Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Mightymuffin]

After reading up on the health care labour and sitting walking around in a jumper on a really hot day, I have come up with the following suggestions:

1. That health care be transformed into a profession on it's own.
2. That the following professions of my own concoction are added into the Dwarven mix:

Doctor: Can heal patients wounds faster than a dwarf with the health care labour, but he can only heal the dwarf if there is at least 1 bandage (which can be created at a clothier's workshop), or a rotten biscuit that could be used as a poultice. (Of course, bread would be far more realistic but biscuits might save Toady from having to make another meal.)
This could be useful for a military centric fortress with mangled veterans, whose wounds may take years to heal.

Another job for a Doctor would be the fitting of wooden legs which could be given to those who

Masseuse: After watching my fortress population slowly become more and more depressed at the lack of alcohol and chairs, I thought that in the meantime depression could be kept down partially by a dwarf with the labour of "Masseuse", who would stand by a massage table (crafted out of wood, stone or metal) and would massage the depressed and stressed out dwarves, giving them a happy thought.

Carer: It was bound to happen, but after my jeweller became a babbling wreck and died of starvation or thirst somewhere obscure on the map, I came to the conclusion that to preserve happiness and prevent tantrum spirals a dwarf could be assigned the labour of "Carer", who would prevent the dwarf from pulling his clothes off and would feed the dwarf by hand to keep him alive and well.

Vet/farrier: The vet or farrier would do the very same jobs as a Doctor, only the difference being his patients would be animals.
I came up with the idea after watching my fortress's only dog suffer from a mangled leg due to skeletal mole dog attacks.

Of course, with this addition Toady could experiment with various gameplay elements such as gangriene from untreated wounds (in which case the surgeon profession would be required to amputate the limb) and disease that could be caught by having too much contact with corpses and rotten food, in which case certain plants could be harvested to be used as medicine.

[chucks]

So, dwarven masseuses do give happy endings!

[Footkerchief]

I'm assuming you meant that you read about the current Health Care labor, because it's being massively reworked for the next version, incorporating most of your ideas.

Here's the summary from the List:

    * New setup for hospital
    * Realigning of compound fractures and traction
    * Sutures for open wounds
    * Use of soap to clean patients
    * Surgery to remove rotten tissue
    * Dressing wounds with bandages
    * Splints
    * Crutches
    * Plaster casts
    * Soldiers able to perform basic first aid
    * Separate out feeding of patients as a job
    * Medical information and chief physician appointment
    * Make dwarves clean themselves up and groom/trim their cosmetic tissue layers

And here's the relevant dev log entries from the health care work so far:

#  03/20/2009: After a brief period of the doctor walking up to our injured dwarf, looking at himself and deciding that nothing was wrong, the medical staff were further educated. Then the doctor went off and grabbed the wooden splint and properly fastened it on the patient's right lower arm. The dwarf left the hospital and mined out a passage with the pick in his left hand.

Next up is 40d10. There's quite a bit left to do with health care, but the correct treatment today means that much of the rest should flow by pretty quickly. I might still get a chance to work with it a bit in the next few days. Either way, the underground's still up for April.
# 03/19/2009: The doctors now plan out our dwarf's care in detail, but lacking the tools they need, we still find them prescribing nothing more than bed rest. Hopefully I can get a positive outcome for tomorrow, as I'm looking at 40d10 the day after that.
# 03/18/2009: He's now surrounded by many skilled medical professionals. They still aren't all that useful, but just their presence must be encouraging for him. Well, I guess that's not true either.
# 03/17/2009: The broken-armed dwarf understood that he needed to run off to the hospital zone properly, but care never came, because I'm still working on that. Poor little buddy.
# 03/16/2009: As you might want to gather and treat the wounded without the benefit of tables or beds (due to resource constraints or otherwise), I went with an activity zone for the hospital. I've added a few options to activity zone placement to make that a little easier (they can overlap now, you can flow them out like rooms, and delete a single zone regardless of overlaps). This'll also be a good test for using zones for things like dynamic workshops (way) later if things go that direction, as hospital zones will need to manage several buildings. It might also be useful for some military applications for this release.

In any case, next up are the specific goings-on at the hospital. Unfortunately for the critters, this means repeated applications of (1) create a hospital zone and staff settings (2) debug-chop a dwarf (3) see how it goes. List updated.

And finally a large post from Toady describing various health care stuff in greater depth:

'Plaster casts', a use for gypsum?

