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 four 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 have to nag them for it). The quartermaster can order a number of medical resupply kits. Advanced drugs can be created by the scientists, assuming they haven't already burned themselves to death. Medbots synthesize many different medicines, which are indicated in the table below.

For a 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 and repairs the lungs and spleen. 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. Having Saline in your bloodstream for too long will cause hypertension due to its blood regenerating effects.
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
Ammonium Bicarbonate (Smelling salts)	Basic anti-radiation medicine, weaker than potassium iodide. Stabilizes critical patients, slightly more effectively than ephedrine but not epinephrine.	Pentetic Acid
Cryoxadone	Heals all organs and 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.
Chicken Soup	Basic anti-viral. Can cure minor diseases, such as food poisoning or the flu, but not as well as Robustissin can. Available from coffee machines.	Robustissin
Space Ipecac	Emetic. May induce vomiting, causing the patient spew out their most recent meal (and whatever reagents/poisons were in it) as half-digested food chunks. May cause food poisoning.
Menthol	Burn and fever medication. Attempts to lower body temperature back to normal, sometimes heals a little burn damage.

Advanced

Drug	Use
Atropine	More powerful version of epinephrine, useful when a patient is near death. Fixes cardiac problems, heals a bit of brain, brute, and burn damage, 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 and heals lung and spleen damage slightly faster. Synthesized by the Head Surgeon medbot instead of salbutamol. Addictive. You might see people walking out of the cloner with a Perfluorodecalin addiction once in a while.
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 all organs and 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.
Robustissin	Can cure minor diseases, such as food poisoning or the flu.
Mannitol	Cures brain damage.
Mutadone	Removes mutations, harmful, beneficial, or harmless.
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.
Filgrastim	Stimulates blood production; usually used after moderate blood loss.
Heparin	An anticoagulant, which will worsen bleeding but will also lessen the symptoms of hypertension, lower blood clots, and help with heart disease.
Proconvertin	A coagulant, which will help lessen blood loss, worsen or sometimes cause clots, and increase blood pressure.

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 and pathogens, 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, BLEEDING, EYE, and EAR.

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 a 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, 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.

LOSEBREATH

The patient is having trouble breathing. Whenever they try to speak, it comes out as whispers. Not really a damage type, but nevertheless acts like one and is very closely associated with suffocation damage and the things that cause suffocation, though, technically speaking, it does not in of itself, cause it.

You won't find it on a scanner reading, but if you ever see an O2 Warning icon pop up on your screen, that's LOSEBREATH at work.

Salbutamol will help the patient breath again, as will cardiac stimulants like epinephrine, but LOSEBREATH will reverse itself naturally, proved there is enough air to breathe, and the patient is not in critical condition or worst. Giving CPR by clicking on a patient with an empty hand while on help intent will also reduce LOSEBREATH.

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.

Toxin damage may also affect the kidneys and/or liver. Their own particular considerations are detailed in their respective sections.

Burn

Burn damage can come many sources, such as:

• Fire, acid and electrical shocks are the most common.
• Exposure to space and Trench 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. Stuffing the patient into cryo will rapidly put out the fire while also healing them - making it perfect for all those flaming assistants running around. 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 weapons.
• 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 somebody has suffered brain damage, the readout will indicate the fact:

• "Significant brain damage detected. Subject may have had a concussion." (More than 10 BRAIN),
• "Severe brain damage detected. Subject likely unable to function well." (More than 60 BRAIN),
• "Subject is braindead." (More than 100 BRAIN).

Examining a person with severe brain damage will also reveal that they appear to have a stupid expression on their face. Heavy brain damage causes the patient to gibber everything they say and involuntarily scream over the radio in all caps. It also makes it difficult for them to do certain tasks, such as using computers and operating doors. Extreme brain damage will make it difficult to even breathe. Too much brain damage (100+ BRAIN) will outright kill them.

Mannitol is the primary counter to brain damage. Holy water is also excellent at healing brain damage, though only if topically (e.g. dropper, patch, beaker splash) applied. 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, the 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. The patient will steadily rack up OXY and BRAIN 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 chemicals, for example, styptic powder, synthflesh, omnizine, and proconvertin. 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 if they have a healthy spleen, chances are an infusion (via blood bags) will be required in case of considerable loss of overall blood volume or severely-damaged/absent spleen, which prevents the body's natural blood regeneration. Filgrastim also helps to replenish the blood supply. 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 built 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.

Eye

Patient's retinas are damaged, typically as a result of exposure to bright lights. One of the least common damage types, though probably one of the most annoying. Potential sources include:

• Welding without protection.
• Improper use of flash powder.
• Flashbangs.
• Getting capsaicin on the skin/face.
• Exposure to flashes and other bright lights while wearing optical thermal scanners.
• Blinding spells.

