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[Angela Christine]

This is related to the idea of doctor dwarfs, but different enough to perhaps rate its own topic.

Essentially an infirmary would be like a barracks.  The most basic infirmary is just a place to store injured people and wait to see if they get better or not.  No doctor required.

If there is an injured dwarf anywhere other than an infirmary, it will create a job to bring that dwarf to the infirmary.  That is the most important function of the infirmary. So instead of injured dwarfs being scattered all over the fortress at whatever bed was available closest to where they fell, they will all be in the infirmary together.  This allows a benevolent ruler to ensure that injured dwarfs will be in a safe, central location that is close to food and water, reducing the chance that health care jobs get canceled because they take too long.  It allows a tyrannical/pragmatic ruler to ensure that all injured dwarfs are stored in a room with a flood trap, for easy disposal.

A minor benefit of an infirmary vs. a barracks is the lack of noisy, sparring dwarfs making all the sick people sleep uneasily, when they get to sleep at all.  Only injured people can use beds in the infirmary, so hopefully random people wouldn't come along and tip them out of bed when they are resting.  

In a large fortress it might be worthwhile to have someone with only health care (and maybe food and refuse hauling) enabled and set their bedroom adjacent to the infirmary.  Not as good as an actual doctor, but they would help keep sick dwarfs fed.

Possible expansions:

• Job: comfort the sick.  This would be a very low priority health care job.  If there are injured people in the infirmary a person doing this job will go hang out with them for a while.  This will generate happy thoughts for the sick people.  It might even result in making a new friend.  (Not entirely a benefit, since they will become unhappy if a friend dies).

• Restraints for the mentally ill.  If someone is crazy but not violent, they will get locked up in cages or restraints in the infirmary for their own protection.  (Berserk dwarfs are too dangerous, and are still killed on sight.)  While they are in the cage they will get fed and watered just like injured or imprisoned dwarfs.  One dwarf per cage.  If there are no cages in the infirmary, or they are all full, then the crazy dwarfs are left to wander around the way they do now.  Each year there is a small (10%?) chance that the dwarf snaps out of it and becomes a productive member of society again, a small chance that they refuse to eat and eventually starve to death, and a very small chance that they go berserk and have to be cut down. This lets very benevolent rulers spend resources in the faint hope that a favorite dwarf may recover his wits, given enough time.  Positive events like the "comfort the sick" job above might help improve his mood, and increase the chance that he will recover.  Being neglected (allowed to become starving or dehydrated before being tended) might make it more likely that he will become berserk.

• Care for orphaned infants.  Wandering babies make me sad.    If a baby has no mother to care for him (the mother is dead or perhaps merely incapacitated) instead of letting the little tyke crawl around under foot he gets placed in the infirmary.  He stays there until he grows into a child, or a family member takes charge of him, or perhaps someone else adopts him.  This keeps him out of the way of wildlife, child snatchers and seasonal floods.  
   

[Behrooz Wolf]

What about those heroic stray War Dogs who eat a fireball in the line of duty?

"Infimary allows injured (D)warves"
"Infirmary allows injured (P)ets"
"Infirmary allows injured (S)trays"

Also, it would be reasonable if an infirmary included a water-filled bucket already on-site for drinks, that could be refilled by dwarven health-care jobs or hauling.

[slMagnvox]

This is an excellent suggestion.  A new room designation to control where my wounded are kept.  I really like the part of making restraints for insane dwarves and the mentioned (very small) chance of bringing them back to sanity.  Especially since my favorite Armorsmith is about to lose it over a lack of ultra-rare gems.  Even if he only refuses to eat and dies I'd still like to see him looked after.  And the bit about orphans really tugs at the heartstrings.

And speaking of watering the wounded, any chance we could get them a sip of booze once in awhile?  They haven't had a drop in ages...

[Tamren]

In the other thread we were talking about fully fledged hospitals.

What if we divided the total hospital into multiple rooms?

First you would need:
1. An atrium, not needed but considering how big the hospital as a whole is likely to get it would be nice to have a central room to branch your hallways off.
2. Infirmary, i guess this would be the place where the stable wounded and dwarves with minor injuries would rest. In an emergency it would also double as a triage center.
3. Emergency room: This is where the doctor does most of his work treating the serious injuries. Once dwarves stabilize and recover enough that they do not need to doctors constant attention they are moved to the infirmary to complete recovery.
4. Seperate rooms for surgery: Because surgery is not a pleasant thing in most cases and would give most dwarves unhappy thoughts. Prefferably soundproof.
5. Storage rooms: No explanation needed.
6. Doctors office: This is where dwarves go for a regular checkup and where the doctor will spend most of his time if not otherwise occupied.

Something like that sound good? we still need to hammer out the flaws, so feedback would be great.

[Angela Christine]

To me a complex hospital seems like something you would find in a well established city of thousands, not something you'd expect to find in a fortified frontier encampment of a few dozen.  It just doesn't feel right.  It is something I wouldn't expect to become available until you have a population of at least a couple hundred.

