First Aid Revamp

[boshmi]

I couldn't think of a god introduction so let's get right on into it!

While patching myself up from a wolf attack ingame a few days ago, I decided upon the conclusion that the first aid system needs to be more horrible and brutal. When playing the game, I'll oftimes keep a first aid kit stocked with ~10 antibiotics, ~10 Painkillers, a bottle of HPO, 5 bandages, and one or two Old Man's Beard bandages, depending on my resources. This is usually so adequate that I am never in any danger of running out of first aid supplies, and only takes up about 5kgs in my inventory. So I came upon the conclusion that this needs to get more horrible.

My Suggestions

- First, make the requirements for patching yourself up in any case, harder to obtain. Make rest times longer, make pills rarer, give disinfectant a possibility to be dodgy. Bear attacks need to f*ck you up more. After getting mauled by a 110kg killing machine, the course of action should not be; splash some disinfectant on your wounds, bandage them up, sleep for five hours, and be in prime condition. (I'm sure you've all seen the revenant.) Similarly with wolves. Splash on some disinfectant, get bandaged, and you're a-okay. It's also a little OP that the wolf you shanked twice with your knife just dies a few hours later. This would be acceptable if your character went for the throat, but that would just instantly kill the wolf, and I don't think that's what they actually do in the animation. For bears, recuperation should take three days, possibly two at the very least. You need to use up to four bandages, depending on the size of the bear. Disinfectant must be applied instantly, and in generous amounts (.30-.40L), and then you need to do the resting. While you are resting, you have a capped tiredness bar at 50%, and the affliction "major wounds" which requires you to crawl everywhere you go, unable to sprint, or walk. This affliction is present from the moment of mauling, and would be real killer. To balance it out a little, I think you should only drop to 10% condition after a bear attack, but it drops quick. This would really emulate the horror and seer savagery of a bear attack. There should also be a chance where the bear just kills you outright, with no chance for escape, as it tears your guts out and you hear your final screams of agonizing pain.

Wolves would be a lighter version of this, dropping you to about 50% condition, stopping you from sprinting with the affliction "Bad wounds" (depending on your ability to fight them off) and requiring you to rest for 12 hours with capped rest at 75% (again, depending on you ability to fight them off). There could also be a chance that a wolf will pull a "hit and run" attack, in which it latches onto your hand, and you must click to pull it off. In this case, you only get the affliction "lacerations" but you are unable to do damage to the wolf in the struggle. In order to make these viable options, during the time that you have the afflictions "Bad wounds" or "Major wounds" there is no sleep limit, meaning you don't need to pass time.

- I have an idea for a "dire" system, where the first aid options are all there like normal, however when you may not have the medicine available. (Assuming that medicine is far rarer and the cost of patching yourself up is far more), you have the option of carrying out a "dire" solution, meaning that there is an alternative, however it is normally (as the name suggests) horrifying and gives the player caps which are often permanent. For example, you could have an infection spreading on your arm, and as it begins to reach the shoulder, the first aid system will tell you this, and rather than get a disease which you cannot treat, and because you have no disinfectant, there is the option to amputate your arm. This would give a permanent cap of only being able to use one handed weapons, such as the flare gun or revolver, and it takes longer to do every action. This is applicable to a few afflictions, such as the upcoming "frostbite"

- Individual body part damage is something I would like to see. It's not high up on the list, and I don't know if it would really work, but you could take damage to your arms, torso, legs, and head as separate entities, and having different condition per each body part. E.g, if you begin starving, you get a condition loss on your torso, as your body's fat reserves are consumed. You get a "Starved" affliction, which caps your rest at 25% and is only cured by eating fatty foods such as steak, peanut butter, etc, until you calorie count is above 2000. Similarly, you could get an obese affliction from a calorie count of +4000 which caps your rest at 75%, until it is solved by dropping your calorie count below the 3000-3500 mark.

I have few other ideas, but this post is already really long, so I might save them for later. Thanks for reading my absurdly long post, and I hope you enjoyed it.

[ShawnB]

I agree the first aid system is OP and wounds are not severe enough. I like some of the ideas above. In essence a wolf or bear attack should significantly alter gameplay for 1-4 weeks. Enough time for you to eat through lots of your supplies while doing much forced rest. This will eventually force you to explore and scavenge while you are injured. Add in some tweeted physical handicap that last this 1-4 week period and there you go.