Eye damage worsens the effects of sources of eye damage. If eye damage is allowed to accumulate, later eye injuries can result in blurriness, temporary short-sightedness, and eventually permanent blindness.

Health analyzers do not detect eye damage. Instead, you must wave a penlight over a patient's eyes/face/head to diagnose any eye problems. If you get a message about their pupils constricting normally and their eyes easily following the light, they're fine. If not, administer oculine in any form, e.g. drops, patch, pill.

Welding masks and most varieties of space helmets outright block most sources of eye damage. Sunglasses, SecHUDs, and polarized eyes offer similar protection, though they only reduce damage from welding. Meanwhile, optical thermal scanners and NVG goggles intensify eye damage, often significantly.

Blindness can be alleviated by wearing VISOR goggles and administering oculine or mutadone. (Pro-tip: if you yourself become blind, simply click a pill/patch/auto-injector while it's in your hand to use it on yourself.)

Ear

The patient's eardrums are damaged, and they are having trouble hearing, often experiencing temporary deafness and tinnitus, "ringing" in the ears. Probably the rarest damage type, though easily the least lethal and debilitating. Potential sources include:

• Improper use of sonic powder/hootingium.
• Flashbangs and sonic grenades.
• Vuvuzelas, amplified and unamplified.
• Unholy screeches and screams.

Oculine quickly repairs ear damage, though ears heal naturally if the patient is not deaf. Heavy ear damage can result in permanent deafness, which can cured with mutadone and alleviated by wearing an Auditory Headset. Wearing earmuffs and being deaf in the first place prevents most ear damage entirely.

Organ Damage & Ailments

Humans, Monkeys, Vampires, Changelings, and most other humanoid mobs with organs can also suffer damage to specific organs, separate but still connected to the other damage types. To analyze organ damage, you need a health analyzer equipped with an organ scan upgrade, which will assess damage in these relative terms:

• 1-9: "Minor"
• 10-29: "Moderate"
• 30-64: "Significant"
• 65 and above: "Critical"

Usually, "Significant" and "Critical" are the most important ratings, for some organs cause extra problems upon reaching the "Critical" damage threshold.

Any ranged or melee attacks that inflict brute damage specifically to the chest have a chance to also damage two random organs listed in this section. The attack has to cause more than 5 damage, and higher damage means more damage to the organs, though only 5-10% of it becomes organ damage. This is low enough that anything that causes significant damage to organs is usually enough to easily put the victim into critical condition, often a greater issue. The spleen and lungs are more resilient to attacks than the other organs in the chest.

Liver Damage

Whenever you take TOX damage, your liver takes damage too, though only about 3% of the amount of TOX damage becomes liver damage. You can also get liver damage by drinking so much ethanol that you overdose. If liver damage reaches 65, the "Critical" damage level, the body has a chance to develop liver failure, and is all but guaranteed to if it reaches 100. Speaking of which, if the liver is missing or has 100 damage, all chems in your deplete twice as slowly, and you suffer continuous TOX damage.

Drugs that treat TOX damage, such as charcoal, also treat liver damage, as do the usual suspects omnizine and cryoxadone. If your liver is augmented, you can heal liver damage just by ingesting a lot of ethanol--alcohol really is a solution sometimes!

Liver Failure

The patient's liver is failing, signified by pains in the upper chest/abdomen. In later stages, the patient may start fainting, collapsing, and/or experiencing TOX damage, and the liver starts to deteriorate and accumulate damage, eventually resulting in TOX damage over time and halved chem depletion.

As usual, omnizine and cryoxadone can slow down liver failure by reversing the damage, and so can anti-tox drugs like charcoal, with the added bonus of also being able to cure the disease. Getting a new liver also cures the disease. Finally, liver failure may very rarely magically clear up in the early stages.

Kidney Damage

Similar to the liver, kidney damage may occur when ones receive TOX damage. More specifically, whenever the patient takes TOX damage, there's a chance one or both of the kidneys to also receive 5% of that TOX damage as kidney damage; this does not reduce the TOX damage in any way. In fact, they do very little until they become too deteriorated.

Speaking of which, the patient will be fine if just one of their kidneys is missing or heavily damaged, but if both of them are, all chems deplete twice as slowly, and they take TOX damage every second. While it's not much, it adds up over time. Moreover, once a kidney reaches the "Critical" damage threshold, kidney failure occurs.

You can fix kidney damage by, fittingly, administering anti-TOX chems, such as charcoal and pentetic acid. As usual, omnizine and cryoxadone do a fair job of healing the kidneys.

