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Author Topic: Making medical skill level more useful.  (Read 2723 times)

synyster31

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Making medical skill level more useful.
« on: May 29, 2015, 03:22:12 pm »

Having read the various suggestions about work related injuries (which I think sound good) and another thread about soap, I got thinking about how to make medical skills more important than just having a dwarf minimally trained.

I'd like to see the skill level relate to 'success chance' and 'malpractice risk'. The less skilled a dwarf is the less likely the proceedure is to work and the longer the recovery time is. Also the less skilled the dwarf the more likely they would be to cause more harm to the patient!

Also, maybe having a skilled Chief Medical Dwarf could help others learn, along with the teacher/student skill.
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Deboche

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Re: Making medical skill level more useful.
« Reply #1 on: May 30, 2015, 10:15:24 am »

This makes sense, especially coupled with book learning and apprenticeships. I'd be surprised if it's not been suggested before though.
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NW_Kohaku

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Re: Making medical skill level more useful.
« Reply #2 on: May 30, 2015, 11:35:31 am »

It has been suggested before, and was last suggested about a week ago. 

I seem to remember it was in the early versions of .31, where dwarves would misdiagnose a broken leg as a lung infection, and start trying to soap their lungs while the dwarf bled out, but was removed because it's so hard to train doctor skills without deliberately hurting your dwarves routinely that making unskilled dwarves misdiagnose would make hospitals more trouble than they were worth.  (You'd kill any dwarf that actually got treatment, anyway, so why bother?) You'd only be fine if you were lucky and got master doctors strolling in with migrant waves (which actually happened a lot, but was still random).

Hence, Toady is fully aware of this one.
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synyster31

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Re: Making medical skill level more useful.
« Reply #3 on: May 30, 2015, 07:02:29 pm »

I had a look through the board but I didn't see anything specifically related. The student/teacher idea was an afterthought.

Yrs the Diagnosis skill is a tricky one to get right.
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NW_Kohaku

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Re: Making medical skill level more useful.
« Reply #4 on: May 30, 2015, 09:08:24 pm »

Threads from the .31 timeframe were about how little medicine could solve.  In general, medicine is getting frequently rebalanced, and more and more body parts are getting actual functions. 

I suspect that, with the education-related stuff and the "negative skill levels" ideas that Toady talked about coming soon, we might get something like this coming, already.

As for the thread I saw a week or two ago... No wonder it was hard to find, it was one of those big list suggestions.  (This is why people need to avoid random list threads, they're difficult to find anything in one of them again...)
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Tristan Alkai

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Re: Making medical skill level more useful.
« Reply #5 on: June 29, 2015, 06:00:04 pm »

I seem to remember it was in the early versions of .31, where dwarves would misdiagnose a broken leg as a lung infection, and start trying to soap their lungs while the dwarf bled out, but was removed because it's so hard to train doctor skills without deliberately hurting your dwarves routinely that making unskilled dwarves misdiagnose would make hospitals more trouble than they were worth. 

This also echoes my thoughts on the subject.  It is currently impossible to train medical skills without providing injured dwarves to train on, and, until that changes, I will remain flatly against this idea. 

That said, I do have a few ideas to provide things other than injured dwarves to practice on.  All rely on functional veterinary medicine, since it is much cheaper to lose a cat (or even a cow) than a dwarf.  See model organism and animal testing.  In order to make this work, I have to assume that treatment of animals (or at least vertebrates) uses, and trains, the same skills as treatment of humanoids. 

1. Vivisection would be a designation applied to individual animals, accessed through the same menu as scheduling them for butchering, and subject to most of the same constraints (no pets, for example).  Depending on exactly which techniques were trained, the remains left by the medical trainee would likely be hauled to the butcher shop for its standard processing. 

2. Dissection of already dead animals (or humanoid cadavers) might also teach some medical techniques.  See also: autopsy

3. There are also ways to provide injured animals that will hopefully be saved.  The most obvious would be to designate animals for target practice, particularly by marksdwarves.  A cat or goose injured by a crossbow bolt provides a genuine combat injury to work on, with the goal that the patient will be successfully treated and eventually return to full health.  If the doctor fails to save the patient (or makes things worse) oh well.  It's a lot easier to schedule the loss of a cat (or something else small and hard to use like a cavy, rabbit, or duck) than to lose a dwarf to a siege or an accident.  By definition, neither of these can be scheduled, and it is much more difficult to ensure that only expendable dwarves find themselves in need of the hospital's services.  Just make sure the training weapons aren't poisoned, so non-surviving test subjects can be butchered normally. 

4. Try to arrange for war dogs and the like to be in front and taking the hits from enemy sieges, rather than melee dwarves, since dogs are generally fairly easy to replace (much easier than trained military dwarves, at least).  This is more of a way to direct siege and accident injuries (which are, by definition, very difficult to control) toward more expendable targets, but functional veterinary medicine would still train medical skills on more expendable subjects. 
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StagnantSoul

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Re: Making medical skill level more useful.
« Reply #6 on: June 29, 2015, 06:26:06 pm »

I had a dwarf get his brain soaped... It worked. His real problem? A broken arm.
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Bumber

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Re: Making medical skill level more useful.
« Reply #7 on: June 29, 2015, 10:34:38 pm »

I had a dwarf get his brain soaped... It worked.
Dwarven brainwashing?
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StagnantSoul

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Re: Making medical skill level more useful.
« Reply #8 on: June 29, 2015, 10:36:19 pm »

Wait, that was when brains were bigger than skulls. Could that explain a successful brainwash?
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Quote from: Cptn Kaladin Anrizlokum
I threw night creature blood into a night creature's heart and she pulled it out and bled to death.
Quote from: Eric Blank
Places to jibber madly at each other, got it
Quote from: NJW2000
If any of them are made of fire, throw stuff, run, and think non-flammable thoughts.

dudlol

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Re: Making medical skill level more useful.
« Reply #9 on: July 04, 2015, 07:29:29 pm »

Perhaps allowing dwarves to render medical aid to members of another civilization?

Dwarves seem pretty honorable, rendering first aid to captured enemies after a battle doesn't seem too far fetched. It'd give a solid base to train medical skills from and as a bonus it'd turn into a way to torture enemies.
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StagnantSoul

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Re: Making medical skill level more useful.
« Reply #10 on: July 04, 2015, 07:44:09 pm »

Yeah, make the worst doctors the ones to treat the enemy. "Okay, so the only cure is an amputation of your head."
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Quote from: Cptn Kaladin Anrizlokum
I threw night creature blood into a night creature's heart and she pulled it out and bled to death.
Quote from: Eric Blank
Places to jibber madly at each other, got it
Quote from: NJW2000
If any of them are made of fire, throw stuff, run, and think non-flammable thoughts.

synyster31

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Re: Making medical skill level more useful.
« Reply #11 on: July 07, 2015, 02:50:14 am »

Live subject medical experimentation, i like it! Well Dwarven eugenics is already a tbing so why not  :D
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