Injuries and medical stuff

[lazerlight]

I'd like to put up some suggestions I had concerning injured colonists and medical care. I like interesting mechanics that are realistic and multilayered while being simple enough to be easy to handle and don't involve too much micromanagement. Also these are just thoughts, not a finished concept. I also think, that RimWorld is too hard in it's current state, so this would be implemented once the game's difficulty is a little more adjustable.

There's one commodity related to this called something like "Medical supplies".

There's two related skills:
Medical skill: this will be disabled on most colonists except those who have gone through medical training in their backstory, like nurses, doctors, veterinarians et al. Leveling up would speed up medical tasks and/or improve the hp gained from performing them.
First aid: all colonists will have this skill. Alternatively this could be tied into some other skill, like Social. Leveling up would speed up first aid tasks.

Colonists can be in a number of injury states. I was thinking maybe five:
100: completely healthy
- Nothing to see here, move along

90 - 99: bruised
- Colonist will heal 1 HP per day.

70 - 89: injured
- Colonist will heal 1 HP per day if untreated.
- Will heal more if treated at least once a day by someone with first aid or medical skill (like randomly heal 1 - 10 HP up to a max of 90 HP)
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are lightly injured can treat themselves

50 - 69: wounded
- Colonist will heal 1 HP per day if untreated
- Will heal more if treated at least once a day by someone with first aid or medical skill (like randomly heal 1 - 10 HP up to a max of 90 HP)
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are wounded cannot treat themselves
- Wounded colonists are slowed down considerably

20 - 49: incapacitated
- Colonist will heal 1 HP per day if untreated
- Will heal more if treated at least once a day by someone with medical skill but not first aid skill (like randomly heal 1 - 10 HP up to a max of 90 HP). This will require an amount of medical supplies and cannot be done if there are none in stock.
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are incapacitated cannot treat themselves
- Incapacitated colonists cannot move

1 - 29: dying
- Colonist will lose 1 - 10 HP per hour if untreated
- Treatment by a colonist with medical skill will stop health loss for 1 day and the dying colonist will regain a small amount of HP. This will require an amount of medical supplies and cannot be done if there are none in stock.
- Multiple treatments per day will not increase the HP gain for that day.
- Colonists who are dying are also incapacitated of course, meaning they can neither move nor treat themselves.

This would just be an idea for the underlying system. Ideally colonists who have the right preferences set would care for patients automatically so the player would not have to concern himself too much with it. I think it would be a decent simulation of reality within the constraints of game rules. Colonists only heal very slowly when untreated, so no miracle recoveries in just a few days. On the other hand it's gamey enough to insure that the player would have their colonists back in running order in a timely manner if they care for them.

TL;DR: have colonists heal only very slowly on their own, but faster when treated. Make so that healing very severely injured colonists would require medical supplies and a medically trained colonist.

Edit: just corrected a few typos

[Workload]

Me like probably how Tynan was going to do it.  Just a thought, feel free to ignore this but what about if someone needs blood, then you need to take blood from someone who hasn't donated blood for a while and if want to go deeper can make them needing the same blood type.

[lazerlight]

Me like probably how Tynan was going to do it.  Just a thought, feel free to ignore this but what about if someone needs blood, then you need to take blood from someone who hasn't donated blood for a while and if want to go deeper can make them needing the same blood type.

I don't know how others feel, but for me that would be far to complicated. I think there are so many aspects to a game like RimWorld that it's best to keep the individual things simple. I was aiming for a system that has some depth to it but mostly takes care of itself.

Just take Dwarf Fortress as an example: it's fun to watch, when it's someone who's really good at the game. But I wouldn't really want to play myself, because there's just way too much going on ...

[Galileus]

I really like this idea, but here's my gripe - the "solid" relation between HP and health. It's good - don't get me wrong. If your guy falls under certain amount of HP, he immediately gets the relevant health status.

BUT! It doesn't need to be the only way. It would be great to see HP more as a "stability of patient". You can be wounded pretty badly, but still be in enough health to get through it - especially under the effect of adrenaline. Or you can be slightly injured, but with your body so weakened that it's way more serious than it would be for the next guy. It could be even tied into age and traits at some point.

