painkiller. Heals small amounts of brute damage. Decently reduces the speed penalty from injuries, and reduces overheating.	Morphine
Morphine	Sedation. Low doses significantly reduce the speed penalty from severe injuries and help with jitteriness. Addictive.

Advanced

Drug	Use
Atropine	More powerful version of epinephrine, useful when patient is near death. Fixes cardiac problems and rapidly flushes sarin out of the body.
Perfluorodecalin	Treats suffocation very well, but leaves the patient unable to talk in the meantime. Slowly heals burn and brute damage. Synthesized by the Head Surgeon medbot instead of salbutamol. Addictive.
Synthflesh	Heals brute and burn damage very effectively, and also stops bleeding instantly. Only apply topically (patch, dropper etc)!
Pentetic Acid	Reduces radiation, heals toxin damage, flushes all other chemicals. Causes brute damage.
Omnizine	Reduces bleeding and heals most types of damage. Addictive.
Haloperidol	Anti-psychotic/sedative. Rapidly removes psychoactive drugs and stimulants, can cure certain psychoses, causes brain damage. Regular darts fired by the tranquilizer rifle also contain it.
Spaceacillin	Treats certain diseases. Part of the standard medbot injection set.
Chicken Soup	Can cure minor diseases, such as food poisoning or the flu. Available from coffee vending machines.
Mannitol	Cures brain damage.
Mutadone	Cures genetic defects.
Oculine	Treats eye and hearing damage.
Antihol	Treats drunkenness.
Insulin	Handles hyperglycaemic shock.
Teporone	Normalizes body temperature. Addictive.
Diphenhydramine	Also known as antihistamine. This can help deal with histamine, itching powder, bee venom and certain bug bites.

Damage

Not all mobs are susceptible to all damage types, but humans and monkeys are generally the most vulnerable. A couple of mutations, for example thermal resistance, offer some immunity. Of note:

• Changelings don't have to breathe and are thus not affected by suffocation and gas leaks, and they also can't contract diseases or develop heart conditions.
• Vampires are immune to diseases and pathogens.
• Cyborgs don't have to worry about toxins, radiation or suffocation, but they can still be dented or burned.

In technical terms, the damage types are often referred to as OXY, TOX, BURN, BRUTE, BRAIN and BLEEDING.

Note: Don't forget that every medical PDA (cyborgs included) is equipped with a reagent scanner! Separate hand-held devices and upgrades for regular health analyzers are also available. Its usefulness to quickly identify poisons cannot be overstated.

Suffocation

The patient has been exposed to an area without proper atmosphere, or strangled. Other possible causes include:

• Presence of CO2.
• Certain chemicals and chemical fumes, for example pancuronium.

Salbutamol will speed up recovery, but suffocation damage will heal naturally if there is enough air to breathe, provided the patient has not gone into critical health. If they are wearing an air tank and mask, make sure the valve isn't closed. If it isn't and they are still gasping, the tank is probably empty or not configured properly, so take it off.

A patient in critical health can't breathe unassisted. Inject saline and/or epinephrine to stabilize them, or give CPR by using an empty hand on them with the help intent. Make sure neither of you are wearing masks or hats.

Toxin

Toxin damage can come from a few sources:

• Breathing plasma causes toxic damage. Move the patient to a safe area if there is a gas leak.
• Certain viruses can cause toxic damage. Treat the virus first, then deal with the toxin damage.
• Ingesting harmful chemicals can cause toxin damage. Treat the poisoning first, then administer anti-toxins.
• Toxin damage is a byproduct of radiation poisoning. Deal with the poisoning first if anti-rad medicine is available.

The primary remedy is activated charcoal (anti-toxin pills). In severe cases, calomel will rapidly flush the patient at the cost of causing toxic damage itself. Pentetic acid is a superior alternative.

Certain toxins warrant special considerations:

• Embalming fluid: Will decay into histamine, which can cause anaphylaxis.
• Amanitin: This poison will cause toxic damage when the last unit decays. The amount of damage is based on how long it was in the patient's bloodstream.
• Coniine: Causes rapid asphyxiation and renders the victim incapable of speech.
• Sarin: Causes paralysis, shaking, vomiting, suffocation, toxin damage, and some burn damage. Neutralize with atropine.
• Venom: Causes toxic and brute damage. Decays into histamine, and can gib in large doses.