Kidney Failure

Kidney failure occurs when a patient's kidney passes 65 kidney damage, the "Critical" organ damage threshold. In the first two stages of failure, the afflicted feels pains and aches in the upper-right abdomen. Once the ailment reaches its final stage, the patient starts suffering TOX damage every few seconds, and the kidney starts to deteriorate fairly quickly and accumulate damage, eventually rendering it nonfunctional. While a patient could theoretically survive one kidney completely failing if continually given enough medicine, if both kidneys are put out of commission by kidney failure, they will suffer the same effects as missing both kidneys, as described above.

You treat kidney failure with "Organ Drug Class 2" chems, medicines that treat TOX damage, such as charcoal. These drugs reverse the kidney damage and may cure it altogether. While omnizine and cryoxadone can't cure the disease, they can still fix the kidney damage and thus slow down its effects. Kidney failure may also, very rarely, magically disappear in the first two stages.

Appendix Damage

Currently, the only source of appendix damage is from attacks to the chest, detailed above in the introduction of this section. You can live without an appendix, and it's probably for the better, because once your appendix reaches the "Critical" level (i.e. 65 organ damage and above, as previously stated), you contract appendicitis. Fortunately, omnizine and cryoxadone counteract appendix damage, the former better than the latter.

Appendicitis

Because of excessive damage or random chance, the patient's appendix is dangerously enlarged, causing abdominal pains and shudders that progressively worsen. In the last stages, the appendix may become so inflamed that it damages itself. If left unchecked, this may cause the appendix to burst, dumping several pathogens and sometimes lots of toxin into the afflicted.

While there is no specific medicine for the disease, omnizine and cryoxadone can slow the disease down, as the appendix does not have chance to explode until it's reached 90 damage, well beyond the "Critical" organ damage level. Removing or replacing the appendix will cure the disease. Very rarely, the disease may go away on its own. Having a cyberappendix or no appendix at all will prevent appendicitis entirely.

Spleen Damage

Just like in the movies, kinetic bullets and melee attacks to the chest have a chance to hurt your spleen, so you really can scream that your spleen hurts after getting shot. Unfortunately, it's the only way to receive spleen damage, so you can't do it after, say, being set on fire (or something that clearly doesn't hurt your spleen) for additional comedy value. Less comedically, if your spleen has more than 100 damage (i.e. well pass the "Critical" damage level), your body can't regenerate blood naturally.

Fortunately, omnizine and cryoxadone can heal your butt monkey of an organ, and any meds that heal lung damage, such as salbutamol, also heal spleen damage, because that's just how spacepeople work.

Stomach Damage

Blows to the chest can sometimes translate into blows to the stomach, as described above. If you have no stomach or one that's too damaged, you can't eat food, though you can still take pills, sip drinks, things like that.

Anything that's good for your liver is good for your stomach. That is, if it heals toxin damage, not only does it repair your liver, but it should fix up your stomach too. That means drugs such as omnizine, cryoxadone, and charcoal.

Intestines Damage

Currently, intestines only take damage from certain melee attacks to the chest, as stated above. While Trent's Anatomy/Surgical Textbook might imply the intestines let you absorb reagents and gain buffs from food, you can do both without intestines, with no ill effect.

Just like with your liver, stomach, and kidneys, omnizine, cryoxadone, and anti-TOX drugs, such as charcoal, all heal your intestines.

Surgery

Several problems require immediate surgery to save the patient, some of which concern their extremities or internal organs. 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, suitably sharp objects such shards and knives and rotary cutting tools such as chainsaws and pizza-cutters 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, alcohol) has a positive effect, as does using 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 the previous section on "Bleeding") on hand for dressing the patient's wounds immediately. A full blood bag can also be required for complicated and lengthy surgery (such as heart replacement).