[Pillock]

Amputate your own arm? You call the solution "dire" - take the 'r' away, and you've got it just right.

[Scyzara]

Hm, quite a difficult topic to talk about as injuries, condition recovery rate and the damage caused by wildlife have a great impact on the game's overall difficulty.

While I agree that the current first aid mechanics might certainly benefit from some tweaks, I'm rather opposed to extremely prolongued recovery times or extremely increased amounts of damage done by wildlife. Not because I worry about myself (I personally wouldn't mind a TLD hard as hell that might kill even the most experiences players within a few weeks^^), but because I don't think the majority of players would find it enjoyable to (nonstop) die within days.

Average Joe (or Joanne^^) is probably getting jumped by wolves at least every second day, just imagine what a mess it would be for them if they lost 70% health during an average attack and only recovered 10% health per day. I guess the forums would be flooded by complaints about such mechanics because they'd probably make the game pretty much unplayable for a considerable percentage of players.

I thus believe it's extremely important that possible tweaks of the first aid mechanics need to be mode-dependant.

Here's what I personally would suggest as first aid tweaks:

For Pilgrim, the current mechanics are probably working quite well. Maybe some very mild forms of cabin fever and parasites might be added in this mode just to give new players the possibility to get to know these mechanics before they move on to Voyageur. Pilgrim parasites and cabin fever shouldn't have any punishing or lethal consequences of course. They should require a shorter treatment period than their counterparts in Voyageur and possibly even heal by themselves after a while if the player just ignores them.

Regarding Voyageur, I would also suggest to keep the current mechanics. People often post feedback here on the forums, that the difference in difficulty between Pilgrim and Voyageur feels very distinct and I thus don't believe it makes much sense to widen this difficulty gap further. It might be an idea to slightly decrease condition recovery in Voyageur(e.g. max 40% per day), but only in combination with a less aggressive wolf behavior. If for example 50% of the wolves just ran away like in Pilgrim by default, people would probably be able to cope with decreased condition recovery rates.

Stalker is actually the only mode where I personally would love to see bigger changes because this mode is meant for experienced players who seek a challenging and unforgiving experience. But even here one has to keep in mind that the game needs to stay playable (and enjoyable) not only for the top 5% of the most "skilled" Stalker players, but for the majority of people who currently enjoy Stalker mode. My personal suggestions would thus be: 

A) removal of stimpaks from the random loot table of first aid kits and having a fixed small number of stimpaks (e.g. 1 per map) at randomized spawn locations instead

B) a condition recovery cap of 25% per day which can be extended to 33% per day by drinking herbal tea

C) a slightly increased (+20%) damage done by wolves compensated by decreased overall wolf numbers

D) a greatly increased (+60%) damage done by wolves if you fight them naked

E) healing sprained ankles/wrists might require both painkillers AND 10 hours of sleep (or alternatively no painkillers and 20 hours of sleep)

F) birch bark tea as a cure for parasites to encourage outdoor activities (birch bark collection trips to birch forests)

and last, but not least

G) the introduction of a few long-term-ailments like e.g. a partially fractured rib, leg or arm.

Long-term ailments should only occur when players somehow really screwed up and e.g. fell from a high cliff or got mauled by a bear. Their cure should take two or three weeks and weaken the player considerably, e.g. by decreasing the maximum condition to 70 or 80% (like it's already the case with parasites).

Long-term ailments might also drastically decrease the player's movement speed (partially fractured leg), carrying capacity & stamina (partially fractured rib) or prevent the use of most tools (partially fractured arm). Unless you're well prepared and have a full storage of food, fuel and water, long-term ailments should be severe enough to kill you. While suffering from long-term ailments, the player would be immune to cabin fever ofc.

I'm rather opposed to bears instantly killing players (they're supposed to be black bears, not grizzlies or polar bears), hence I would rather prefer to possibly die due to the long-term effects of a bear attack and not due to the attack itself.

Apart from that I agree with @Pillock that amputating your own arm is pretty much impossible. You would probably pass out because of the pain and bleed to death afterwards.

 

Sorry for the wall of text, I guess I better stop writing now. 

