Let me tell the story of a round I played earlier today:
The station is full up on jobs, >80 players. Every single Medbay role is filled to capacity...except for Doctors. Previously, there'd be up to five MDs on the manifest, with at least one or two bouncing around the Medbay at any given time. Yet in a round absolutely stuffed with players, with everything from Chemistry to the Coroner all staffed up properly, only two people even bothered to play MD. Needless to say, both of them are nowhere to be found.
Two large bombs go off, in the middle of the station. Casualties are everywhere. Of course, between fastmos and the explosions themselves, it's >2 minutes by the time the bodies are brought to Medbay. None of them are revivable. Previously, MDs would receive them and begin the difficult and dangerous job of trying to SR and revive these players. Instead, they're all dumped at the Cloner like a stack of logs, where a Chemist and the CMO take turns shoving each corpse through like it's a microwave. Cloning was jam-packed, and both surgical theaters were literally spotless. I have a very, very hard time imagining the ORs being clean back when they were still relevant...but when no one's revivable, who needs 'em?
This same pattern has repeated itself almost every single round that I've played during the recent changes, with only slight variations in each one. Reviving and Strange Reagent made for interesting, suspenseful resuscitation efforts, where you had to repeatedly zap someone to keep their heart afloat, do surgery to patch up their many injuries, transfuse to keep them from bleeding out again, clean as much as possible to prevent infection, etc etc etc. The new changes make Medbay - even worse, death itself - downright boring.
Speaking as a real-life RN, the old approach of suspenseful, high-acuity action alongside regular, low-acuity fractures or cloning made for surprisingly on-point gameplay. The actual practice involved in treating someone is surprisingly simple most of the time; the issue in RL care is not some Dr. House-esque mystery solving and much more a question of efficiently managing resources. The new medical system, though, is less like working at a trauma center and more like working at a community health clinic (where I've seen nurses downright panic over epistaxis, a.k.a. "a nosebleed"). To try and summarize the basic issues in play:
1. Predictability: Past the two-minute mark, it's over. Boom. Done. Minimize the game and go do your laundry. Needless to say, this does not make for an interesting and engaging experience. There's no question of whether you'll get found in time, because you never get recovered in time for a defib anymore. There's no question of whether or not a competent MD will hit you with SR, because all they can do is to pop you into the cloner like a Hot Pocket and wait for it to finish cooking. Death has become boring; it's now just a question of twiddling your thumbs and watching something on YouTube until the metaphorical microwave has done its work.
2. Lack of human agency: If your corpse gets recovered, you'll likely get cloned eventually. There's nothing anyone can do to speed it up beyond the basic R&D upgrades, which means that there's no point in having anyone competent in Medbay; even the best players can't do anything more than wait for the magic cloning pod to churn through the corpses. Medbay could be crewed by the A-team or a pack of dribbling incompetents, and it has little impact (if any) on patient outcomes.
3. No effect past Medbay itself: Cloning has some new temporary downsides, but those are easily fixed with a trip in the cryopod or a bit of mutadone. It may mean more time spent twiddling your thumbs (yay, such fun, much excite), but once you've done a little more time in the cryopod then you're in the clear. The new death system means more time spent being dead, but it means literally nothing once you're alive again.
4. Lack of alternate playstyles: I've had quite a few games where some whiz-bang MD patched me up in the SS13 equivalent of a back-alley medbay. Rare, to be sure, but being revived even when the original Medbay was a flaming crater made for an interesting round that I can still recall today. The current system prevents all that, because without the cloner or getting really lucky with a defib, you're basically toast. Whoo-wee, such fun, much excite.
I'm looking to effectively reverse these four factors. To elaborate a little on what I'd like to see:
1. Unpredictability: I don't want death to be the same thing every time. Maybe I'll get found, defibbed, and get back on my feet in no time. Maybe I'll get patched up in a cave by a guy with a box of scraps. Maybe Malpracticebay is in full effect, and the best I can hope for is to get cloned. Maybe, maybe, maybe.
2. Human agency: In keeping with the above, I want a good Medbay to be able to save lives like there's no tomorrow. Sure, make SR expensive and difficult to acquire - that just means it's cooler when the Chemists are on-point and the stuff is available in spades. Make bodies rot sooner, forcing them to be quickly injected with formaldehyde in order to be saved, or put more restrictions on how it can be used...but leave the option open. It makes for much more suspenseful, interesting, and compelling gameplay when things could happen. I don't mind failure, but I want there to be a chance of success in the first place, because having an alternative to failure makes it that much more poignant and interesting.
3. Long-term effects: To put it bluntly, I want the cloning pod to be the failure-state. I want people to hate being cloned, and the easiest way I can see that happening is to put some sort of un-fixable, long-term penalty to being cloned. Having some sort of unsolvable penalty counterbalances the ease of the cloner: it can still be the simple answer, but it's also not the one which people should want to take. The possibility of a full recovery would leave an incentive for good doctors to go through the effort of patching every boo-boo and fixing every wound (and for players to sit around in their broken bodies long enough for docs to fix them), whereas the cloner would still be a potential, if undesirable, option for people to re-enter the round. More on this below.
