Bay 12 Games Forum
Dwarf Fortress => DF Suggestions => Topic started by: Raveline on March 02, 2012, 08:16:28 am
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I've got two problem with doctors :
1°) First of all, they are useless most of the time. They only work when your dwarves are injured. And thanks to OCD, I want my number of iddlers to be as low as possible.
2°) Since the new release, it's very rare to get talented medics coming to your fort. Even before, it was hard to get them to have good skills without having to harm voluntarily your dwarves (not that I object to this, but it means painful micromanagement that I don't really like).
I don't know if it's planned, but there should be some not-too-complex ways of improving this situation :
- Dwarves could go to the doctor for other reasons than serious injuries. They could have medical check-ups, that would improve the diagnostician skill ; they could have small scratches that would need small stitching, training this skill ; and let's not forget about taking care of animals, which would allow to practice surgery and "bone-doctoring" without risking to need more coffins for your dwarves. Of course, diseases could be added, but that would make thing much more complex.
- For the more sadistic players, it could be nice to have their doctors be allowed to "experiment" on trapped animals or goblins. (Or at least practice dissection on corpses, as they did in antiquity and middle-age, so they would get better in all medical skills).
- It would be nice if there could be some "quarantine", particularly for migrants. You know, like, trying to see if one of your new dwarves do not have curiously long canines and a curious pale skin. Once again, that would put the doctor to good use and would improve the diagnostician skill. (Though I reckon this would a bit more difficult to code than the previous idea). And of course, bad diagnostician would not spot vampires.
- And lastly, having the doctors be mortitian and preparing the corpses before burial would be nice. (Of course, this would NOT be their priority in case of urgent surgery !).
I understand there are still many bugs with doctors and hospital, so I imagine the system must be quite complex, but that would be some nice additions to the game.
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I agree doctors need other methods of raising their skills... even if it means testing on corpses and animals.
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I like this idea overall.
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Seems kinda gamey. If doctor training is to be improved, I think the first motivation should be realism, not the dissimilarity to other easy to train professions in the game.
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I'd love for check ups so you can see how pepole are doing, I'd also like doctors use more items like plants to fix things (last I check they dont)
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It would be nice if doctors could skill up by experimenting on corpses like real life med students but until then we got our drop shaft being fed a continuous stream of migrants for five years until they earn the "Right" to join dwarven society. Bam! Covered your need for training, and quarantine. Gotta love burrow designations. Use Garbage dumps to drop food and supplies in for your medical team & their guards. Volunteer a few migrants to take care of turkeys or farm.
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Yeah check ups would be nice, anything to keep those doctors bussy, im a lil OCD about that too. i end up asigning them new jobs, but then u have to go back and unasign them when someone gets hurt. and it just ends up being a pain. and Urist Golbin fodder dies of infection cuzz the doctor is hauling refuse instead.
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I would think that they need:
- Poultices made from herbs that can increase/decrease efficacy of healing, remove toxins, pain relief.
- Any doctor that has a doctoring labour needs it to be of the highest priority besides immediate survival (drink, food, fleeing from evils) - a doctor should be prepared to work when tired, but they have a higher fail rate.
- A doctor should either only work with corpses or only with live patients by default, but this could be overridden, providing more utility/faster training at the cost of higher infection risk.
- Certain activities the doctor partakes in spare time can modify success/failure rates or infection rates. Things involving battle, butchery, cooking, and similar increase risk of illness. Burying dead dwarves increases risk of illness. Certain jobs don't modify the risk (masonry, architecture, etc).
- Ideally doctors should be able to be (as I said) ordered to work on prisoners. These prisoners must be restrained, and maybe sedated with a herbal poultice, or any syndrome bearing material that causes both pain relief and unconsciousness. Depending on the prisoner's race, the dwarves should be able to research how their body works. Highly unethical, and could prompt a war, if enough prisoners are experimented on.
- Once a certain quota is fulfilled of a particular race (ie. 100 goblins experimented on) with the next caravan your civ will gain understanding and get a slight buff to combat against them. The danger of this is of course juggling the ethical questions of it, and how the civs react. Your own dwarves could be experimented upon as well, this would give a. the ability to dispose of unwanted migrants/uristmcfailures, b. training, c. higher success rates in subsequent operations.
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Golf clubs- 2 or more doctors with no current work to do will go golfing, where they socialize and share expertise. The actual golfing job just has them walk around any convenient grass/moss covered area (or maybe a new zone type?)
Birth rates- If TV has taught me anything about the medical profession, it's that doctors are as promiscuous as rabbits. Every adult female dwarf should have a 5% chance per male doctor of getting pregnant, checked once per season.
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Anything to keep those doctors bussy, im a lil OCD about that too.
I know, right ?
Your own dwarves could be experimented upon as well, this would give a. the ability to dispose of unwanted migrants/uristmcfailures, b. training, c. higher success rates in subsequent operations.
Not sure about this (though, any moral consideration put on the side, that would give a way of making use of armless or legless dwarves). I'd think that would be to be reserved for when Toady will add the diseases, and would only be to experiment medication. Perhaps you could be given the choice to do it for other things, but it would create massive bad thoughts, and a bad reputation with the mountainhome.