[hauteecolerider]

7 hours ago, boshmi said:

It's also a little OP that the wolf you shanked twice with your knife just dies a few hours later. This would be acceptable if your character went for the throat, but that would just instantly kill the wolf, and I don't think that's what they actually do in the animation.

I disagree. Depends on where that blade goes.

A single stab with a decent blade into the thorax (chest) is nearly always fatal. Why? Pneumothorax if high up, liver hemorrhage if low enough. Both are fatal within hours. 

As a seven year veteran of animal emergency clinics, I've seen how small wounds can lead to death if not taken seriously enough. Puncture wounds (i.e. those inflicted by "shanking" as @boshmi says) are the worst.

To someone like me, in a situation like that, I'd go for the liver. Easier target (as opposed to heart, throat or even armpit) on a moving animal, and massive hemorrhage leading to death within minutes if not hours. All that blood just goes into the abdomen and stays there, unless you gash it open.

I do find myself wishing for Pilgrim animal behavior with Voyager difficulty. Yet I understand this game is for a wide selection of people, and not everyone likes the really graphic elements as those described above. And as @Scyzara says, ramping up the difficulty with the first aid/recovery as @boshmi describes will only push more people away. Already there are many players who try it out, then give up after failing to survive a single day. One single day. That tells me there are many who think the game is already too hard. Or too boring (no zombies, after all, and minimal weapons).

[Aelaera]

I would enjoy a more severe injury system, but in turn we need to be less likely to be attacked. As @Scyzara said, being attacked by wolves so frequently would lead to a frustrating experience for someone who has first turned on the game. If we had a way to prevent attacks (except in our own stupidity or lack of awareness, or sometimes just a bad roll of RNG) such as intimidating a wolf into backing down then I would be all for severe wounding. But I agree, bear injuries are currently way too easy to handle. An experienced, well stocked player can easily exploit the current bear attack mechanic (especially in Pleasant Valley) to gain a bearskin bedroll. I did such a thing on one of my runs, where I loaded several bullets into the bear, was mauled, immediately treated myself and then finished the job on the bear. I never dropped below 9% condition, because I had a nearby fire and bedroll, so I immediately went to sleep and returned home several hours later armed to the teeth with bear meat, fur and guts with around 65% condition. A bear attack should be one of the biggest dangers to a run and I feel like right now it's not devastating enough. 

[cekivi]

In my opinion some tweaking would be nice for first aid but it does work. As a long time Voyager player the quest for supplies when I didn't know what I was doing was always tense and wolf attacks were terrifying. I may play mainly Stalker and the Challenges now but Voyager is already in a good zone difficulty wise to not need additional complications. I am also absolutely against any death that's purely random. You have to always have choice (or at least the illusion of choice). It's one thing to say "I messed up, I can do better" versus "what the hell? I just died and there was nothing I could do! This game sucks". For bears it's still far to easy to walk up on them without seeing them until the last minute especially if you don't know where the dens are.

What I would like to see for additional depth:

1. Birch bark tea for parasites
2. Wounds that require stitches
3. Wounds that require rehabilitation to fully treat. E.g. you can have a light sprain, a severe sprain or a regular sprain. You can still run on light or regular but it risks giving a severe sprain where you can barely walk. A light sprain would heal just by not running for a few days (e.g. rest not necessary). Running - even with painkillers - damages you more so the rehabilitation time would be longer.
4. Slower condition recovery
5. Actual health penalties for starvation

 

[boshmi]

7 hours ago, Scyzara said:

Not because I worry about myself (I personally wouldn't mind a TLD hard as hell that might kill even the most experiences players within a few weeks^^), but because I don't think the majority of players would find it enjoyable to (nonstop) die within days.

Average Joe (or Joanne^^) is probably getting jumped by wolves at least every second day, just imagine what a mess it would be for them if they lost 70% health during an average attack and only recovered 10% health per day.

G) the introduction of a few long-term-ailments like e.g. a partially fractured rib, leg or arm.

Long-term ailments should only occur when players somehow really screwed up and e.g. fell from a high cliff or got mauled by a bear. Their cure should take two or three weeks and weaken the player considerably, e.g. by decreasing the maximum condition to 70 or 80% (like it's already the case with parasites).

