Alright obligatory disclaimer:
I, MONDONGO/Igor Petrov/Nahuel Torres/CAF3 admit that I am writing this post out of pure, unyielding and non-adulterated salt and spite because of events that transpired in the previous round (27600). Because of that, the quality of this post is subpar and henceforth I understand, allow and encourage people to endlessly poke fun at this fact in the comments section of this post.
With that aside, I’ll also admit that ideally this would be a part of a complete CMO guide that I was working on. But with my endless procrastination that thing will probably drop in 2030 and I’ve seen that I need to post what is in here so I won’t overdose on copium.
With that cleared up:
STEP 0: Preparations and main principles
The main step to take into becoming a good doctor is knowing what your job is and what makes you special, also you should know what you job is NOT in order to delegate tasks properly in order to raise speed and efficiency, so I’ll be clear as water on the following:
- YOUR MAIN JOB IS FIXING BONES AND ORGANS IN INCOMING PATIENTS. AND THAT MAIN JOB TAKES A BACKSEAT WHEN THERE IS AN INFECTED MARINE.
With that in mind you should ideally optimize your workspace and gear in order to most-efficiently fulfil your duties. Everything in this part of this step is optional, but it’ll help to raise your speed as a doctor, and because of that it’s heavily recommended:
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Prepare a quick surgery chemical pouch: Pills take 1 more click to use (open the belt, take out a pill and then feed it to a marine) and most importantly it takes some time to metabolize, because of that any kind of chemical that is meant to enhance a medical process that has to be quick MUST be injected. Everyone will have their pick but my certified sweatlord mix is:
- 240u of oxycodone
- 240u of meralyne
- 240u of Iron
- 240u of Sugar (or nutriment if you are obsessed with trends)
This will get you instant brute healing (which will be needed as you’ll see later), instant painkilling and instant blood recovery to fulfill most your needs.
Also just to be clear: This mix will be used to fill chemical tank that will itself be used to fill a compressed chemical pouch with a 3x60u injector (ask it to researchers, they’ll print it without issues) and you use ONE injection.
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Prepare your keyboard shortcuts: Set up a key for every body part, have in mind that the controls for aiming at the arms will cycle through the arm itself and the hand, so you don’t need to set up a keyboard shortcut for every hand and foot, just R/L arms, R/L legs, head, torso and groin will suffice.
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Prepare your working environment: This involves a couple of things that you could do depending on your needs and workflow:
- Claim an Operating theatre for you, stick close to it and say that you’ll be working on it in medical comms. If you don’t want to mark your territory with the head of the last doctor that decided to ignore this message then prepare every single OT with the intent of feeling at home in every single operating theatre.
- Get the surgical tray out of the cabinet and then close it to store the portable surgical bed, unless you are an OG and you are feeling particularly spicy in order to do dual-surgery.
- Get yourself an HF2 scanner and leave it on the table nearby to use. You want to position it in a way that you’ll be 1 click away out of picking it up, no movement needed.
- Get in your Operating Theatre an inaprovaline and a tricord injector in hand to keep barely alive marines actually alive and to heal minor burn damage respectively. They must also be near and accesible.
- Get an O- blood bag into your operating table IV stand.
- Get some metal into your limb printer.
- Get a roller bed and a stasis bag into your labcoat.
- Disrespect MPs by getting any kind of decent melee or ranged weapon in your satchel or webbing vest to murder any larva that might come out of your patient (which should not happen btw). If you can’t store it in your satchel and if it is not a good throwable then it’s not a good pick.
After doing all of this nail in your mind the following mantra: “If I am in a surgery, then every milisecond of it must be spent doing a step of a surgery, if there is not a dial-up icon on top of my head then I’m doing something wrong.”
Additionally, have in mind that BRUTE, BURN and TOX are things that -if not overwhelming- you can let slip by,
With all of that done we can proceed.
STEP 1: Diagnosis
Broken skull? Probable brain damage/eye damage, feed IA indiscriminately. Broken groin? Probable kidney damage, open up and click sprite with a brute kit indiscriminately. Broken chest? Given that defibs cause heart damage the chances of there being any kind of organ damage are almost guaranteed (remember that the chest holds the heart, lungs and liver), Seize the oportunity of NOT having to use a bonesaw and click with brute kit indiscriminately on the opened chest. Pregger? Seize the oportunity of having to open the guy up to click with a brute kit the opened chest indiscriminately.
Don’t ask yourself “what if” or “how much”, because most of the time it doesn’t changes the modus operandi given that you are in a medbay with enough gear to quickly fix even the worst mistakes, which are incredibly rare to begin with. Speed is the name of the game, a full-body scanner will tell you the obvious 90% of the time.
Step 2: Butchery time
Get your patient in, use the HF2 scanner to figure out what precisely needs fixing and move the health scan window out of your patient (or in other words, DO NOT CLOSE IT, you can throw the scanner into the trash if you want to and still you will have the latest scan available for you to see in a separate window), tell him to remove his armor and/or helmet (you want this because having them take it off is faster than undressing them yourself, drag them on the table and inject them with a painkiller (oxycodone or your quick-surgery mix), you use painkillers because they don’t remove agency from the patient, if you suck as a doctor then your patient can’t run away from the reflection of your bald head or it can’t run away from the approaching doom of hijack because it’s permastunned on the table until it’s unhooked from the anesthetic and until it’s shaken up until it’s awake (and pray to god that you can shake them, because any bit of oxygen damage will replace a shaking with CPR).
So with them on the table, get in position (between the surgical tray and the surgical table), middle click your surgical tray to readily access whatever tool you might need. And on that note: For the love of all that is holy don’t be a troglodyte, we have tables, use them. The surgical tray won’t run away if you don’t use 50% of your hand capacity to hold it.