4. Allowing alternate playstyles: I'd like to give more options for fixing people, rather than a "one-and-done" approach. Maybe Genetics has a a power which prolongs defibrillation time with few downsides; the issue then becomes one of effectively spreading that same power stationwide, or at least to the most at-risk individuals (i.e. resource management). Maybe Medbay is reliant instead on the Coroner or a similar triage person during an MCI (Multiple Casualty Incident), with them running around and moving defib-able people to the cryopod area while injecting the long-term cases with formaldehyde before they start to decompose. Maybe transplantation would remove the cloning penalty, allowing for someone who'd been cloned by MD-McDumbass to get fixed if there were other MDs and Genetics on the ball that round. Overall, though, I'd like to see the game mechanics encouraging more options rather than simply railroading everyone towards the magic cloning microwave.
A. The defibrillator issue:
-Slightly increase defib times. IIRC the old defib-capable times were up to five minutes, while the current number is two. The current number is far too small, given that defibrillators are rarely ever used in the field; unless you die inside the Medbay itself or near a mediborg, there's no saving you. I'd suggest moving it back to five minutes, to be counterbalanced with a significant penalty (see below). If you're dead-set on reducing defib times, though, then please at least split the difference and make it 3.5 minutes instead of the current "flash in the pan."
-Increased defibrillator times could be counterbalanced by having defibrillation inflict severe damage on the heart like it does IRL. This would require doctors to be careful and sparing about their defib use, and make it a gamble every time you place the paddles. Inflicting variable 10-35 heart damage per shock would allow someone to survive a single defib at a bare minimum, but would make multiple uses of the defibrillator a very dangerous game (i.e. suspenseful). Heart damage requires either chest surgery or mitocholide to fix, so either Chemistry or an MD being on the ball would be able to fix the damage. This'd add additional uncertainty due to the ever-present question of player competence, and would allow for meaningful success-stories to happen, such as "a competent Chemist saves patients from a defib-happy MD's mistakes" or vice versa.
B. Strange Reagent:
I'd suggest limiting SR through:
-Requiring a higher dose and/or more exotic materials. Space fungus might be a good 'un, or diamond, or some similarly hard-to-acquire substance. The goal here should be to make SR achieveable to make, but only by someone who knows what the hell they're doing. Alternatively, it could require help from another department, such as needing a high power draw from Engineering, ambrosia gaia or a similar higher-level plant from Botany, or upgraded parts from Science.
-Shortening the time available before a body begins decaying. I'm not sure how long the current time is until bodies start decaying, but the first stage (i.e. "They are beginning to smell") is the cutoff point for SR. If you shorten that time down, then formaldehyde and good corpse-triage becomes vital to saving them. In other words, something like this.
-I think the current system of "SR revives with brain/genetics" damage is good enough as-is. It allows for revives in the field, but inflicts a serious penalty if you lack access to a cryotube, and also requires that the field medic have remembered to pack along some mannitol as well.
As mentioned, I'd like cloning to be the "failure-state" of Medbay. People should have a real, lasting reason to not want to be cloned, and I'd suggest the following mechanisms for doing so:
-Implementing Clone Memory Disorder (CMD) for an in-character penalty. A rule like "you aren't able to remember anything that happened for the past thirty minutes" would allow for some interesting RP opportunities for anyone who's so inclined, and also keep people from being able to easily nail their killers. After all, if someone starts yelling "JOE IS A 'CLING!" the moment they pop out of the cloner, that's fairly bwoinkable. There won't be 100% compliance, and the initial implementation will be patchy as usual, but having some IC penalty for getting cloned should make RP-heavy, powergamey-light players want to avoid it. If possible, I'd like to also include some mention of "You will only be able to retrieve these memories with heavy counseling" or the like, to provide people with an IC reward for visiting the Psychiatrist. Basically, if you sit down and RP out talking through "shit I'm a clone, what happened back there," you can circumvent the penalty (and ID your killer). This should hopefully make the Psychiatrist a little more relevant, while also allowing for a method of dealing with the penalty providing the player is willing to put in enough effort.
-Implement some sort of [was cloned] penalty tag for anyone whose body was cloned. This would have a significant mechanical drawback which cannot be easily removed (that part is key). Options here include a brute/burn damage multiplier like IPCs, decreased maximum health, or a similar significant mechanical disadvantage. The goal here is to provide a penalty which even the powergamey-est of players would have to sit up and pay attention to; even if you don't give a shit about CMD, the mechanical cloning penalty would still make you sit up and pay attention. This could then be circumvented by brain transplantation into a humanized monkey (which would require both Genetics and an MD to be on the ball), or a similarly-circuitous method for anyone who really wants to get around it.
-I don't mind autoprocessing and autocloning, and I'd suggest keeping it in light of the above penalties. This would make prescanning a gamble: do you hope that your body gets found, or do you just say "screw it" and hop into the cloner, hoping that you can find a competent Geneticist and MD to help you out on the other side? (or will you be too busy once cloned, and have to just deal with the penalty anyway?)
Thank you to whoever took the time to read all this, and I hope this provides some decent food for thought. I agree that the previous Medbay system was definitely flawed in some respects, but I don't this approach is a positive one to fixing it. In lieu of the current changes, I'd like to provide labor-intensive methods to circumvent death, and to make cloning a last-resort option which no one wants to have happen. If you have any questions or comments about my proposal, feel free to make 'em.