2.0.0

One setting, and it splits the mod in half.

[difficulty] realistic is off by default, and while it is off nothing changes. Arcade is the mod as it has been for eight versions: open the body chart, read "left leg, two breaks, infected, 4 of 14", go and treat that.

Turned on, it changes exactly one thing - where that knowledge comes from. The body is identical: same injuries, same rates, same treatments, same minigames. What goes is the free answer.

The chart stops being a readout

It becomes what a chart is in life: a form you fill in. A part nobody has examined reads as a blank. Not zero, not healthy - blank.

The difference between "I know there is nothing there" and "I did not look" is the whole of this mode. In arcade that difference does not exist, because there everything is known at once.

Why this became possible now

Because the instruments were already built, one version at a time, on a principle written into their own javadoc: the reward is a fact, not a repair.

A pulse is a fact about a body - fast and thready on somebody with nothing showing is internal bleeding. Asking where it hurts is the only channel that comes out of a patient, the only one that stops when they do, and the only one that can lie. Asking for a number out of ten is an opinion, and an opiate lowers it. Pressing on a burn is a finding that is an absence: the patch that does not answer is through the skin. A thermometer is a figure off an instrument. An X-ray is the only certain answer about bone.

Eight versions of building ways to find out what the chart was giving away. This mode is switching the chart off and leaving those.

What is plain

Whatever anybody walking into the room would see, in either difficulty: blood and how hard it is coming, a dressing, a strap, a splint, a limb that is not there, a prosthetic, a burn on the skin, a displaced fracture, an open one, a limb gone black to necrosis.

The rule behind that list is one question asked of each fact: would somebody know this without doing anything? A missing arm, yes. A leg lying at an angle it does not bend at, yes. Two cracked ribs under unbroken skin, no - and that "no" is the mode.

And the rule that matters more: it never hides what is plain. A black limb, a bone through skin and blood coming out of somebody are facts about the world rather than entries on a form, and a difficulty setting that pretended otherwise would be a difficulty setting about lying to people.

Feeling for a break

A new action, and the answer to the question the mode is built around. A bone out of line can be seen across a room; a bone that broke and stayed put leaves nothing on the outside, and there are exactly two ways to find one: a film, or a hand.

Three places along the bone, one press each, and the whole skill is how hard. Lighter and the hand is on skin and learns nothing. Harder and you have hurt them for nothing - and on a break that is still fresh, a press like that moves it, turning a bone that would have healed straight into one that has to be pulled back into line first. Between the two there is a band, and hitting it three times running is what an examination is.

It is the first reading here the patient pays for. A pulse costs them nothing and a question costs them nothing; this is pressure on something already broken. The examination can cost more than the finding is worth, and knowing when that is true is the skill.

On yourself it is worth less. Your own hand stops early, every time, and that is not cowardice - it is why this is a job for somebody else's hands.

The stethoscope

A new item, and the only finding in the mod with no free way in at all.

Everything else has one: a limb is a shape, a burn is on the skin, a bone grates under a hand, blood that has gone somewhere drives a pulse two fingers can find. A collapsed lung gives you none of that. The chest looks like a chest, and what the patient says - I cannot breathe - is the same sentence they say with a mouthful of blood.

Four places, a second at each, and hold the bell still. The finding has the same shape as the burn press: an absence. Air moving on both sides, or air moving on one.

What writes itself down

The instruments that were already here now remember. A film closes every bone and every piece of metal in one go, which is what the machine is worth its weight for. Pressing a burn closes its depth. An operation closes what it exposed. Hands that have been inside a part know what is inside it.

And a finding goes stale. It carries a time - the part tooltip says how long ago somebody felt along it - and a blow to a part erases everything known about it. The leg somebody examined two minutes ago and found sound is not the leg that has just fallen off a cliff.

Looking somebody over

Realistic had a hole in the middle of its loop and it was mine: standing over somebody you have seven parts and one way to ask about each, so the honest play is seven palpations in a row. That is not thoroughness. It is four minutes of pressing on a person who is bleeding, and no medic has ever worked that way.

The first thing anybody does to a casualty is go over all of them at once and find out where rather than what. Now that exists, and the mod finally does the thing it is named after.

One pass tells you how bad each part is - exactly what looking at somebody tells you. It does not tell you why: a leg in a bad way could be a break, a bleed, a burn under the cloth or a limb that died under a strap. That is the work the hands and the instruments do, and it starts after this.

The whole game is pace. A band moves down at the speed this is done at and the job is to stay in it. Hurry and your hands go past the quiet leg - the one nobody is complaining about, which here as in life is the one that kills them an hour later. And the mod says so: your hands went past something. You do not know what.

One sweep turns seven questions into one.