Afterwards, you channel your inner Michael Myers to rip appart your victims, or as the filthy regulatory institutions call them: “Patients”.
As I said, speed is the name of the game, so disregard unnecesary steps in surgery and speed them up as much as possible.
This means: Forget the hemostat unless it’s for larva removal, forget the retractor unless it’s for opening up a ribcage.
A big waste of time is scrambling around for tools, because of that, once you take out a tool you MUST make the most out of it. In the practice this means you use the scalpel to make EVERY SINGLE INCISION and ONLY THEN you leave it into the tray. The fastest way to open up people is:
- Use scalpel on help intent (basic incision).
- Use scalpel on shove intent (forcibly and instantly push tissues out of the way at the expense of some brute damage, this replaces the retractor step).
- Proceed to the next area to open up.
- …
- ONLY AFTER OPENING EVERY AREA THAT YOU NEED TO WORK ON SWAP TO ANOTHER TOOL
As you might notice in the process we don’t really remediate and/or mitigate the loss of blood this is because ideally we have an IV drip with a blood bag hooked in or even better you use the quick surgery mix to have IS (Iron + Sugar) quickly replenishing the lost blood unless there are more than 4 incisions open.
Also you might notice the brute damage stacking up as you open more areas, this is why the surgical mix has meralyne, but if you don’t use the mix you shouldn’t worry too much unless the patient is already injured, at that point the accumulated BRUTE damage might be lethal, so use common sense and your best judgement.
After doing all of this you can move on having in mind the principle of making the most out of each tool before saving it into the tray, so (assuming there is not a larva in the patient) prioritize fixing IBs to prevent unnecesary blood loss and fix every organ you got to before picking up the bonegel. Ideally when you pick up the bonegel you should have the ribcage closed up so you can use the bonegel on just about every part of the patient.
STEP 2.a: Quick larva removal:
Alright, it eventually had to happen. Either because marines love to walk into eggs as the hive is crumbling or because you want to impress a jarhead you find yourself into the position of needing to do a fast larva removal.
For this individual scenario we won’t ask them to remove their gear, just ctrl+click the stasis bag, click the surgical table to drop them in and hook them into the anesthesia (oxycodone MIGHT be able to cut it, maybe not, I don’t know but if I’m not mistaken I’ve seen it working once), remove the armor and do the medical shaker:
- scalpel on help intent (can’t do the incision on shove).
- scalpel on shove intent (instant retractor replacement).
- Bone saw on shove intent (instantly breaks the ribcage, which lets you…).
- Retractor on help intent to open up the ribcage (not sure if shove intent is doable here, but shove’d bonesaw already saves a decent ammount of time)
- Queue hemostat and PICT (read the “queue up” part on the “some considerations” section).
- Use PICT on help intent.
- Use hemostat on help intent (some say you can use your bare hands to remove the larva faster at the extent of some BURN damage, I’ve tried it on help intent and I found it to be slower, maybe it was another intent or something).
- Aura farm after a speedrunned planned parenthood-style abortion.
STEP 3: Closing up
A.k.a. When you should do it.
You know how to do it but this is where I talk about what state of patient is actually acceptable depending on circumstances:
If you got a nurse you gotta evaluate their skill level. Plenty of nurses are actually really skilled doctors that just want a chill round, try to spend some time with them to discretely gauge their skill and if you see them viable let them know that they can close basic incisions, send patients into the autodoc to close up complex incisions and they can also use the autodoc as an infinite source of blood.
Also have in mind that marines can just use the marine wey-med on the exit of medbay to continuously vend/refill the tricordrazine EZ injectors to treat themselves, don’t underestimate what a “Get tricor”/“Get food” can do when talking to marines and don’t underestimate your nurses. A doc with a good nurse can easily work like a team of 3 doctors if they are coordinated enough.
With that cleared, the solution is simple: Hugged people stacking up? Don’t close them up, let them on some corner of your OT if need comes to be (that’s why you should have inaprovaline at hand), dead people can be revived, infected marines die permanently and they cause a ton of problems shipside should they go unattended. Only after it’s all solved begin handling them after triaging based on ammount of damage, state of the operation (the military one AND the medical one), ammount of stabilized/unstable patients and information in comms (more larva removals might come soon, be attentive of what corpsmen and pilots are saying).
If you aren’t in a rush then take the chance to RP with the marines on the table and have fun with them as you work or close them up, plenty of rines will take you as a sort of therapist as you fix their pulverized bones, so fuck it, have fun with them, chat with them, offer them a complementary cigarette or happy pill as they leave, ultimately this is a game and it should be fun.
Also that’s why sedation sucks when compared to pain-killing, sedated marines are hard to talk to, and having their guts opened and having them awake meet-the-medic style is unironically a good conversation starter.
SOME CONSIDERATIONS:
Using the scalpel on the head of a patient shove intent as a replacement for the retractor MIGHT cause IB. So either use an HF2 scanner to check for IB or try to close up with fix-o-vein to try to see if you get the window to choose between an IB fix or closing up, if that window does not appear then it means there is no IB, move around to cancel the process then close up with an hemostat.
You can aim to other parts of the body mid-step without any repercussion, so by all means if, for example, you are using bonegel on a left leg you can switch your aimed area into the left foot as you apply it so as you are done applying it on a leg you can click again to inmediately begin to apply it on the foot, minimizing idle time.
Try to “queue up” your tools in your hand, so if you have to start with the bonegel step on 5 areas you can take out the bonesetter, press “x” to switch into your empty hand and then you can take out the bonegel. This will leave you with your selected hand already geared up with what you need and when you’ll need to move onto the next step you can just press “x”.
I might polish up this post later based on feedback, so if you see something wrong please let me know!