I'm rather opposed to bears instantly killing players (they're supposed to be black bears, not grizzlies or polar bears), hence I would rather prefer to possibly die due to the long-term effects of a bear attack and not due to the attack itself.

Apart from that I agree with @Pillock that amputating your own arm is pretty much impossible. You would probably pass out because of the pain and bleed to death afterwards.

 

5 hours ago, hauteecolerider said:

As a seven year veteran of animal emergency clinics, I've seen how small wounds can lead to death if not taken seriously enough. Puncture wounds (i.e. those inflicted by "shanking" as @boshmi says) are the worst.

To someone like me, in a situation like that, I'd go for the liver. Easier target (as opposed to heart, throat or even armpit) on a moving animal, and massive hemorrhage leading to death within minutes if not hours. All that blood just goes into the abdomen and stays there, unless you gash it open.

 

53 minutes ago, cekivi said:

In my opinion some tweaking would be nice for first aid but it does work. As a long time Voyager player the quest for supplies when I didn't know what I was doing was always tense and wolf attacks were terrifying. I may play mainly Stalker and the Challenges now but Voyager is already in a good zone difficulty wise to not need additional complications. I am also absolutely against any death that's purely random. You have to always have choice (or at least the illusion of choice). It's one thing to say "I messed up, I can do better" versus "what the hell? I just died and there was nothing I could do! This game sucks". For bears it's still far to easy to walk up on them without seeing Birch bark tea for parasites

1. Wounds that require stitches
2. Wounds that require rehabilitation to fully treat. E.g. you can have a light sprain, a severe sprain or a regular sprain. You can still run on light or regular but it risks giving a severe sprain where you can barely walk. A light sprain would heal just by not running for a few days (e.g. rest not necessary). Running - even with painkillers - damages you more so the rehabilitation time would be longer.
3. Slower condition recovery
4. Actual health penalties for starvation

 

Thanks all for your comments! I don't have much time at the moment so I've just selected the few that stood out to me the most and made responses. Hopefully I can get around to everyone eventually

Scyzara
Yeah, I kinda meant these for higher difficulties though, players who want a challenge. The chief reason I dislike stalker is the wolf spam breaks the immersion harder than a toddler breaks a crunchie bar (I speak from experience, in both cases XD). I enjoy the "Long Distance" travel in this game more than anything else, and the sensation wandering beneath birch trees crunching footprints in the snow is kinda ruined when you've got a wolf running up to you and two more on the horizon. You could apply some of my higher difficulty suggestions to stalker mode, but reduce the number of wolves to both improve the immersion and the first aid.

The roadmap says that grizzlies are on the list, and if a black bear can take you down to 4% I'm assuming grizzly bears could do worse. (projecting roadmap hype)

The thing about fractures and major injuries is something I wanted to address in my original post, yet ran out of time. Giving a similar trait to my suggested "major wounds" aliment. Two or three weeks (while realistic, and in fact a bit lenient) might not work so well as a gameplay feature, which is why I suggested 127 hours (five days) but who knows? It could work.

I've thought about it some and figured amputations are a little overboard, but I feel like there should be some aliments which leave permanent handicaps.

hauteecolerider
Wow, I didn't even think about liver. In the animation (I checked yesterday) it appears as though the character goes for the upper neck with the knife, but I have yet to check with the hatchet.

ceviki
Oh yeah, bears need a buff. Personally I wouldn't mind if bear attacks could kill you outright, but maybe some do mind. I agree with all your points, especially stitches. Sewing kit comes in handy for something rather than clothing!

[cekivi]

1 hour ago, boshmi said:

I've thought about it some and figured amputations are a little overboard, but I feel like there should be some aliments which leave permanent handicaps.

 

An improperly set broken leg would definitely give you a permanent handicap. You'd limp for the rest of your life.

[Aelaera]

2 hours ago, cekivi said:

An improperly set broken leg would definitely give you a permanent handicap. You'd limp for the rest of your life.