So the status of patient (bruised, wounded and so on) could be gained independently from HP. Sure, your HP falls under set threshold, you get it anyway - but you can get it even without HP falling down. A stray bullet could get your hand before you reach X HP, and get you a wounded status anyway. It could even be represented by random roll for a "trait" of the status - you get wounded, game randomly chooses the description of "deep leg wound" or "broken arm". It doesn't need to actually do anything Would be great if it did, but that's something to think about once basic system is up and running. As would be adding perks after some serious injuries

And one more thing on first aid / medical skills. I LOVE the separation, but I don't love having two very similar skills. I would propose one "Medical" skill, that works as first aid if not a speciality and works as a medical skill when colonist reaches first point of speciality in it.

This would obviously need some tweaking in the core concept, so here it comes:

Non HP-relevant: completely healthy (Non HP-relevant, because I want recovering people to be able to be fully healthy, while still recovering strength (HP))
- No HP cap
- Heals 1-5 HP a day randomly.
- Can be treated by anyone with first aid or medical skills once a day, for 5-10HP heal boost.
- Can treat himself.
- Can be cured by anyone with shooting skill or melee skill.

90 - 99: bruised
- Colonist will heal 1 HP per day.
- No penalty to max HP.

70 - 89: injured
- Colonist will heal 1 HP per day if untreated up to max HP of 89.
- Will heal more if treated at least once a day by someone with first aid or medical skill, including injured pawn.
- Status can be cured by anyone with first aid or medical skill, including the injured pawn.
- Multiple treatments per day will not increase the HP gain for that day.

40 - 69: wounded
- Colonist will heal 1 HP per day if untreated up to max HP of 69.
- Will heal more if treated at least once a day by someone with first aid or medical skill, but can't treat himself.
- Status can be cured by any other pawn with first aid or medical skill.
- Multiple treatments per day will not increase the HP gain for that day.
- Wounded colonists are slowed down considerably

15 - 39: heavily wounded
- Colonist does not heal passively. Max HP capped at 39.
- Will heal 1-5HP per day if treated at least once in last 24h by someone with medical skill or first aid skill
- Status can be changed to wounded when colonist is at 39HP and treated by someone with medical skill. This will require an amount of medical supplies and cannot be done if there are none in stock.
- Colonists who are heavily wounded cannot treat themselves
- Heavily wounded colonists rarely move, and only wander around their bed.

1 - 14: dying
- Colonist will lose 1 HP per hour if untreated. Max HP capped at 14.
- Treatment by a colonist with first aid skill will stop health loss for 1 day.
- Treatment by a colonist with medical skill will stop health loss for 1 day and heal some HP. This will require an amount of medical supplies and cannot be done if there are none in stock.
- Status can be changed to stable by anyone with medical skill once colonist have 14HP. This will require an amount of medical supplies and cannot be done if there are none in stock.
- Colonists who are dying are also incapacitated of course, meaning they can neither move nor treat themselves.

Non HP-relevant: Critically wounded
- May be gained randomly if enemy "crits".
- Colonist looses 1HP per hour. Max HP capped at 39.
- Will stop health loss if treated at least once in last 24h by someone with medical skill or first aid skill
- Status can be changed to wounded when colonist is at 39HP and treated by someone with medical skill. This will require an amount of medical supplies and cannot be done if there are none in stock.
- Colonists who are heavily wounded cannot treat themselves
- Colonists who are critically wounded are also incapacitated of course, meaning they can neither move nor treat themselves.

Non HP-relevant: Incapacitated
- May be gained randomly if enemy "crits" and with heavily wounded, is gained automatically with dying and critically wounded
- Colonist cannot move or treat himself
- Can be cured by people with first aid or medical skills.

Non HP-relevant: Stable
- Recovery state only available to treated dying people.
- Colonist heals passively for 1HP per day up to max HP of 50
- Can be treated by anyone with first aid or medical skills for small portion of HP.
- Can be treated by anyone with first aid or medical skills for large portion of HP. This will require an amount of medical supplies and cannot be done if there are none in stock.
- Cannot be cured - ends automatically on 50HP.
- Keeps the incapacitated status from dying

PS. I made some adjustments, so that there is no "unhealable, will die" after first Raiders attack.

Me like probably how Tynan was going to do it.  Just a thought, feel free to ignore this but what about if someone needs blood, then you need to take blood from someone who hasn't donated blood for a while and if want to go deeper can make them needing the same blood type.

I don't know how others feel, but for me that would be far to complicated. I think there are so many aspects to a game like RimWorld that it's best to keep the individual things simple. I was aiming for a system that has some depth to it but mostly takes care of itself.