Burn

Burn damage can come many sources, such as:

• Fire, acid and electrical shocks are the most common.
• Exposure to space tiles without protective gear.
• Exposure to extremely high or low temperatures.
• Explosions.
• Inhaling superheated gas will fry someone's lungs from within, causing massive burn damage. Make sure you have internals on before rushing to help these patients.
• Certain weapons (such as a welder or phasers) will also cause burn damage.
• Eating spicy food or food injected with certain hot chemicals.

If the patient is on fire, put the fire out before anything else. The burning sprite can be slow to update sometimes, so it can be hard to tell if you have extinguished the fire. Don't stuff a burning patient into cryo, they will take burn damage faster than the apparatus can heal them! Once the source of the burn damage is removed, treat with burn medication (e.g. silver sulfadiazine, burn patches) or cryo.

Brute

Brute damage is probably the most common form you will see. It comes in many forms:

• Bruises from physical combat, melee weapons etc.
• Being struck by a thrown object.
• Being shot by a revolver or other kinetic weapon.
• Explosions.
• Certain viruses and chemicals, for instance itching powder.
• Slipping on space lube.
• Taking a trip through a waste disposal chute.

Brute damage can be treated with styptic powder, synthflesh, healing patches or cryo. If the patient has been shot, they will continue to bleed until the bullet is removed. This requires surgery. If you cannot get the bullet out immediately, administer a pill of salicylic acid, which will boost their movement speed to normal, and send them to medbay for further treatment.

Brain

Brain damage is typically caused when other types of damage force a person into critical condition. Other possible factors include:

• Severe head injuries.
• Certain viruses.
• Exposure to a number of chemicals, such as neurotoxin, haloperidol, sarin or mercury.

Health analyzers don't provide an exact value for brain damage. If the patient has suffered brain damage, the readout will indicate the fact: Concussion (slight), "Unable to function well" (heavy), Braindead (unable to breathe). Examining the patient may also reveal that they appear to be badly disoriented. Having brain damage also makes it difficult to do certain tasks, for example using computers or operating doors.

Mannitol is the primary counter to brain damage. If the patient is in critical condition, stabilize them with epinephrine or other means first, preventing further accumulation of brain damage. To deal with any poisons, follow the standard detox procedures and then follow up with a pill of mannitol.

Bleeding

The cardiovascular system of human or monkey contains 500 units of blood. Any attack with a sharp object (e.g. broken bottle, scalpel or energy sword) or kinetic firearm is likely to open a wound, and the rate of the blood loss depends on the severity of the injury. Vampires are another major threat, as they tend to drain their victims dry when given the opportunity. While minor cases can be fairly harmless, blood pouring out at an alarming rate will have a life-threatening impact in a matter of minutes. If the blood level is lower than...

• 400: Small chance to go into shock.
• 300: Medium chance for shock, patient will be slowed down to walking speed, experience random stuns or pass out.
• 200: High chance for shock, walking speed, random stuns and KOs.
• 100: High chance for shock, walking speed, lots of random stuns and KOs. Patient will steadily rack up OXY damage, enter critical condition and pass away in short order.

You can assess the patient's condition with a health analyzer or by examining them. Somebody with a low blood level will appear "pale", for instance. More accurate readings can be obtained by upgrading the analyzer, which will tell you the exact amount of blood and blood loss per life cycle.

When dealing with a bleeding patient, the priority should be to mend the wound, as they'll just bleed out any medicine you put in their bloodstream. Topical drugs (such as styptic powder) can still be somewhat effective, though. You have a number of options:

• Wait it out. The body can occasionally heal 1 BLEEDING over time, so minor wounds can be ignored under certain circumstances. Don't make the mistake to depend on it to save somebody's life, however!
• Using the help intent on somebody may slow the rate of bleeding, but it's not very reliable. Both parties have to stand still.
• Cauterize the wound with a welding tool, zippo lighter, igniter or lit cigarette. Beware, this will burn the patient as well.
• Medical patches can reduce bleeding.
• Certain medical chems, for example styptic powder, synthflesh and omnizine. See Drugs for more info.
• Bandages and sutures work reliably and don't have negative side-effects.

Note: Only sutures are capable of mending surgical incisions. Every other option can slow the rate of blood loss, but won't close the wound entirely no matter how hard you try. If examining the patient reveals one or multiple "open incision[s] on their [body parts]", target the correct one and use a suture as many times as necessary to mend all incisions.

All patched up? Great, but your job isn't done yet. While the patient's body will replenish blood at a slow-but-steady rate, chances are an infusion (via blood bags) will be required in case of considerable loss of overall blood volume. Also of note: bullet and shrapnel wounds can be bandaged, but surgery is still necessary to get rid of the random stuns and accumulating brute damage.

