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Author Topic: Healthcare fail  (Read 3103 times)

Aravin

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Healthcare fail
« on: September 16, 2013, 02:30:10 am »

Recently i've noticed an unwanted tendency of broken arms and legs losing functionality after the dwarf was given a wound (or a broken limb). I mean even after a doctor did his job, applied a cast etc ... the limb should heal alright, but instead of that i have a dwarf who can't use his, say, left arm anymore (it's impaired) and he prefers to hold both shield and sword with his right arm. Doesn't really affect anything but that somehow doesn't make any sense. Or is it because of doctor's low qualification?

And one more question now that i've mentioned it. Is there a way to train doctors (just to keep their skills from rusting) without having your own dwarves beaten on regular basis so the doctor could have a fodder to practice?
« Last Edit: September 16, 2013, 04:17:54 pm by Aravin »
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WanderingKid

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Re: Healthcare fail
« Reply #1 on: September 16, 2013, 05:46:05 am »

Recently i've noticed an unwanted tendency of broken arms and legs losing functionality after the dwarf was given a wound (or a broken limb). I mean even after doctor did his job, applied a cast etc ... the limb should heal alright, but instead of that i have a dwarf who can't use his, say, left arm anymore (impaired) and he prefer to hold both shield and sword in his right arm. Doesn't really affect anything but that somehow doesn't make any sense. Or is it because of doctor's low qualification?
Basically, yes.  A novice bonesetter kind of sucks at it, so does a bad surgeon.

Quote
And one more question now that i've mentioned it. Is there a way to train doctors (just to keep their skills from rusting) without having your own dwarves beaten on regular basis so the doctor could have a fodder to practice?
Nope.  If you get a large enough fort, donate a few victims with almost no relatives to a drop bridge. :)

Larix

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Re: Healthcare fail
« Reply #2 on: September 16, 2013, 06:27:43 am »

Recently i've noticed an unwanted tendency of broken arms and legs losing functionality after the dwarf was given a wound (or a broken limb). I mean even after doctor did his job, applied a cast etc ... the limb should heal alright, but instead of that i have a dwarf who can't use his, say, left arm anymore (impaired) and he prefer to hold both shield and sword in his right arm.

Look through the health screen, it's almost certain that the dwarf has nerve damage in the affected limb. Damaged motor nerves make a limb 100% useless. Nerve damage cannot be healed, and without re-writing parts of dwarven physique in the raws, there's no preventing it, either.

Quote
Or is it because of doctor's low qualification?

And one more question now that i've mentioned it. Is there a way to train doctors (just to keep their skills from rusting) without having your own dwarves beaten on regular basis so the doctor could have a fodder to practice?

Skill of the healthcare professionals is only known to affect the speed, not the quality of the jobs. A 'dabbling' bonesetter will set a broken bone just fine, it'll just take a pretty long time.
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WanderingKid

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Re: Healthcare fail
« Reply #3 on: September 16, 2013, 07:01:03 am »

Skill of the healthcare professionals is only known to affect the speed, not the quality of the jobs. A 'dabbling' bonesetter will set a broken bone just fine, it'll just take a pretty long time.

I thought only diagnosis obeyed that rule.

wiki:
Quote
Diagnosis skill level does not affect the diagnosis, only the time it takes for the diagnosis to happen. Embarking with a dwarf skilled diagnosis (and other medical skills) is helpful, both to speed diagnosis and to stave off skill rust when long periods of time go between injuries
Out of curiosity, how did you determine that?

Larix

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Re: Healthcare fail
« Reply #4 on: September 16, 2013, 07:30:10 am »

Just empirically by enabling all healthcare jobs on everyone who doesn't actively dislike helping others. Everyone gets treated by dabblers without a single full skill rank in anything. Nonetheless, broken bones which need setting get set and heal properly, surgery is performed and does... whatever it's supposed to do, i guess. The individual jobs take a while to perform, but dwarfs who enter the hospital with treatable wounds are released with the wounds treated and don't incur new injuries.

That's to say, i've never seen a limb become unusable due to poor healthcare, all who left with unusable limbs had already _entered_ the hospital with nerve damage.

So yeah, i don't know what the wiki means when it says bone doctoring and surgery skills affect the 'outcome'. It feels rather like they behave like no-quality jobs like threshing and wood burning. But i'll happily admit error if i encounter good evidence.
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Garath

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Re: Healthcare fail
« Reply #5 on: September 16, 2013, 02:15:13 pm »

I second that opinion. I always set all healthcare jobs on non-critical dwarves and I never had someone lose the use of an arm or leg that didn't walk in with nerve damage already. It's one of the funier things that even a novice surgeon can operate to cut rotting tissue from the lungs without any danger to the patient
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WanderingKid

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Re: Healthcare fail
« Reply #6 on: September 16, 2013, 02:26:38 pm »

Hunh.  Well, learned something new again.  Thanks gents.