Surgical removal

-ectomy	Scenario	Prognosis	Tools	Procedure and considerations
Headspider	The patient fought a changeling and ended up being infected by its headspider.	Time is of an essence and surgery is the only way! Unless removed quickly, the parasite will take over its new host.		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, the transformation has already been completed.
Implant	The patient has an implant that requires removal.	Surgery is the only way.		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.
Bullets, shrapnel	The patient has bullets and/or shrapnel in their chest and cannot bear the random stuns and brute damage. Scan them with a health analyzer ("Foreign objects detected") to confirm your suspicion.	Surgery is the only way.		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.
Limb	The patient is a healthy human with four limbs. For augmentation or other reasons, some of the limbs have to go.	Surgery is the only ethical way.		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.
Butt	The patient is alive or dead, and you need their behind for a buttbot or the kitchen.	Surgery generally is the only way.		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.
Eyeball	You need to remove somebody's eyes, presumably for augmentation.	Surgery is the only way.		Place the patient on an operating table and aim for the head. Follow the sequence spoon-scalpel-spoon to remove the eye, while also paying special attention to which hand you're using. Hold the surgery tools in your left hand to target the left eye, and vice versa.
Brain (Humanoid Corpse)	Your patient is quite dead, or wishes to be a cyborg, and you need their brain.	Surgery is the only way.		Place the patient on an operating table and aim for the head. If they are wearing any 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.
Brain (Critter Corpse)	Your patient has, through special wizardry, been turned into an animal, and now is quite dead, or wishes to be a cyborg, and you need their brain.	Surgery is the only way.		Simply use the scalpel on the player-controlled critter to skin it (doing it with NPC ones does nothing), then use it gain butcher it and get a usable human brain.Somehow.
Head	Your wish to sever your patient's head for...science?	Surgery is the only way.		Place the patient on an operating table and aim for the head with harm intent. If they are wearing any 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.
Skull	The patient is dead and you for some reason require their skull.	Surgery generally is the only way.		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	Your patient has a heart and needs it removed or replaced.	Surgery is the only way.		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. Several types of replacement hearts exist (see Roboticist for a comprehensive list). Cardiac stimulants are also essential for any successful transplant. However, it's worth noting that removing a heart will also transfer all the chemical reagents currently in the patient's system into the heart, so you'll need to top off on those stimulants after removal. You don't even have to wait to insert a new heart since the reagent holder is tied to the patient's body rather than to their heart.
Lung	Your patient has a lung and needs it removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove a lung, use the tools in the order scissors-saw-scissors. Whether you remove the right or left lung depends on the hand in which you do the final cut with the scissors. Naturally, the patient is less able to breathe if a lung is missing, moreso if both are, so salbutamol and the like are useful for counteracting the suffocation.
Kidney	Your patient has a kidney and needs it removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove a kidney, use the tools in the order scalpel-scalpel-scissors. Whether you remove the right or left kidney depends on the hand in which you do the final cut with the scissors.
Appendix	Your patient has an appendix and needs it removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove the appendix, use the tools in the order scissors-scissors-scissors.
Liver	Your patient has a liver and needs it removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove the liver, use the tools in the order scissors-scissors-scalpel.
Stomach	Your patient has a stomach and needs it removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove the stomach, use the tools in the order scissors-scalpel-scissors.
Intestines	Your patient has intestines and needs them removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove the intestines, use the tools in the order scissors-scalpel-scalpel.
Pancreas	Your patient has a pancreas and needs it removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove the pancreas, use the tools in the order scalpel-scissors-scissors.
Spleen	Your patient has a spleen and needs it removed or replaced.	Surgery is the only way.		Place the patient on an operating table and aim for the chest with help intent. To remove the spleen, use the tools in the order scalpel-scissors-scalpel.
Chest Item	Your patient is tired of keeping a terrible secret inside them and wants it removed/replaced.	Surgery is the only (safe) way.		Place the patient on an operating table and aim for the chest with grab intent. Then, use an empty hand with help intent on the patient to yank the item out.

Other surgery

Surgery	Scenario	Prognosis	Tools	Procedure and considerations
Limb replacement	The patient is either an amputee or already underwent limb removal, and wishes to have all of them restored.	Surgery is the only way.		There are several options for replacement limbs (see Roboticist for a comprehensive list), 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.
Butt replacement	The patient has no bum and requests a new pair of buttocks.	Surgery is the only way.	None	Place the patient on an operating table and aim for the chest, then attach a spare butt (any type).
Butt attachment	The patient wishes to wear somebody's butt as a hat, permanently.	Surgery is the only way.		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.
Eye replacement	The patient is missing at least one eyeball and wishes to have all of them restored.	Surgery is the only way.	None	Place the patient on an operating table and aim for the head, then insert a spare eye (any type). You have to hold the replacement organ in your left hand to target the left eye socket and vice versa.
Head reattachment	You are in possession of a detached head in need of a new body.	The head needs a new host, and surgery is the only way.		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 transplant	You are in possession of a detached brain (e.g. from a husk) and want to clone it into a new body.	The brain needs a new host, and surgery is the only way.		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.
Chest Item Implant	The patient wishes to become a living [noun].	Surgery is the only way, as there is no suitable implant available and/or easily obtainable.		Place the patient on an operating table and aim for the chest with the scalpel on grab intent to make a large incision. Place the item inside the chest, again on grab intent. Then, sew the chest area back together with the suture, still on grab intent. Optionally, you can secure the item before sewing the patient back up by sewing it into the chest cavity on help intent.

Other Ailments

As an 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 promptly, 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

If 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 accumulate toxin damage every second, with more damage per second at higher doses, occasionally suffer burns, and may even randomly mutate. Worthwhile cures are:

• Potassium iodide, basic anti-rad medicine. Trivial to synthesize in chemistry, should you have to.
• Pentetic acid is superior in every aspect, healing 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 drink chicken soup, take Robustissin, and/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 fatal 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 Admin screwery or rainbow fluid ingestion. Without some spaceacillin, this virus gradually turns the patient into a clumsy clown.