Vampires can bleed as well, but only if they've already build up a reserve of blood. They bleed on a per-attack basis only (as opposed to a certain amount per tick), and are completely unaffected by the debilitating side-effects detailed in the paragraph above.

Surgery

There are several problems that require immediate surgery in order to save the patient. People coming into medbay will expect you to be able to help, so you should familiarize yourself with this guide. There are multiple operating tables in the MedSci department. Medical cyborgs can utilize them as well by using drag & drop, but not actually assist with limb reattachment.

Alternatively, some operations can be performed on people buckled to a bed. Because it doesn't encompass certain essentials such as limb reattachment, you may want to use a regular table instead, which requires the patient to be unconscious, for example by breathing N2O. Should proper tools be unavailable, shards and chainsaws may be substituted for scalpels and saws respectively, but there are of course certain risks involved with back alley surgery. Likewise, a significant amount of liquid courage is a must before you can perform self-surgery without an operating table.

Several factors influence the probability of complications. Injecting the patient with sedatives (morphine, haloperidol) or painkillers (salicylic acid, booze) has a positive effect, as has using a N2O (anesthetic) tank. Jitteriness should be addressed beforehand. Clumsy people have no place in the operating room and surgeons may also wish to avoid excessive consumption of alcohol. Last but not least, trained professionals (the medical staff) are less likely to screw up in general.

Since surgery can be a very bloody affair, you may want to make use of a hemostat where available to reduce the amount of bleeding damage taken. Either way, it is never a bad idea to have sutures (see previous section on "Bleeding") on hand for dressing the patient's wounds immediately. A filled blood bag can also be required for complicated and lengthy surgery (such as heart replacement).

Bullets and foreign objects

Scenario: The patient has an implant that requires removal.
Diagnosis: Surgery is the only way.
Required tools: Scalpel
Remedy: Place the patient on an operating table and aim for their chest with the scalpel on help intent. The implant can be recycled by loading it into an empty implanter.

Scenario: The patient complains about chest pain and/or is bleeding profusely.
Diagnosis: Your patient has likely been shot or within the blast radius of a pipe bomb. Scan them with a health analyzer ("Foreign objects detected") to confirm your suspicion.
Required tools: Scalpel
Remedy: Place the patient on an operating table and aim for their chest with the scalpel on help intent to remove one foreign object at a time.

Scenario: The patient fought a changeling and ended up being infected by its headspider.
Diagnosis: Time is of an essence and surgery is the only way! Unless removed quickly, the parasite will take over its new host.
Required tools: Scalpel
Remedy: Place the patient on an operating table and aim for their chest with the scalpel on help intent. This should cut a "strange tumor" out - if it doesn't after repeated attempts, it means the transformation has already been completed.

Limb removal

Scenario: The patient is a healthy human with four limbs. For augmentation or other reasons, some of the limbs have to go.
Diagnosis: Surgery is the only ethical way.
Required tools: Scalpel, circular saw
Remedy: Place the patient on an operating table and aim for the limb in question, then use the tools in the order scalpel-saw-scalpel. Note that even if you neglect to do the final step, the half-cut limb will still fall off after some time. This procedure will inflict a lot of tissue damage and will put the patient in critical condition very quickly. You need to have bandages and medical drugs at the ready.

Limb replacement

Scenario: The patient is either an amputee or already underwent limb removal, and wishes to have all of them restored.
Diagnosis: Surgery is the only way.
Required tools: Staple gun
Remedy: There are several options for replacement limbs, but the surgery is the same. Place the patient on an operating table and aim for the stump. Attach the corresponding limb and swiftly secure it with the medical stapler. Said limb may be:

• From the patient themselves.
• A robotic limb. Cyborg treads increase the patient's running speed slightly.
• From a donor.
• A synthetic limb grown in hydroponics.
• A vaguely limb-shaped apparatus. (Chainsaws are currently the only supported item.)
• Strange limbs found in deep space or taken from certain critters.

Butt removal

Scenario: The patient is alive or dead, and you need their behind for a buttbot or the kitchen.
Diagnosis: Surgery generally is the only way.
Required tools: Scalpel, circular saw
Remedy: Place the patient on an operating table and aim for the chest with harm intent. Follow the sequence scalpel-saw-scalpel-saw to detach the butt.

Butt replacement

Scenario: The patient has no bum and requests a new pair of buttocks.
Diagnosis: Surgery is the only way.
Required tools: None
Remedy: Place the patient on an operating table and aim for the chest, then attach a spare butt (any type).