Yeah, that's right.  Anhydrite too, I guess (depending on how fast it sucks up water, no idea), but I don't know what I'll actually end up doing.  I don't want to mess around with flows over rocks that interact with water yet.  I'm also not sure how much water will be involved in the use of plaster for casts...  lots of jobs that should use water right now don't use water, and I don't see a reason to alter that right now if it makes things too annoying for me.

Does the new healthcare system mean that adventure mode characters can no longer heal just by Traveling off the site?  And as Heph mentioned, will we then be able to seek out healers in Adventure mode settlements for this task?  Will there even be any real changes to Adventure mode this time around?

Nah, I don't think it's quite ready for that -- before travel changes in nature, I want things like hunting and camping to be more solidified, as it'll determine the pace more.  I'm not sure what sort of healing options will be in for adventurers, as it'll kind of trickle along after the dwarf mode changes.  When you ask if there are any real changes to adventure mode, do you mean in any way at all?  I guess that question is hard to answer, because "real" doesn't have a meaning attached.  I think some things will feel quite different with combat, and the underground changes should yield many new stuffs.

So, health care.  Will a hospital be designated from a bed, like the barracks is?  Since unclaimed beds already function like hospitals.

Do we get to pick a chief doctor, or does one come like a noble?  Do they get a medical corp like the Fortress Guard?  Because it would be nice to see dwarves who are actually dedicated to healthcare and not just peasants with no other jobs enabled.

Will physicians need tools to get the job done (like woodcutters/miners)? Will there be dedicated dwarfs (besides current health care)/professions/nobles associated with healing?

I wonder if the Physician will have settings, like the bookkeeper? Like preferences for treating patients, including patient status and wound severity? So if you have a lot of people with broken limbs, but you need them working soon, you could set the guy to prioritize yellow injuries and leave the more costly and lengthy healing of red injuries for later.

The hospital is an initially building-less zone, but it claims any beds, tables, boxes and traction benches that are covered for hospital use.

The current idea is to allow the chief doctor to be appointed by you.  The others are treated like any other profession -- I'm going with the historical model that surgeons/etc. didn't enjoy a special place in society for the time being, so you can just turn the professions off and on.  However, I'm considering starting up a notion of "knowledge" as opposed to skill, so that picking some random guy to perform surgery through trial and error might not be the best idea.  However, if I don't get to that, then it'll be just like starting up a new blacksmith from scratch (which is equally silly).

"Healthcare" is gone -- there are currently 7 new labor settings, 5 unit types, and 6 skills.  I've grouped the entire vpl list into 15 sections to make it easier to mess with (I'm aware of further changes people want there, but I can't do it all now).

The chief doctor wouldn't be necessary but would allow you to get a good overview of your wounded dwarves (as the bookkeeper does with stocks).  Other abilities will depend on how it plays out (things like prioritization or whatever).

As for tools, the default would be to handle it like other jobs, which would leave all these concerns about scalpel edges for later.  The items surely coming in are things like splints, traction benches, plaster, plaster casts, and then the use of thread/cloth for sutures and bandages.  I'm not going to handle restacking right now, but I might do amounts within a single object to handled the medical use of thread/cloth.  That might save some headaches versus turning cloth into 10 or 100 bandage items to scatter around, although it implies headaches of its own.  Not 100% clear yet.  I might do surgical equipment, but it might be early.  I kind of want to think about all the other jobs when I do that.

I'm more curious about the noncombative aspects of healthcare. Will dwarves get sick, terribly sick, and fatally ill? Will there be different kinds of doctors? How about a healing success rate? How long will treatment take and is it possible to conduct treatment over a course of time.

Aside from venom, there's nothing yet, and they don't really have any good treatments for venom.  There are different kinds of doctors associated to the skills, but I'm not quite sure how that'll play out in a large fort.  It'll really depend on the injury rate and types whether you ever need more than one.  Some treatments like being placed on a traction bench or wearing a splint/crutch definitely take place over a course of time.

I'm interested to see if a dwarf with a broken arm will get a cast/sling or something, and then go back to work with, say, reduced production speed.  Instead of the wound being completely unimpeding, or the dwarf just sulking around until it heals.

There's that annoying speed split that needs to happen first before I can do too much properly.  Right now, a dwarf on crutches will likely be slower and therefore slower at everything.  A dwarf with an arm in a cast might act at the regular speed unless I add specific provisions to increase job time, which I might not do.

Actually, a bigger question, is the healing of breaks/mangles (or whatever the wounds are now), still tied to the season change.

