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 damage, which works 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 arrest. If left untreated, they will eventually reach a certain amount of damage (overall, but brain in particular) and die. Generally, 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. Reduces the duration of stuns and increases movement speed slightly. 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 people with burn damage. Only apply topically (patch, dropper etc)!	Synthflesh
Saline-glucose Solution	Slowly heals brute and burn damage, handles circulatory shock. Part of the standard medbot injection set.
Activated Charcoal	Treats toxin damage, absorbs other reagents in the body. Part of the standard medbot injection set.	Pentetic Acid
Calomel	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	All 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.
Synthflesh	Heals brute and burn damage very effectively. Only apply topically (patch, dropper etc)!
Pentetic Acid	Reduces radiation, heals toxin damage, flushes all other chemicals. Causes brute damage.
Omnizine	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 viruses. Part of the standard medbot injection set.
Mannitol	Cures brain damage.
Mutadone	Cures genetic defects.
Oculine	Treats eye 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. Changelings don't have to breathe and are thus not affected by suffocation and gas leaks. This also applies to cyborgs, but they can still be dented or burned. On the other hand, they don't have to worry about toxins, brain damage or radiation.

Note: Don't forget that every medical PDA (cyborgs included) is equipped with a reagent scanner! 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 laser guns) 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 and a scalpel. 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. It is the only type of damage that will directly kill a human or monkey. 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), Retardation (heavy), Braindead (unable to breathe). Examining the patient may also reveal that they have a stupid expression on their face. 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.

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, it is possible to operate on somebody by using a regular table if the patient has been rendered unconscious, for example by breathing N2O.

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 has all his limbs, but is bleeding profusely.
Diagnosis: Your patient has likely been shot or within the blast radius of a pipe bomb. Ask a few questions 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. Any implants will be removed first, so you may have to repeat the procedure twice.

Scenario: The patient was fighting 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 and cauterization

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 safe 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 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 from botany.
• A vaguely limb-shaped apparatus. (Chainsaws are currently the only supported item.)

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.

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, glasses), you have to get them off before proceeding. To remove the brain, use the tools in the order scalpel-saw-scalpel-saw.

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 in genetics.

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. Replacement hearts can be grown in botany or taken from a donor.

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. If not addressed in a timely manner, their condition will continue to deteriorate with an increasing chance to developed cardiac arrest. 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 arrest

Cardiac arrest is a major emergency that, if left untreated, will rapidly lead to the death of your patient by heart failure. 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 arrest 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.

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). 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.

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 health scanner won't show anything, but you can deduce why they're collapsing and unconscious by using your PDA's reagent scanner or a blood test. 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 get rid of all mutations, good or bad.

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.

• There is little you can do. If they still have the chemical in their veins, you can try flushing it out as if it were a poison.
• The patient 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.
• Chronic jitteriness can be fixed with five units of morphine or haloperidol.

In the meantime, you can offer your patient a bed in medbay until they no longer feel reliant. This is more for their safety, as they are very weak and open to mugging/assault during withdrawal.

Viruses

There are many different types of viruses on the station, each with its own effects and possible cures. 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. There is no quick fix, so advise your patient to take a nap. They can either fall 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 heart failure).
• 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 at genetics 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.