Butt attachment

Scenario: The patient wishes to wear somebody's butt as a hat, permanently.
Diagnosis: Surgery is the only way.
Required tools: Staple gun
Remedy: Ask the patient to put the butt on their head, then aim for the head with the staple gun on help intent. Once affixed, the butt cannot be removed by the wearer, but it may still be ripped off by external forces.

Beheading

Scenario: Your wish to sever your patient's head for...science?
Diagnosis: Surgery is the only way.
Required tools: Scalpel, circular saw
Remedy: Place the patient on an operating table and aim for the head with harm intent. If they are wearing any kind of headgear (hats, masks), you have to get them off before proceeding. To sever the head, use the tools in the order scalpel-saw-scalpel-saw.

Head reattachment

Scenario: You are in possession of a detached head in need of a new body.
Diagnosis: The head needs a new host, and surgery is the only way.
Required tools: Scalpel, circular saw, suture
Remedy: Find a suitable body (human or monkey), which should not be rotten or a husk. If necessary, prepare the body by placing it on an operating table and beheading it. While aiming for the head, proceed by attaching the severed head, then sew it on with the suture. The new host can now be cloned.

Brain surgery

Scenario: Your patient is quite dead, or wishes to be a cyborg, and you need their brain.
Diagnosis: Surgery is the only way.
Required tools: Scalpel, circular saw
Remedy: Place the patient on an operating table and aim for the head. If they are wearing any kind of headgear (hats, masks), you have to get them off before proceeding. To remove the brain, use the tools in the order scalpel-saw-scalpel-saw. You can use the same procedure (headgear removal not necessary) on severed heads.

Scenario: You are in possession of a detached brain (e.g. from a husk) and want to clone it in a new body.
Diagnosis: The brain needs a new host, and surgery is the only way.
Required tools: Scalpel, circular saw
Remedy: Acquire a body (human or monkey), which should not be rotten or a husk. Place it on an operating table and prepare it by removing its brain. After you've done that, insert the new one and clone the whole abomination.

Skull removal

Scenario: The patient is dead and you for some reason require their skull.
Diagnosis: Surgery generally is the only way.
Required tools: Scalpel, circular saw
Remedy: Place the patient on an operating table and aim for the head. Remove their brain first (see above), then use the scalpel and finally the saw to cut out the skull. You can use the same procedure on severed heads.

Heart surgery

Scenario: Your patient has a heart and needs it removed or replaced.
Diagnosis: Surgery is the only way.
Required tools: Scalpel, circular saw
Remedy: Place the patient on an operating table and aim for the chest with help intent. To remove the heart, use the tools in the order scalpel-saw-scalpel-saw. Any implants and then bullets will be removed first, so you may have to cut into the chest several times. Needless to say, the patient won't survive for long without a functioning heart. Replacement hearts can be grown in hydroponics, manufactured in robotics or taken from a donor. Cardiac stimulants are also essential for any successful transplant.

Other Ailments

As a MD, you will likely encounter a wide variety of oddities which require special attention. Don't make the mistake to view them as an isolated condition. The treatment should always be flexible enough to handle any ailments and other underlying conditions at the same time. If these go unchecked, chances are the patient will simply relapse.

Shock

Shock is usually the first medical emergency that occurs when a patient enters critical health, and can also be caused by severe blood loss. If not addressed in a timely manner, the patient's condition can continue to deteriorate with an increasing chance of developing cardiac failure. What you should do:

• Inject saline either manually or with the sleeper control panel. Medbots may also be of help.
• Stabilize the patient with CPR or epinephrine if required.

Cardiac failure

Cardiac failure is a major emergency that, if left untreated, will rapidly lead to the death of your patient by cardiac arrest. Suggested cures include:

• Epinephrine can be sufficient, provided the patient's health isn't worse than -60%.
• In acute cases, atropine should be administered instead.

Be aware that shock and cardiac failure are, to a degree, independent from the patient's overall health. Even somebody with full HP will eventually suffer a heart failure without epinephrine, so you have to take care of these conditions specifically.

Cardiac arrest

Also known as heart failure. The final stage of the struggle with death, so to speak. If they aren't already in medbay, it is rare for patients to survive this encounter. Aside from grave injuries, it can also be caused by certain poisons (initropidril being the primary candidate) or a defective cyberheart. Remedies include:

• Application of a defibrillator.
• Atropine may be effective as a substitute.
• If both are unavailable, one should find other sources of electric shock. Examples: stun batons, messing with powered wires, electrified grills or doors.