Also, the complex hospital depends on the idea of some sort of skilled healers, and perhaps medicines.  If you don't have doctors you don't need doctor's offices, emergency rooms, surgical suites, and so on.  

There are some currently useless items that could eventually become part of a more complicated medical system.  Items like golden salve, spider venom and soap are just trade goods right now, they are not useful for anything. The Alchemist looks like a potentially useful noble, but all he's really good for is making soap.  Since you probably won't get him until after you hit the lava, by the time you have the alchemist you probably don't need soap as a trade good.  (I'm not going to burn a bunch of wood to make clear vials to build the alchemist's laboratory, a building that is only useful if I'm willing to burn more wood to make lye, not until everything else is under control anyway).  The alchemist isn't that useful right now, but he has the potential to become useful in the future.  The alchemist could convert cave spider venom to anti-venom, allowing you to treat those poor bastards that get bitten by a spider and spend the rest of their lives as narcoleptic.  Or convert the venom (perhaps combined with another item) into an anesthetic, allowing even severely injured people to get to sleep (lack of sleep seems to be what drives them crazy).  Having soap and anesthetic would greatly improve the chances of a surgeon being able to complete a complex surgery without killing his patient.  

I'd make the requirements for a Physician Noble to already have the Alchemist Noble, and a population of at least 200.  You aren't going to attract a top guy if all you have is a few dozen laborers living in a rough walled cave, you just aren't.  His primary job is to start the health care system the way the Manager activates workshop management and the Bookkeeper starts the economy.  Once the health care system is active, dwarfs will start having happy and unhappy thoughts about the state of health care in the fortress.  
  "The Baroness got her ingrown toenail looked at right away, meanwhile my son had to wait three weeks to get the arrow pulled out of his arm."  
  "Only three weeks?  Lucky bastard.  I've been waiting nearly a year for knee surgery."  

I think it could be a great addition, eventually.

A simple infirmary could be added now.  It is basically a modified barracks, reserved for the injured.  It keeps them corralled in one place, which would be handy right away.  Even without medicine and no more care than they get now, keeping the invalids together in a central location would make it easier to care for them.  It could also serve as one of the stepping stones toward a more complex medical system.

[Funkadelic Jive Turkey]

Angela, a population of 200 is way too high to set a noble requirement to. The dwarf cap can be set to 1000 as of the current version, showing that the idea is to be able to have a metropolis, however hardware limitations are an issue with populations entering triple digits. (Plus your attention span may just go bonkers at HUGE populations.) Personally I'm against the idea of doctor or physician nobles. A noble might have a personal healer, but doctors generally didn't recieve that kind of status till this century, if at all.

Also, as for the infirmary handling orphans, I would suggest a seperate children's ward\daycare room. This would also be helpful for the military dwarves that currently have a habit of dragging their babies into combat, as they could leave them in the daycare center. (Milk should be consumed, but only after there are more milkable creatures then purring maggots.)

[Tamren]

Well just because healers in the past didnt recieve much status does not mean we have to carry that convention over here.

Presumable these dwarves have had at least about 1000 years to build up a store of knowledge advanced enough to build farms, retractable bridges, forged metal weaponry and siege engines. Why not healing?

A hospital might sound like a gigantic structure but it does not have to be. In the other thread we have on doctors i suggested that your first doctor when you hit 40 dwarves.

Just one doctor and his assistant can easily run a decent sized "hospital".

The hospital itself would be compact out of structural limitations. Imagine the size of a typical veterinary office, not the massive hospital complex present in most cities.

All you really need is one room with beds, everything else is just there to increase the efficiency of the building.

[Funkadelic Jive Turkey]

You can mostly build one now then, using the infirmary idea suggested by AC. Plus it gives the player more control.

Also, of course this game doesn't have to follow real-world historical conventions, but fantasy is still rooted in reality. Within the context of popular dwarf mythos as per my understanding, they aren't particularly reknowned for healing. It'd make more sense to me to have your legendary craftsdwarf be made a noble than the physician, not that I would suggest this.

My personal vote on a doctor noble is nay. I'd rather see doctor nobles as one step above hacksaw-dwarf, and that one step would be their learning recipes for medicine when recipes are in. Which you may need an alchemist to produce, but then I don't think an alchemist should be a noble either. Perhaps a head alchemist who would occasionally turn lead into gold and do other nifty things like that.

Ok, now I'm done before I go on too long a rant.

[John Hopoate]

quote:Originally posted by slMagnvox:
<STRONG>This is an excellent suggestion.  A new room designation to control where my wounded are kept.  I really like the part of making restraints for insane dwarves and the mentioned (very small) chance of bringing them back to sanity.  Especially since my favorite Armorsmith is about to lose it over a lack of ultra-rare gems.  Even if he only refuses to eat and dies I'd still like to see him looked after.  And the bit about orphans really tugs at the heartstrings.
ages...</STRONG>

Look on the bright side. Even if your armorsmith survived his fey mood and became legendary, he'd probably go nuts as soon as someone carrying a legendary piece of armor fell in the chasm or the river.