Just take Dwarf Fortress as an example: it's fun to watch, when it's someone who's really good at the game. But I wouldn't really want to play myself, because there's just way too much going on ...

My feeling exactly. If you have only blood loss, it's a strap-on feature that hints there should be more, but someone forgot to code it in. If it is more - you end up with a huge and complex system with loads of different resources and low on depth (because while every different treatment needs something else, they all work the same).

I tried to keep that "deep, but takes care of itself" feel in my re-imagining too, but it can be a little rough on edges.

[Evul]

OR!
No Hit points for characters and animals

Damage classifications:
Bruised (Lightly, Moderately, Heavily)
Broken bone (Leg, Arm, Back, Spine, Neck)
Lost Limb (L-Arm, R-Arm, L-Leg, R-Leg, L-Eye, R-Eye)
Projectile Wound (Gun, Shatter)
Burns (1st, 2nd, 3rd)
Bleeding (Lightly, Moderately, Heavily, Extremely, Controlled)
Crush Damage
Infected Wound
Unconscious
Dead

Depending on the type of injury the character suffers different outcomes. For example if you get a grenade thrown at you and it detonates a little bit away from you. You might get this kind of damages: Heavily Moderately, Bleeding Moderately, 1st Degree Burns and Shatter Wound.
But the guy standing on top of the grenade might get these damages: Heavily Bruised, Lost Left Arm, Lost Right Leg, Broken Spine, Broken Left Leg, Bleeding Extremely, Shatter Wounds and Unconscious.
They guy on top of the grenade will probably die in approximately 2 or 4 seconds while you might survive longer due to the distance of the grenade.

This kind of system will also need medical supplies and equipment, And implants

[Galileus]

While I like such systems, they shine when we're talking about single-person experience or -at most - 3-4 people squad. Trying to remember who had what wounds and what wounds were how bad every time you draft your 15 colonists would be needlessly complicated and complex.

[lazerlight]

And one more thing on first aid / medical skills. I LOVE the separation, but I don't love having two very similar skills. I would propose one "Medical" skill, that works as first aid if not a speciality and works as a medical skill when colonist reaches first point of speciality in it.

There's a very specific reason why I kept the two separated: To perform actual medical treatment/surgery as opposed to first aid, you need someone who is medically trained. Medical training takes a long time and very good training facilities. I don't see a way to get medical training in the circumstances our colonists find themselves in. That's why I think the medical skill should be deactivated for all colonists who did not go through med school (or something similar) in their past.

Also, I think in a game where you will be able to control upwards of 20 individuals, you should be able to judge their health status instantly by looking at them (or their health bar). Otherwise it will get too fiddly.

But, again I'm just throwing stuff out there. When other people think differently, and most importantly, when the developer of the game thinks differently, so be it.

[Galileus]

I agree on the medical training part from the RW perspective, but not necessary from game logic one. You do get something great in here, with the med training stuff - but it cannot be too hard to come by. One - you would actually turn a lot of wounds for death sentences for players, and that would be frustrating. Two - because it needs to come to play, otherwise the whole thing is needless complexity for no payoff. It IS oh so tempting to make sure there will be situation where you risk your one and only doctor. But this could cost way too much in terms of gameplay. Implement that system badly and full team wipe-outs due to lack of medical staff are sure to ensue in horrifying numbers.

I also absolutely agree with ability to be able to tell status from health bar. This shouldn't be too hard to address - just throw in an icon for status, or - even better - a right-aligned black bar ONTO the healthbar. Black bar shows the HP that is blocked off by wounds - so by it's length player would also be able to tell what kind of wound this is on the spot. Would make some getting used to to differentiate between wounds on the spot - but that is not a bad thing in this case! Even before player climbs to that level he already can tell a lot from that black bar - if colonist is wounded at all and how badly. So the learning curve in here is very forgiving, and once player gets to tell wounds on the spot he only gets to enjoy it even more.

[lazerlight]

I agree on the medical training part from the RW perspective, but not necessary from game logic one. You do get something great in here, with the med training stuff - but it cannot be too hard to come by. One - you would actually turn a lot of wounds for death sentences for players, and that would be frustrating. Two - because it needs to come to play, otherwise the whole thing is needless complexity for no payoff. It IS oh so tempting to make sure there will be situation where you risk your one and only doctor. But this could cost way too much in terms of gameplay. Implement that system badly and full team wipe-outs due to lack of medical staff are sure to ensue in horrifying numbers.