Cardiac abscondment

Indicated by "Subject has no heart" on the health analyzer's readout. The patient's heart is missing, plain and simple. While you can prolong their suffering with cardiac stimulants, this can only be a temporary measure at best. You may try:

• Attempt to stabilize the patient with epinephrine or atropine.
• Combine this with salbutamol and mannitol to address the escalating suffocation and brain damage.
• Transplant a replacement heart as soon as possible.

Anaphylaxis

Is the patient full of histamine and rapidly accumulating brute, toxic, and suffocation damage? You should try:

• Epinephrine is plentiful and works reasonably well.
• Diphenhydramine/antihistamine is the superior alternative.

Hyperglycaemic shock

In the event that someone has a lot of sugar in their bloodstream (around 200+ units), they may fall into a diabetic coma. Scanning the patient with a standard health analyzer won't show anything, but you can deduce why they're collapsing and unconscious by using a reagent scanner. The treatment is:

• Inject them with insulin, which will dramatically increase the depletion rate of sugar.

Radiation

Radiation sickness usually isn't obvious at a glance, but a health analyzer will reveal the extend of the contamination. Exposure can come from multiple sources, such as radstorms, cerenkite ore, being shot by a rad-bow or radium. As long as the patient is irradiated, he will suffer from increasing toxin damage, slight burns and may even randomly mutate. Worthwhile cures are:

• Potassium iodide, basic anti-rad medicine. Trivial to synthesize in chemistry, should you have to.
• Superior in every aspect is pentetic acid, which heals toxin damage too.

If those are unavailable, the patient will have to wait for the radiation to subside on its own.

Genetic defects

These are often a direct result of large doses of radiation. Other common factors are imperfect cloning cycles or unstable mutagen. Some jobs, for example the chef, may spawn with a mostly harmless mutation. The cure is simple:

• Administering mutadone will gradually remove one mutation (good or bad) per life cycle.

To elaborate, this may also come in handy to stop a cloaked, superfarting geneticist.

Addictions

Addiction functions similar to a non-contagious disease. When scanning the patient, the health analyzer will tell you to which substance (methamphetamine and nicotine are common) they are addicted to and the stage of withdrawal. With each progressive stage, the symptoms become worse: falling over, vomiting, shaking and so on.

• If they still have the chemical in their veins, you can try flushing it out as if it were a poison.
• Ask the patient to hibernate a minute or two in a sleeper, which should cure all addictions.
• Should the patient refuse, they can either take a further dose of the drug for temporary relief, or they'll just have to tough it out and wait until they overcome the addiction. You can offer a bed in medbay until they no longer feel reliant, but this is more for their safety, as they are very weak and open to mugging/assault during withdrawal.
• Chronic jitteriness can be fixed with five units of morphine or haloperidol.

Viruses

There are many different types of viruses on the station, each with its own effects and possible cures. Some of them will always follow the same pattern, whereas pathology research may synthesize unique diseases every shift. Using a medical analyzer on someone who is infected will display specific information. For minor protection, wearing gloves and a biosuit is recommended. It doesn't hurt to have a syringe of spaceacillin on hand either. You may come in contact with:

• Food poisoning
  • The most common condition you will encounter, which is caused by eating bad food. The patient can either drink chicken soup or take a nap by falling asleep in medbay or any other bed.
• Robotic transformation
  • The patient has nanomachines in their bloodstream. If nothing is done, their flesh will eventually rip apart to reveal a cyborg. Treat with electric shocks (see cardiac arrest).
• MRSA
  • The patient is suffering from an aggressive bacterial infection. Fairly harmless in its early stages, but later on the accumulating toxin and burn damage can be lethal. As the bacteria are resistant to antibiotics, more than one syringe of spaceacillin may be required.
• Kuru
  • This lethal condition can be caused by cannibalism, eating brain burgers or exposure to prions. There is no known cure, so scan them with the cloner before they inevitably die.
• Grave fever
  • Transmitted by vampires. It must be quickly counteracted with spaceacillin to prevent the patient from rotting away.
• Clowning around
  • Usually the result of a random event. Without some spaceacillin, this virus gradually turns the patient into a clumsy clown.
• Necrotic degeneration
  • Initially spread by NPC zombies. Extremely dangerous and contagious. Don't approach someone who is infected unless you have protective gear and the ability to heal yourself. Even then, it's much safer to avoid them entirely. Should you dare, an injection (not topical application!) of styptic powder is rumoured to cure this condition.