Golf clubs- 2 or more doctors with no current work to do will go golfing, where they socialize and share expertise. The actual golfing job just has them walk around any convenient grass/moss covered area (or maybe a new zone type?)
Birth rates- If TV has taught me anything about the medical profession, it's that doctors are as promiscuous as rabbits. Every adult female dwarf should have a 5% chance per male doctor of getting pregnant, checked once per season.
The the golf idea is hilarious ("Hauling job / Caddies"). With the birthrate being what is right now, though, I really wouldn't want to have even more babies...
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I don't think doctors performing checkups and practicing on dolls is reasonably realistic for the period- my suggestions would be
1) dissecting animals or corpses for practice (another use for corpses besides butchering)
2) studying from texts
3) Helping with pregnancies / caesarian sections / fertility / that sort of thing
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Exactly, Raveline! The whole point of it would be weighing up whether it would be useful to you in the long run or not. If your mountainhome hates you to a certain point they'd refuse to trade, or perhaps even siege to stop dissecting their compatriots.
The dwarves who are resident should not see such a thing, so these doctors would be operating in a closed off part of the fort. Of course, if another dwarf finds out about it, s/he could get a bad thought varying from 'relatively bad' from seeing 'slaughter' to extremely bad (a friend/family/lover being dissected). A doctor found operating in such a way could be charged.
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I don't think doctors performing checkups and practicing on dolls is reasonably realistic for the period- my suggestions would be
1) dissecting animals or corpses for practice (another use for corpses besides butchering)
2) studying from texts
3) Helping with pregnancies / caesarian sections / fertility / that sort of thing
I mostly agree with you on this but would add one thing:
4) dealing with minor work / accident related injuries.
While performing most jobs dwarves should occasionally hurt themselves. There could be burns from furnace operating, cuts from most jobs, dwarves could accidentally drop things on their feet, trip over, and even fall down stairs (wasn't this once possible?).
These kind of injuries should provide a steady stream of work for your doctors but anything more serious should take priority.
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Im really into the idea of doctors helping with pregnancies and preparing the dead for burial.
One could also suggest that without medical help, weaker infants would die, but that's one step from seeing Dwarven Eugenics thread.
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This is an incredibly common suggestion.
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This is a fantastic idea! If you want your voice to be heard I suggest putting this on the DF Eternal Suggestion Voting (or voting for it, if it's already there!) http://www.bay12forums.com/smf/eternal_voting.php
I'm really OCD about idlers too :P
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After Urist McBloodbag has been found dead, the body could be shipped off to the hospital, where diagnostician Urist McHouse will attempt to find a cause of death.
A dabbling diagnostician's examination will take ages, an might not even have results. ('The cause of death was unknown.')
More skilled diagnosticians will find the cause of death faster and more accurate. ('missing head' vs. 'two puncture wounds on the throat, through which Urist McBloodbag was drained of blood')
If dwarves salivate this could lead to an interesting cat-and-mouse-game where the fortress guard will take a saliva sample from Urist McFalselyaccused because 'The cause of death was two puncture wounds on the throat, through which Urist McBloodbag was drained of blood. There was saliva on the wounds.'
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Occasional minor injuries from work tasks would be a fun addition.
Carcing and hauling rock all year long has to result in a strained back every now and then, and not everything should be solvable by dwarven rum to get through the working day.
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I just want to add to the idler issue, doctors should be able to be on duty even if they have no actual work, just remaining in the hospital and making sure everything is in place in case they are needed (and getting paid once that's in). That way the one time your hunter comes back with a unicorn horn in stuck in his pancreas, you can make reasonably sure someone will be in the hospital instead of off by the well killing time.
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Allow me to propose two things:
1. Regular checkups. Even if the dwarf isn't injured (or doesn't know he's injured) he should go in occasionally 1/year?) and talk to a doctor. Doctor does a diagnosis job that takes say, 1/2 the normal time but gives 2% the normal XP. (So it helps by keeping the skill from rusting, giving minor but steady XP, and provides a useful function of ensuring your dwarves are getting the care they need)
2. CMD visual exams. When there is a dwarf within sight range who has not had a checkup in say, 6 months, the CMD glances him over and performs a Diagnosis job. Additionally, any dwarf in the hospital zone where the doctor is gets checked every week. Time is extremely low (1 step/frame), gives no xp. If anything is wrong, it detects that but does not actually diagnose; it marks the dwarf as requiring diagnosis as per normal.
The end result would be to (with any luck) end the problem of injured dwarves who get diagnosed but not successfully treated and have to be deliberately re-injured to jump start the medical process.
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If dwarves salivate this could lead to an interesting cat-and-mouse-game where the fortress guard will take a saliva sample from Urist McFalselyaccused because 'The cause of death was two puncture wounds on the throat, through which Urist McBloodbag was drained of blood. There was saliva on the wounds.'
Erm, I think going all C.S.I. Dwarf Fortress would be sort of counteractive for the mood of the setting... The DF world is, after all, pretty much modeled on the Medieval period, when medical knowledge, let alone forensic science, was ...somewhat less than sophisticated.