It may be harder to come by than you think. Is any of your friends a doctor? If yes, ask them. There's a reason why they're paid so well (or used to anyway).

If you read my rules carefully, the only patients that are "doomed" are those who are in the "dying" state. Everyone else will heal on their own. But they will heal very slowly without a doctor around. It is very important to have medical personnel. That means that doctors are not front line fighters. If a situation gets dire they may need to defend themselves. But be prepared that things go bad in that case. But I think if it gets so rough that you absolutely need to count on your last guy, you have a wipe-out on your hands anyway.

For me personally it would be weird if you took, let's say, a deep space miner, gave him a 2 week crash course in human anatomy and he would be able to perform surgery on a dying colonist.

[Galileus]

It may be harder to come by than you think. Is any of your friends a doctor? If yes, ask them. There's a reason why they're paid so well (or used to anyway).

I mean in game logic In real life? Sure, In game logic? It's a matter how often they should come around to maximize gameplay.

If you read my rules carefully, the only patients that are "doomed" are those who are in the "dying" state.

But that's the big game here. In combat you rarely have luxury to get colonists out reliably, so you REALLY need that doctor. Having no doctor simply screws you over big time - any fire-fight and all your colonists have 30% less health (if they hit that 30HP mark, they die) because your doctor went crazy and jumped off a cliff, believing he can fly. It can screw you over in early game VERY easy, it can screw you in late game, it can always screw you and screw you big.

Now, obviously I don't want to throw doctors at player like candy. Bah, you can see I made sure there is even more ways wounds can screw you over - while keeping in mind that you can keep colonists in veggy-state even without doctor. "Wounds screw you over" thing is big - true - but also a great game element and randomness that player understands, is fair in rules and clearly presented and provides additional challenge that is - even more! - additionally simply taking control of itself. Now, that's just crazy, this is a real awesome thing, a lot of stuff going there and done right - it still can be kept easy and low on complexity. But the catch is in this balancing - player needs to have an active way of countering such a huge risk as wounds and colonists temporarily taken out of commission. If we don't give him this active chance - he's going to be screwed over not by his bad planning but by RNG. And game over through RNG is always a bad, bad thing. Unless it's a dungeon crawler. But in a game where you can soak a lot of hours only to get killed of by random bad luck? Bad, bad, bad!

Now, that's why I wanted to tie it in into perk system I presented in another post. I don't know if you read it - so here's how it works. It's possible to get a doctor out of deep-space miner, true. I know how it sounds - I don't like it either. BUT! There is a but! The way specialization works we can balance this investment out. So sure - you get this deep-space miner to be an awesome doctor. Let's say he gets 2lvl specialization doing nothing but training for 2 weeks - so he is now a doctor. But now he's a mediocre miner - and best of all, he can't get better. Once you reach a specified amount of specialization levels, it's done - you stop levelling up. I originally proposed max of 4 levels of specializations per character (with specialization in any single skill maxing out on 2), but with medical specialization working in this huge way I would lower it to 3. So you can get one max specialization - medicine - and that's that. That guy will never ever be able to get lvl 2 specialization in anything else. He can get a lvl1 specialization in another skill, but this is not this fancy big thing you want to shoot for. So now you indeed can train a doctor of your own - you can react to misfortune and problems at hand. But this is going to get you pretty badly in the long run - you just wasted a guy who was supposed to be much better at mining or shooting. Now - that's a bigger choice, and this still makes keeping doctors alive worthwhile. You can get another one... but you'll pay for it in time and potential. And why waste that, if you can keep your own doctor alive and simply get that great miner you always wanted?

I'm sorry I'm dragging this out so much, but I really like this system and I think it can be flushed out much more if it's not limited by the fact that doctors are rare

Edit:// Now, it just hit me in the head. Why not simply tie the status removal (curing) to skill by a way of the percent? You have fully developed doctor? He can cure any status any time any day any way you get what I mean by now I bet. Doctor with around 50% skill development? He can heal light wounds just fine, but anything more and the chances are getting lower. And if your doctor is not even a doctor (first aid equivalent) - he still may cure statuses, but the chances are low - you'll waste a week or two just trying to get this roll in your favour. You still have direct control (can waste potential and time to train new doctors), you still have huge use for doctors, and now you have no death-traps per-se. Of course two weeks long wounds are still a death trap of sorts, but it's not all THAT scary anymore.