And two more effects

Listing onto the good leg. The only thing on this screen with a side to it. Everything else is a state - how much blood, how hot, how tired - and a state has no direction. A body that leans is naming the leg it will not stand on. In realistic that is a finding arriving through the floor instead of through a form, and it is the only one that does.

Grey on standing up. The only effect here about a transition rather than a state, and the one everybody has had: blood that was level with your head a second ago is now a foot and a half below it, and a body short of it cannot catch up. Stand from lying or from a crouch while you are down on volume and the world goes grey and narrow for a second or two.

Five more things you can see from inside

In arcade they are illustration. In realistic they are the channel: a person feels themselves rather than reading themselves, and this is what they feel with.

One rule for all five: an effect that does not mean a particular thing is decoration, and decoration on a screen somebody is trying to read a body through is worse than nothing.

Floaters. Specks at the edge of vision when blood is short or the head has taken something. The sign that arrives before the walls close in - by the time the tunnel is obvious the decision has been made for you, and this turns up while there is still a decision. Anybody who has stood up too fast knows what it means without being told.

The chest. Two bands, top and bottom, closing and opening on the breath - at the rate the mod already works out for that chest. Not a speed of its own: an effect running at its own pace is an effect that disagrees with the readout beside it, and nine versions have gone into making those agree. A collapsed lung, smoke, a wrecked ribcage: the bands barely open.

Blood in the eye. Not a tint and not a vignette. It runs from above, goes where the shape of a face sends it, and dries rather than fading. The only injury here whose first cost is that the person it happened to cannot see what they are doing about it. A dressing clears it; nothing else does.

Shivering in bursts. Cold used to be a constant tremble. Now it is a run of it, a pause, another run. Inside a burst it is as fast and as regular as it was - that part was right - but a body that shivered without stopping is a body with nothing left to shiver with.

The head going. What a rattled head does that a slow drift does not: it goes, suddenly, and comes back. Rare, short and sharp - once every twenty-odd seconds - and the lesson is the right one: stop moving for a second rather than fight it. The drift alone never taught that.

Three complications, and none of them another fever

There were twenty-two illnesses already, so the bar for a twenty-third is not "one more thing that makes you hot". Each of these three has a shape none of the others has: its own cause, its own way of being found, its own answer. And two of them are caused by treatment rather than by dirt - an injury the medic made is the only kind that makes somebody read their own last decision again.

Lockjaw. The only thing in this mod that cares what shape a wound is. A gash left to go bad goes septic; that was already true. A deep narrow hole from an arrow or a fragment, closed over dirt by a dressing, does something else. It is silent, and it is silent for exactly as long as it is treatable; when the silence ends, a course stops working, for good. The one tell in all that time is not a reading and not an instrument - it is a sentence: ask the patient, and somebody whose jaw is stiffening answers slowly. No tool in this mod finds it. A medic who never talks to anybody never sees it at all.

And when the silence ends: spasms. A spasm interrupts a treatment from the inside, and it is the only thing here that does - everything else that knocks hands off somebody is somebody hitting them. A patient nobody can finish working on is a new problem, and it is the correct one.

Crush injury. The most purely medic-made injury here, and the only one caused by doing the right thing too late. A limb with nothing going through it fills up with what a living limb flushes away, and the moment the strap comes off, all of it reaches the heart at once.

Not an argument for leaving the strap on - that kills the limb. Not an argument for taking it off faster either. It is an argument for fluid first: a patient who is not short of volume takes what comes back diluted, and nothing happens. The same bag of saline, hung before rather than after - and it is the only place in this mod where an infusion is something you set up in advance.

Relapsing fever. One bottle is one dose, and a dose is not a course. Sometimes the fever lifts, the patient gets up, and it is back in waves a few minutes later. What makes it worth having is what it does to the instrument: a fever that cycles is normal at the bottom of its cycle. A reading taken then is honest, accurate, and says there is nothing wrong. Nothing else in this mod can be right and wrong at the same time. Measure twice, ten seconds apart.

The colour of a person

Every finding in this mod is fetched: walk over, kneel down, put something on somebody. The two a real medic uses before any of that, this mod has never had - the colour of the skin and the colour of the lips. Both are visible from the other side of a room, before anybody has been asked anything.

Now they are on the model. White is volume. Blue is air. They cannot be confused with each other, they are never the same emergency, and they want opposite things done first. In realistic they are the only two facts a medic gets for free - and that is enough to know who in a room to go to first.

The room going quiet

Every symptom until now has been something to look at. Hearing in this mod did one job - being blown up - and because of that, the most reliably reported sign in all of first aid went unbuilt: the sound going away.

Ask anybody who has fainted what happened first. Not "my vision narrowed". "The voices went far away."