As for medical check-ups and such in general, I really don't see the point.
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Largely so that I don't have to systematically engineer "mining/construction accidents" in order to get the medical system to patch people up Sus.
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These ideas all sound pretty awesome. I'd really like to see better use of the healthcare system - it's pretty comprehensive and realistic for the time period, but there's almost never a reason to use it, and then when we do need it our doctor's are unskilled and useless.
The upcoming hauling improvements seems like the perfect place to add a work-related injuries - sprains, strains, broken bones. It would be feature creep, though, and I'm not sure I'd like a hauling overhaul delayed to make Urist McDorf pull a muscle more often. :-\
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The upcoming hauling improvements seems like the perfect place to add a work-related injuries - sprains, strains, broken bones. It would be feature creep, though, and I'm not sure I'd like a hauling overhaul delayed to make Urist McDorf pull a muscle more often. :-\
I don't like the idea of work-related injuries since I don't need my soldiers with sprains and broken bones while marching upstairs to battle! The better solution was previously suggested of performing training on dead animals/people. I have plenty of corpses I'd gladly donate to training my idle doctors.
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The thing is, work-related injuries wouldn't really keep a soldier from fighting to defend his or her home. Yeah they might drop by the medical area to get something looked at, get a poultice or have a minor injury stitched, but generally speaking it would be done to speed their healing rather than forcibly bed rest them until the bruised fat on their left toe healed fully. :)
It might also slow the occasionally ludicrous rate of production, which could be a good thing some and also a provider of !FUN!. :)
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If doctors are going to perform autopsies and dissections shouldn't they also perform transplant and removal surgeries. Organs could come from the freshly deceased, kept on ice for a few months, and/or from a volunteer. The recipient will then have to go through the rehabilitation process, but will still be at risk due to possible incompatibility and infection. The volunteer, if willing, can get a happy thought...but at the expense of a vital/sub-vital organs and the subsequent debilitating consequences (i.e. decrease breathing if lung, less ability to handle alcohol and diseases if kidneys and/or part of liver, etc).
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And of course there should be complications from surgeries, and the lifespans cut down as with real life transplants... But then again DF is early medieval fantasy, so medicine was little more than 'Chop it off and see if he lives'...
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I don't think doctors performing checkups and practicing on dolls is reasonably realistic for the period- my suggestions would be
[snipped]
If we're going period-appropriate, it'd be "Barber Surgeons", surely?
Normally I wouldn't even suggest such an abomination with dwarves, but that's my Pratchetesque background speaking. While it appears that including the females Cassanundra alone out of the entire Disc Dwarves population voluntarily shaved, DF Dwarfs are quite fond of altering their facial hair significantly.
May I suggest a 'job-doubling' situation across the medical field? Maybe something like:
- Barber-Surgeon
- Herbalist-Suturer
- Carpenter[1]-Bone doctor
- Conversationalist?[2]-Diagnostician
- Butcher[3]-Diagnostician
- Clothier-Wound dresser
(Are modders amongst us are already quite capable, and probably willing, of designing a custom "mini-golf" workshop, BTW? Wouldn't be a social thing, with only one worker allowed[5], but might allow potential surgeons/etc to "give time to think" about medicine.)
[1] And/or bone-crafter?
[2] For conscious patients, representing bedside manner. (The actual alternate profession might be Mayor/equiv[4] social-skill user, or this is where otherwise unoccupied doctors idling around would be a good thing!)
[3] For unconscious patients. Also post-mortem? (Not so common, though, in-period, save for the actual anatomists of the day where were as likely to be purely academic or artistic, rather than medical practitioners.) And if there's a potential for spontaneous syndrome creation/transference, during medical procedures, this should be drastically increased for post-mortems.
[4] And thus promote the disentangling of Bookkeeper and the semi-elected social-skill noble positions, because you need them to be out and about and 'mixing it' not stuck in their office writing the books up, like I habitually have them do.
[5] Although maybe a 'golf course' needs both "Tee" workshops and "Green" workshops, Tees produce "ball" items but do not skill up, Greens absorb "ball" items and do skill up. Though I'm trying to work out how (even if this is possible) to stop a peasant being told to tee-off continually, allowing a 'golf professional' to sink each produced shot so produced. Something that makes balls be undroppable haulage items so that once created, the teeing off individual can only go to the green, and can't haul anything else[6]? I think that's beyond modding, though. Also, I started off by talking about being 'in period', and this probably aint. ;)
[6] And thus take on any other job requiring material-hauling, including construction of buildings and almost every other workshop reaction.
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One thing I think is, especially if this whole "Mad scientist medical experiments" thing gets implemented, is doctor sadism. Just like how any time a dwarf gives food or water they get a positive or negative mood effect based on empathy, I think any doctor who does a surgery, suturing, and possibly bone doctoring should get a mood bonus/penalty based on how low their empathy stat is. "(got/was forced) to perform a painful medical procedure recently". however, it would also come with an unhappy thought for the patient, worse for a sadistic doctor, i.e. "underwent a painful procedure recently.". :-[