On the topic of permanent handicaps, its an option I wouldn't mind seeing implemented into later versions of the game, particularly in hard difficulties. You would always have an option to do something the "right" way, which may be more time consuming (such as properly setting a broken leg- since for the sake of not being incredibly boring, we won't argue that our character isn't capable of setting a broken leg right), which would take lets say four in-game hours, or continuing to walk on it with a gradual condition loss. Continuing to walk on it could increase the chance of a handicap forming (say at a rate of 5/10/15% each in-game hour) that would affect that character for the remainder of the sandbox run. I would say that this should only be an optional feature, or a feature exclusive to Stalker difficulty, as I know for a new player, who isn't aware of this system, or maybe doesn't realize the severity of it, the inability to ever run again would be frustrating, but I'm sure I'm not alone in terms of not minding added difficulty to the current game mode. 

[Sly]

Good post, respected @boshmi, the topic starter!

I concur, that it is to simple just to have one bandage or 1 small portion of disinfectant etc to fix the damage of wolf/bear attack.

It is good to have more elaborate system with more afflictions like: wound, deep wound, bad wound, bleeding wound, infected wound, bleeding, severe bleeding, blood loss with grades (light-mild-severe) that occurs after severe bleeding and/or after not stopped in time simple bleeding, fever, sepsis and some more.  Lets say, after suffering some major harm was inflicted to survivor, 1 bandage could be good enough to decrease the tempo of blood loss essentially (to give player opportunity to get to his base/some safe place to attend his wound - it is better to be done not in field, the frost and the wind could kill weakened person easily). But then more things must be done: cleaning wounds: disinfectant, sewing deep wounds (if any): sewing kit+more disinfectant, dressing wounds: bandages 1-2-3-4..., taking antibiotics (almost obligatory) once/several times, long rest for 2-3-4 days. 

Surviving the wild animal attack should be much harder then it is now. 

And fighting the wolf naked should be punished with so many afflictions that must result in death before something could be done! Multiple wounds, multiple bleeding, multiple mutilations (damaged gut, neck, big blood vessels etc). When well clothed - just ripped clothing + some minor damages like lacerations and minor wound/wounds. So some bandages + disinfectant + antibiotic + some rest (8-12-24 hours).

On 5/12/2016 at 5:42 PM, Scyzara said:

I'm rather opposed to bears instantly killing players (they're supposed to be black bears, not grizzlies or polar bears), hence I would rather prefer to possibly die due to the long-term effects of a bear attack and not due to the attack itself.

I`m rather for this. Fear the mighty Bear. Avoid the mighty Bear, even it is "little black one". It is just the way the life is. Or you or avoid the bear, or kill it, or it kills you. Not 100%, but probable enough not to try. 

On 5/12/2016 at 0:39 PM, boshmi said:

t's also a little OP that the wolf you shanked twice with your knife just dies a few hours later.

Oh, how I want to wildlife could sometimes recover from damage caused bu Survivor!!! Very much! Please, please...

On 5/12/2016 at 5:42 PM, Scyzara said:

Apart from that I agree with @Pillock that amputating your own arm is pretty much impossible. You would probably pass out because of the pain and bleed to death afterwards.

Amputation performed on ones self is possible when the limb is almost torn apart. In other cases it is really hard imaginable. Nevertheless I believe, there is proven case that one women performed Cesarean section on herself somewhere in the wilderness!!! 

https://en.wikipedia.org/wiki/Self-inflicted_caesarean_section 

The self-performed amputation of the leg seems even more doable.

Amputation of you own arm is pretty much impossible, as you said. Maybe not because passing out from the pain, but rather of technical difficulties. 

[sir ice]

I'm having trouble with the resting times actually. I think they are too long, but pain killers should be rarer. So should the anti-bacterial juice. If I had to amputate my arm I would just restart my game. I can't use a weapon.

[Shyassasain]

If possible I'd like to see scars and maybe more significant permanent body damage. Getting tossed about by a bear would probably give you a few broken bones, dislocated limbs, scars and not to mention internal organ damage. Plus it'd be cool seeing your character get more grizzled and scarred over the months or years. As for handicaps like your hands or legs needing to be lopped off... I don't really know how that'd be handled, cool a feature though it would be, trudging through the snow with a peg leg doesn't seem at all easy. Loading a rifle with only 1 hand would take a while too. 

[Dirmagnos]

22 hours ago, Sly said:

Good post, respected @boshmi, the topic starter!

I concur, that it is to simple just to have one bandage or 1 small portion of disinfectant etc to fix the damage of wolf/bear attack.

