Part 14: 10: Caduceus
Chapter 2-10: Caduceus
Get ready for a whole lotta words in this chapter.
Hoffman: Please come in.
Kasal: Why don't you have a look at this examination report, first?
Derek: Who's this for?
Kasal: Linda Reid.
Derek: What do those headings mean? I don't recognize them. Positive Chiral reaction? GUILT: Positive... spectral analysis... G1-R?
Kasal: Those tests are beyond our capabilities, so we enlisted some help from an outside organization. In the last few years, a bizarre disease with varying symptoms has been reported in several isolated cases. The two things they had in common? Each victim's body turned against itself, and they all died.
Sounds like they just got sick. Certainly nothing like evil blue parasites in the lungs.
Kasal:Because of that, we believe each subject was infected with GUILT
Here are my best attempt for these words:
Gangliated means having ganglia, which are little densely-packed bundles of nerve cells.
Utrophin is a gene. It's a component of the cytoskeleton, which is like a regular skeleton but for your cells. A cell-aton!
Immuno is easy, it just means dealing with the immune system.
Latency is the stage where the virus is dormant.
Toxin, you probably know.
Put it all together and you get... something.
Derek: Then, you think Reid's illness was...
Hoffman: Exactly. Linda Reid is a GUILT victim. I'm surprised you were able to treat her without the proper resources.
Derek: It was a difficult operation, but I wanted to save her.
Hoffman: Well, that decision may have changed your life. The organization we mentioned before has requested that you join them.
Derek: What? Why me?
Hoffman: Your Healing Touch ability allowed you to successfully cure a GUILT victim.
But I didn't use-ah, hell. I broke the plot.
Derek: What organization is this, anyway?
Kasal: They're an arm of the World Health Organization that specializes in exterminating intractable diseases that threaten mankind. They're called Caduceus.
This organization is named for the staff of Hermes, often associated with medicine. As I said before, it actually has little or nothing to do with medicine, but is mistaken for the Rod of Asclepius.
Derek: I remember seeing them listed in essays on Cancer and AIDS treatment. Aren't they the ones who eradicated the TFTA influenza last year? Caduceus wants me?
I expected that TFTA was a real disease I just hadn't heard of, but a search turns up nothing.
Kasal: You've been offered the chance to work at the forefront of modern medicine.
Derek: Well, I mean, it's an honor. But, it's all so sudden. I'm not really sure what to do. I mean... it'd change my whole life.
Kasal: You don't need to decide right away. Just remember that this is a choice, not an order.
Hoffman: The only reason I'm telling you this is because an old friend asked me to. To be honest, I'm against you joining Caduceus.
Derek: What? Why?
Hoffman: I don't think a research laboratory is the right environment for you. Didn't you say you wanted to help patients, face-to-face?
Hoffman: You should probably see this, as well.
Derek: A letter?
Death is denied those who seek it, though it be their destiny. They search for it like treasure, but the modern age conceals it."
What's this supposed to mean?
Kyriaki is, as you'll see, the name of the GUILT strain Linda Reid had. It's also the Greek word for Sunday. Technically, it means "Lord's Day."
Hoffman: It arrived shortly after Linda Reid was hospitalized. We don't know who sent it. Supposedly, these letters arrive shortly before GUILT does.
Nice of you not to warn anyone, then.
Kasal: That means GUILT doesn't occur naturally, which means it could be some kind of man-made virus. The World Health Organization is considering it terrorist activity.
I know I've said this, but why must that be his response to EVERY SINGLE THING?
Kasal: Someone is creating GUILT and releasing it into society. We don't have any leads as to who, or why... almost as if it was meant to confuse us.
I'm thinking it probably was.
I think we already call that "bio-terrorism," but who am I to argue with the UN?
Kasal: Caduceus is anticipating a large-scale GUILT outbreak, and they need skilled doctors to be ready for it.
Hoffman: Hopefully now you understand the stakes involved in this. Think it over, don't make your decision lightly.
End of Chapter 2-10
Chapter 2-11: For the Greater Good
Note: In Under the Knife, this chapter was titled "For Everyone's Sake"
-Hope Hospital, Room 207-
Man: It just hurt so badly... I thought I was a goner.
Derek: Well, appendicitis is a fairly common condition, but congratulations on your recovery, Mr. Sasano.
Mr. Sasano: If my wife gets sick, I'll make sure you're the one operating on her!
Derek: Heh, well, it would probably be better if she didn't get sick at all.
Mr. Sasano: I guess that's true. Ha ha!
This is the full extent of his lines, but I'll show you the DS art for this guy anyway.