It is also the only symptom here in a channel of its own. By the time somebody is that far gone the screen is already full - the edges are in, the specks are up, the grey is over all of it - and a player who has stopped reading the picture will still notice the world go quiet.

Sweat that gets into your eye

A fever does not put droplets on the inside of your eyes, and nobody has ever seen their own face; beads on the screen would be a film effect rather than a symptom. What a hot person actually gets is the one thing sweat does to the person producing it: it runs down, it arrives in an eye, and it stings. For a second they squint, and for that second they cannot see what they are doing.

Which is exactly where a symptom in this mod is supposed to land: it tells you nothing, it takes something away, and what it takes is what somebody tying a knot in a bandage needs.

A weapon that stayed in

There was a line in a comment in this mod: only arrows lodge, and "a sword does not stay in anybody". That is true of ninety-nine swings out of a hundred and false of the hundredth - and the hundredth is worth more than the rest put together, because three things happen at once that happen nowhere else here.

The thing in the wound is holding the wound shut. Not a figure of speech: the wound is not bleeding because the thing that made it is still in the hole. The bleeding in that part stops, which reads exactly as wrong as it should. Nothing can be bandaged over it, nothing clots around it, the part will not mend. So the injury is the removal, and that is the whole decision: hands now, or a kit in a minute. Hands leave the worst bleed in the mod. A kit leaves one a dressing answers. You are asked at the worst possible moment, every time.

It is also the one piece of first aid everybody has heard and nobody believes: do not pull it out.

Whoever swung it does not have it any more. The only disarm in the mod, and it happens to the winner of the exchange. A zombie with an iron sword can be taken apart by one unlucky swing. So can a player.

And you can see it from the other side of a field. Every other free finding here is a colour or a posture. This one is an object, standing out of somebody who is still walking around. Nobody has to be taught what it means.

The odds are long and it needs a heavy blow, so armour mostly prevents it and no armour mostly does not. Every step moves it; sprinting costs four times as much. And the X-ray finally does the thing X-rays were invented for, and says: metal, and a great deal of it.

To see it without waiting for the hundredth swing: /triage blade <part> puts whatever is in your hand into it.

A chest you can hear

The mod has spent ten versions making a chest worth reading and never once made one worth hearing. The first thing that happens when you kneel next to somebody is that you can hear them.

Now a chest that is working badly makes the noise it makes. Quietly, at about a body length, which is the range at which it is true. What you hear is only that something is wrong - never the rate, never the cause. A wet chest, a chest that cannot finish a breath and a chest working far too hard all sound different.

This does not devalue the stethoscope; it promotes it. The instrument stops being how you find out a chest is bad and becomes how you find out which bad it is, which is what a stethoscope is for.

And the worst case makes no sound at all. That is not a gap: a chest that has stopped is silent, and somebody who has learned to listen for the noise will one day notice it missing.

A patient who will not hold still

Everything that could stop an operation came from outside the room: somebody hits the medic and the screen closes. The patient - the only person present with an opinion about what is being done to them - has never once objected. Awake. With nothing in them. With a saw against their leg.

That one unwritten line quietly made three of this mod's own systems decorative. Ether existed and nobody needed it. A second pair of hands existed and did nothing a first pair could not. Painkillers were for the patient's comfort, and a patient's comfort is not something a game can make anybody care about.

Now they pull away, and all three became the difference between a job that finishes and a job that does not - without any of the three being changed.

Only on jobs that open skin, and scaled by how much pain they are actually in. Ether, a dose, or a second pair of hands, and it never happens. Nothing is spent when it does: what it costs is the time, and the walk back for whichever of the three you did not bother with.

How it is built, and why that way

The server keeps the truth and sends the client a body with everything unestablished taken out of it. Otherwise the mode is worth exactly what a modified client says it is worth.

What is taken out is replaced by the value that means nothing is wrong, never by a sentinel. That matters more than it looks: any drawing code that forgets to ask whether a fact is known draws a healthy body. Which is wrong, and safe. Only the chart can tell "no breaks" from "nobody looked", because the findings travel beside the body.

Findings live on the patient, not on whoever found them. That is how a chart works: it travels with the person, and the medic who arrives second reads what the first one wrote.

Your own body is never redacted, and that is not an oversight. The symptoms, the ringing, the leg that will not take weight all read that body, and taking away what a person feels is not what this mode is about. Your own chart simply prints something else: how bad each part is and how much blood you have left stay, and a cracked rib stays a chest that hurts until somebody puts their hands on it.

Arcade did not change

Not one line. The new action and the new instrument exist there too - you can feel along a bone in arcade, and somebody will, because that is what hands are for - but what they learn is what the chart already said. That is the only difference, and it runs one way.