Pinstar

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Re: Healthcare fail
« Reply #7 on: September 16, 2013, 02:40:38 pm »

"Hey guys, you know how I've been repeatedly injuring you over and over again for the purpose of training up a team of high skilled doctors? Yeah well we didn't actually need to do that."
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Garath

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Re: Healthcare fail
« Reply #8 on: September 16, 2013, 04:15:34 pm »

"Hey guys, you know how I've been repeatedly injuring you over and over again for the purpose of training up a team of high skilled doctors? Yeah well we didn't actually need to do that."
I might just put this in my sig. It sums up DF quite well

In any case, if you get a lot of injuries, highly skilled doctors definately speed up the whole diagnosing and operating process by an enormous amount
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Quote from: Urist Imiknorris
Jam a door with its corpse and let all the goblins in. Hey, nobody said it had to be a weapon against your enemies.
Quote from: Frogwarrior
And then everyone melted.

Aravin

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Re: Healthcare fail
« Reply #9 on: September 16, 2013, 04:21:14 pm »


In any case, if you get a lot of injuries, highly skilled doctors definately speed up the whole diagnosing and operating process by an enormous amount

That is if you can prevent the skill rusting, which occurs pretty much too often to my liking.

Thanks for answers. Kinda annoying thing it is, nerve damage, but i guess it can't be helped. Highly unlikely for dwarves to perform high level surgery with basic crude tools.
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Garath

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Re: Healthcare fail
« Reply #10 on: September 16, 2013, 04:27:01 pm »

you can set nerves an extremely low healing value. It'll heal in 10 years or so, faster if it was partial damage
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Quote from: Urist Imiknorris
Jam a door with its corpse and let all the goblins in. Hey, nobody said it had to be a weapon against your enemies.
Quote from: Frogwarrior
And then everyone melted.

sirdave79

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Re: Healthcare fail
« Reply #11 on: September 16, 2013, 06:34:15 pm »

There's a good mod with the title dwarves higher learning that allows dwarves to train skills including social and medical using books. Need to be in from world gen tho. It's going in for my next fort.
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Merendel

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Re: Healthcare fail
« Reply #12 on: September 17, 2013, 12:03:40 am »

There's a good mod with the title dwarves higher learning that allows dwarves to train skills including social and medical using books. Need to be in from world gen tho. It's going in for my next fort.
I think the masterwork mod also has this, at least it did last time I played masterwork.
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Aravin

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Re: Healthcare fail
« Reply #13 on: September 17, 2013, 02:26:44 pm »

you can set nerves an extremely low healing value. It'll heal in 10 years or so, faster if it was partial damage

How do i do that?
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Garath

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Re: Healthcare fail
« Reply #14 on: September 17, 2013, 04:57:36 pm »

in the raws is a txt file named tissue_template_default. It has all the comon body materials such as bone, cartilage, flesh, fat, nails, hair, skin, well, a lot. Most have healing rates of either 100 or 1000, with 100 being very fast and 1000 being slow. While I think nerves and such should not usually heal, we all know that in many cases partial function returns after time. A long time often, but it's still recovery of a sort. A value of 10.000 or so, or more, would simulate that a bit. My problem with this bit of raws is about something else though.


I usually add healing rates to some of the materials for the following reason. Wounds can be healed etc etc, but some materials in the game don't heal by themself. Cartilage, nerves, some are entirely reasonable. Another one that makes for a barrel of fun is nails. As you probably know, dwarves with open wounds can get infections. Since nails don't heal, any dwarf who had a completely smashed foot will be fine, except if he also broke a nail. The nail won't heal, he'll be trailing an infected foot for the rest of his life. In fort mode this is annoying and if the dwarf is not too strong he may succumb, but he'll be geting regular medical treatment. Good for the doctors. In adventure mode it basically means the end of your adventures. There are no treatments, no doctor cutting away infected parts, no washing with soap to prevent or kill the infection. Someone some time ago put it quite well: The worst enemy of an adventurer; the infected toenail. Don't worry about the dragon, if all else fails you can run away from it. You can't even cut off your own toe (I just realized that might be worth a try, but do I want to make a new adventurer to perform a sort of surgery on my previous one in order to amputate his left pinky toe with a sword or axe?)
Similarly, animals in fort mode with smashed hoofs, tusks or horns are doomed. They're not even treated and the damage never heals, unlike in real life.

I think, btw, that if you edit healing rates in the save raw, you don't have to generate a new world, but I'm not quite certain
« Last Edit: September 17, 2013, 04:59:27 pm by Garath »
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Quote from: Urist Imiknorris
Jam a door with its corpse and let all the goblins in. Hey, nobody said it had to be a weapon against your enemies.
Quote from: Frogwarrior
And then everyone melted.
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