He's a bit younger-looking here, but that's all. He even has the same outfit.
Derek: (Talking with patients is one of my favorite parts of the job. Could I really leave that behind?)
Kasal: Derek, we'll be starting the operation briefing soon.
Sarah Chalke is the actor who plays Dr. Elliot Reid. That makes two references to the character in a row.
The mitral valve controls the blood flow between the upper and lower chambers of the left side of the heart. Mitral Valve Prolapse is when it can't close properly, and blood may flow back into the upper chamber (that's the "regurgitation" part.) Symptoms are actually often minor, but there is a risk of complications such as arrhythmia, or irregular heartbeat.
Kasal: Today, you'll be operating on Elisa Chalke, who's been in our pediatric ward.
Derek: She's a very young child with valvular heart disease.
Despite this, she actually weighs more than Linda Reid.
Kasal: It was a tough decision, but her parents finally decided to go ahead with the procedure. There is only one main objective in this operation:
-Replace a valve in her heart with a synthetic one.
You'll use a triple incision to excise the valve-cut three times. You'll need to be as cautious as possible, understand?
I think even Derek can guess that triple means three.
Kasal: Technology has made a lot of situations much easier for us, but heart surgery will always rely on a skillful doctor. Angie, keep an eye on the oscillograph to aid Dr. Stiles.
Angie: I understand.
Kasal: Don't let the gravity of this operation intimidate you. This conference is over. She's in your hands now, Derek.
After about a thousand years of talking, it's time for some more gameplay. Let's begin.
Angie: Be ready for the unexpected, just in case...
That was fast.
Angie: I'll attempt to stop the convulsions. 3...2...1...clear!
In UtK, Angie says this as she tries the defibrillator, and then you need to message the heart. In SO, she says it... and then makes you use the defibrillator. It's the kind of oddity that's bound to come about when you change the gameplay like that.
Angie warns that the patient may continue to go into convulsions. This means that every little while, you need to use the defibrillator again. It's a bit of a pain, especially since you'll get a miss if you try to do anything as it's happening. You also want to avoid having it happen too many times for a bonus. The solution is to work quickly, but there's a good workaround.
Use the Healing Touch, and you can easily finish without having to defibrillate after the first time.
To get rid of the valve, you first drain, and then do the triple incision. First is the left side, then the right, then the tissue itself. This translates to "do two circles around it."
With the old valve gone, you drain, place the new valve, and suture, as shown here. It's a very simple process, only complicated by the convulsions.
Angie: Now she can play outside with all of her friends.
Even with restoring vitals, I finished while still high on Asclepius.
Angie: Having someone cut open your chest is so unnatural, but something in that little heart refused to give up. Maybe it sounds silly, but I keep thinking about it. The human body is truly amazing.
If you missed the video, I mention in it that this is the last operation for the chapter. Sadly, it's pretty underwhelming for that milestone.
These are all straightforward.
[I]What the hell is wrong with her nose?
I mean, she looks the same except her nose is trying to escape through the mouth.
Derek: The operation was a success. She'll need about two months to fully recover before she can go back to school, but after that, she'll be good as new.
Mrs. Chalke: That's good news. Oh, thank you so much, Doctor.
Derek: People are always worried about heart surgery-especially on children. But, modern medicine allows us to treat such conditions with much greater success than ten, even just five years ago. Young patients like your daughter face very little risk of permanent physical damage. To be honest, I'm more worried about the psychological stress operations like this might have on small children. Please take good care of her during her recovery.
Mrs. Chalke: Oh, of course. Elisa... we love you so much...
"You have my condolences..."
"Mom, why are you crying? Dad's okay, right? He's... gonna get better, right!? B-but, why isn't Dad getting better? You can fix him! You just gotta! He's my dad!"
"I'm sorry, son. No doctor in the world could save your father from this."
Hoffman: So, you're willing to throw away your own happiness for this?
Derek: I know about what happened to you in the past. I know that having superior skills will only create more pressure to succeed. That everyone will expect me to have answers no one else has. I'm sure those are valid concerns. And, the path I've chosen will probably cause me a lot of pain. But I became a doctor so that no one would have to die from an incurable disease. Not ever again.
Derek: Diseases are painful. And, losing someone to a disease is even more painful. It's hard for doctors to tell people their loved ones can't be cured. I'm going to make sure they won't have to. Caduceus has already found ways to save thousands of people. If I can somehow help them find cures for "incurable diseases," then...
End of Chapter 2-11
That's the end of the longest chapter in the game. Next up, we visit Dr. Weaver for another operation, then it's on to chapter 3, where things get especially silly.