It is good to have more elaborate system with more afflictions like: wound, deep wound, bad wound, bleeding wound, infected wound, bleeding, severe bleeding, blood loss with grades (light-mild-severe) that occurs after severe bleeding and/or after not stopped in time simple bleeding, fever, sepsis and some more.  Lets say, after suffering some major harm was inflicted to survivor, 1 bandage could be good enough to decrease the tempo of blood loss essentially (to give player opportunity to get to his base/some safe place to attend his wound - it is better to be done not in field, the frost and the wind could kill weakened person easily). But then more things must be done: cleaning wounds: disinfectant, sewing deep wounds (if any): sewing kit+more disinfectant, dressing wounds: bandages 1-2-3-4..., taking antibiotics (almost obligatory) once/several times, long rest for 2-3-4 days. 

Surviving the wild animal attack should be much harder then it is now. 

And fighting the wolf naked should be punished with so many afflictions that must result in death before something could be done! Multiple wounds, multiple bleeding, multiple mutilations (damaged gut, neck, big blood vessels etc). When well clothed - just ripped clothing + some minor damages like lacerations and minor wound/wounds. So some bandages + disinfectant + antibiotic + some rest (8-12-24 hours).

I`m rather for this. Fear the mighty Bear. Avoid the mighty Bear, even it is "little black one". It is just the way the life is. Or you or avoid the bear, or kill it, or it kills you. Not 100%, but probable enough not to try. 

Oh, how I want to wildlife could sometimes recover from damage caused bu Survivor!!! Very much! Please, please...

Amputation performed on ones self is possible when the limb is almost torn apart. In other cases it is really hard imaginable. Nevertheless I believe, there is proven case that one women performed Cesarean section on herself somewhere in the wilderness!!! 

https://en.wikipedia.org/wiki/Self-inflicted_caesarean_section 

The self-performed amputation of the leg seems even more doable.

Amputation of you own arm is pretty much impossible, as you said. Maybe not because passing out from the pain, but rather of technical difficulties. 

More and in-depth  medical system would be nice, as long s its not ever the top and properly balanced(also you dont use disinfectant and antibiotics in the same treatment, unless its warranted - more the merrier is a sure way to get yourself killed).

I do believe that surviving predator attacks should be a challenge. But it must also be counter-balanced by something positive coming out of it. Predators are already being screwed by parasites, while fishing and trapping have received several boosts over last several patches, hunting becomes more and more pointless.

And yes, bears should be a force to be reconed with, not this current ridiculous shit, when they deal percentage of player current condition, allowing surviving their attacks in 99% of cases.

Amputation, especially self-performed, id say player would have like 0.01% chance of surviving whole ordeal. Hed most likely pass out from shock and bleed out. Even if by some miracle he will survive whole process, there are just a ton of other conditions waiting to happen, sepsis being one of the first ones. Being or not able to hold a rifle would be quite irrelevant at this point.

[Sly]

14 hours ago, Dirmagnos said:

also you dont use disinfectant and antibiotics in the same treatment, unless its warranted - more the merrier is a sure way to get yourself killed

Sorry, are you mean the real life?

[cekivi]

Taking too many drugs when you don't need to can make you very sick although I don't know if it's necessarily fatal.

And there are proven cases where you can survive an arm amputation. There's 127 hours. However, again, that guy survived partly because he was eventually able to get to a hospital. If there are friendly NPCs in the game than I'd be much more willing to have these terrible afflictions in the game since you'd have a more realistic survival chance.

[miah999]

When it come to many of the extreme afflictions disused here I see three game development possibilities.

1: They add in extreme injuries, but take dramatic license with the treatment, in order to both balance the game, and prevent lengthy down time.

2: They add in extreme injuries, and try to create a realistic first-aid system, which will add complexity and increase the risk of game ending injuries.

3: They don't add any extreme injuries, but add more realistic first-aid, which adds complexity, without increasing the number of possible game ending injuries.

Honestly I don't see any of these possibilities furthering their goal of creating story mode, and some these will probably draw more complaints than praise.

[TROY]

@boshmi  While I agree that there are many things which could be reworked in the medical and injury aspects of this game, and I also agree that there are many things which could be added to it to increase overall game difficulty, I can say with confidence that I would not play this game if your system was adopted.