No, not at all.  Every wound is tracked individually, and this includes exactly how far along it is, and all the times are run against healing rates for tissues in the creature definition.

So..my first question: The dwarves will be able to take care of the injured friendly units, after the health care system will get implemented?
Second question: What about injured pets/animals/friendly tamed beasts? Will it be possible to heal their wounds in the hospital?

On the first question, it's not any different than it is now.  It would be a bit of a pain to allow neutral units to interject themselves into the dwarf framework.  It'll come up later, but not for this release.

I haven't decided on the vet stuff...  up to this point it has happened under the semi-magical "animal care" profession.  That code is kind of gutted now, so I'll have to do something, but I'm not sure there will be any animal surgery.

So, regarding crutches.  I wonder if permanently crippled dwarves will get canes, or lamed dwarves get peg legs.

Hopefully!  I don't think I have canes up anywhere, but I have a bloat for prosthestics, so something will happen sometime.  I'm not quite ready to take it on yet.  Splints, casts and crutches (and bandages and sutures if those items are maintained after application) will be a stepping stone toward other add-ons.

[SirHoneyBadger]

I do like the idea of the masseuse, Mightymuffin.

The idea of a massive, burly, hirsute dwarf handing out back-cracking Swedish massages seems both appropriate and entertaining. It might also be tied somewhat into the Wrestling skill, since a wrestler should benefit from a masseuse's knowledge and experience, and visa-versa, and massage might be incorporated into some kind of dwarf "physical therapy."

If you'd like to help, by the way, I'm still recruiting volunteers to do medical research. Just send me a PM if you're interested, or if you have any questions. I'll do my best to answer them--and I'll put you to work, if you want.

[RavingManiac]

I do like the idea of the masseuse, Mightymuffin.

The idea of a massive, burly, hirsute dwarf handing out back-cracking Swedish massages seems both appropriate and entertaining. It might also be tied somewhat into the Wrestling skill, since a wrestler should benefit from a masseuse's knowledge and experience, and visa-versa, and massage might be incorporated into some kind of dwarf "physical therapy."

I suddenly get the mental image of an ex-champion wrestler cracking some poor dwarf's back over his knee, then proceeding to snap all his bones and leaving him to bleed to death on the massage table.

[SirHoneyBadger]

I suddenly get the mental image of an ex-champion wrestler cracking some poor dwarf's back over his knee, then proceeding to snap all his bones and leaving him to bleed to death on the massage table.

Like I said: Swedish massage.

[tsen]

I like the idea of physical therapy. Maybe add it in as something that the dwarf occasionally has to do like food or drink and it iterates a counter making him less disabled (slowly eliminates injury-rust from his physical stats)

[Craftling]

Masseuse: After watching my fortress population slowly become more and more depressed at the lack of alcohol and chairs, I thought that in the meantime depression could be kept down partially by a dwarf with the labour of "Masseuse", who would stand by a massage table (crafted out of wood, stone or metal) and would massage the depressed and stressed out dwarves, giving them a happy thought.

That is NOT the Masseuse's I thought this thread was about.

[SirHoneyBadger]

I like the idea of physical therapy, too. It's pretty amazing that Toady has gotten the game to the point where we can discuss something *like* different types of physical therapy, in a serious way, though.

I can't think of any other game-let alone a fantasy game-that would treat it as something other than a bizarre fringe idea, but here it's really topical.

And it may not seem like it's a central theme, but "little" things, like massage, like spas and physical therapy and gymnastics, and other ideas connected to medical care, are what makes the game deeper and better than it would otherwise be. Thinking about, and seeing, each separate component, among thousands and thousands going on in the game, get fleshed out and expanded upon, it really makes me happy about the game, and gives me a reason for continued enthusiasm.

We're getting crutches and splints and plaster, and we're getting skill-rust (Different forms of skill rust? That's another good idea right there, tsen.), so this fits into all of that, as another dimension, among equal dimensions, of the game.

Pretty interesting stuff.

So I really think it's great, even if it takes a really long time for something like this to be realized. I think it can and should be worked on and developed as far as it can go.

[Urist McDetective]

So, dwarven masseuses do give happy endings!

I can't believe you went there.
Now I've got that mixed with the idea of a dwarf grabbing another dwarf by the arms / legs & bending them into a ring until their back cracks.

[chucks]

Urist McMrsSwan says "You want happy ending?  HAPPY HAPPY ENDING!  YA!"
Urist McMrsSwan tickles you with her beard.'
Urist McMrsSwan gestures for a tip.
Urist McDesperate feels gravely unsatisfied.