Part 24: Hope Hospital

Derek Stiles took his first steps here as a doctor... ...and has now unexpectedly returned.



but I never imagined that I'd find myself mentoring you again.
I-I know. Sorry to be such a burden.



With that in mind, we'll be going pretty hard on you. Think you can handle it, Derek?
Y-Yes...
Alright then, that's it for today. You'll be on extended active duty starting tomorrow, so you should get rested up.
I understand. Please excuse me. *leaves*
...What do you think?
It's worse than I thought... He doesn't even smile anymore. It's like he's a shell of his old self... ...He never used to be so uptight.

The game doesn't bother showing that using Derek's non-smiling portrait for this section

You're right. He's lost all of his composure. I guess that's why they sent him to us... By the way, have we made any progress in trying to get "her" here?
Actually, it looks like she'll be able to transfer here as early as next week. We didn't give her much notice, but she's gone to a lot of trouble to adjust her schedule.
Great, then we'll be able to put our master plan into action that much sooner. This isn't going to be easy... but we're going to make it work, no matter what.





A lot of slightly recolored sprites today.

*The patient leaves*

Phew... That's the last outpatient for today. It's hard to step backward into the role of apprentice... But it really does feel like those days when I first started working here.
...... I wonder how everyone at Caduceus is doing... Are they working like usual without me...?
*sigh* Of course they are. Who needs a doctor who's lost the Healing Touch...? Heck, I can't even do a routine operation. I'd be of no use if I was there...

That Costigar Fever can't be called a routine operation, really.

*Phone rings*

Hm, better get that. Yes, this is Dr. Stiles.
...What!? I'm... performing an operation!?



What are you doing here, Derek? You're supposed to be in the O.R. Stop wasting time and go get prepared.
W-Wait! I can't handle an operation right now...
Remember what I told you back then? A doctor has to cast aside his emotions during an operation. In there, you're just a doctor who saves patients. Nothing more, nothing less.

This was said when Greg got infected. The quote was originally about relationships, but emotions kinda works too.

B-But... that's just it. What if I can't save the patient?
Don't worry, "rookie." I'm assigning a veteran assistant to you.
...Huh?



...!
You need at least six hours! The patients depend on you!
Long time no see, Derek.
M-Mary!? Why are you here...!?
Well, I have my reasons.



She's the nurse in the first three operations in UtK/SO before getting replaced by Angie. She's also the character who suffers the most from the artstyle change from UtK.

By the way, that quote about sleeping is from the second chapter in those games. There's lots of throwbacks in this chapter.

Regardless, I'll be working here for at least a little while. So, let's do our best.
Y-Yes, of course!
Wait... then the veteran assistant you were talking about...
That's right, do you get it now? If there's nothing else, then go scrub up.
Come on, Derek. Let's go.
A-Alright...!



...Fuck you, game.

Your patient today is Mr. Saltman. He's a 52-year-old male suffering from cholelithiasis.
Cholelithiasis...

Cholelithiasis is the formation of gallstones.

If you just stay calm, Derek, this operation won't be difficult. Think back to when you first started operating... and concentrate.
I understand. I'll try.
Good. I'll explain the operation procedure then. Like I said, the patient suffers from gallbladder cholelithiasis. It's progressed quite a bit, so we'll have to extract his gallbladder. We have two objectives for this operation:

• Excise and extract the gallbladder.
  
• Fragment the gallstones.

Now, listen up. What's most important right now is precision, not speed. Put yourself in the patient's position and think each treatment through.

That applies more to UtK than this game. Speed is VERY EXTREMELY SUPREMELY important in this game. As we'll see in this operation.



Operation Video


Let's begin th operation. Do your best, Derek.
Y-Yes, ma'am. (Precision over speed... And more importantly... I need to focus solely on the operation!)

You can't see it just from the portrait, but Derek apparently changed clothes between the briefing and the operation.



There's an emulator graphical bug, but it's minor enough.

Gallstones are flowing out of the gallbladder. Keep in mind that the patient's vitals will drop if the stones pass through the entire bile duct. The gallstones can be detected with the ultrasound, so let's be as thorough as possible.



After detecting the stones with the ultrasound, we can shatter it with the laser. The laser won't have any effect if we didn't use the ultrasound.

The stones will move downwards and will tank our vitals if they manage to get offscreen. The timing is tight since the developers put the gallbladder in the middle of the screen instead of the top

Treatment complete. Let's begin extracting the gallbladder. First, inject the white sedative into the gallbladder.



This operation is similar to the one in NB, but there's a few key difference. For example, in this one we can see the stones before using the ultrasound. Also, the big stones takes longer to shatter, but they won't fragment into smaller stones.

Now we can extract it, but we can't cut it out all at once... So, we'll excise it in multiple segments. But don't forget about the gallstones, either.



So yeah, we have to cut the gallbladder while dealing with the gallstones.



Blood pools work kinda differently from usual. They won't cause another blood pool to appear next to them, but they will prevent any cutting even though they're nowhere near the cutting area.



If we take too long to cut after draining the blood pools, they will reform. Having those blood pools form (including the initial wave) will also tank our vitals, so make sure to watch out for it.

I don't know for sure, but it feels like the more section we cut, the faster the stones will appear. So make sure to get vitals to maximum before cutting this one.



The final one has three blood pools. We need to drain all three at once to be able to do any significant cutting. Don't forget about the stones, though, as you won't be able to keep up if the vitals are too low.

The stones feels like they come too fast. I suggest to drain the blood pools right after shattering a small stone. Don't bother doing it if you just shatter a big stone; there won't be enough time to both shatter the next stone and cut the gallbladder.



Even then, you'll probably still need two sessions to fully cut it. And there might be close calls like this one. This is by far the hardest part of the operation. We REALLY need to be speedy to be able to do this operation.

This would be a perfect time to use the Healing Touch. You know, if we're able to. Full disclosure: I wasn't able to finish this operation on Hard until literally a few days ago.



After cutting that final section, the game will release one final gallstone just to spite us. We can then drain the blood pools and remove the gallbladder.

These blood pools will still drain our vitals if they reform, though, so make sure not to take too long. You really don't want to do the cutting all over again.



All that's left now are blood clouds that appeared where the gallbladder was and the wound from all those cutting.

Normally a small wound like that would require the gel, but for some reason we have to suture this one. It's kinda finicky.



There's no need to raise the vitals before bandaging because...

Wait, Derek. We're not done yet.
You mean there's another patient!?

...we have a surprise second operation!



Another patient was carried in, so we'll move onto him now.
Really...? Alright...
This patient is suffering from severe appendicitis. The main objectives for this operation will be the excision and extraction of the appendix. Please perform the treatment quickly, but carefully.

That's right: it's a completely different operation. Sucks to be someone who finished the first operation with 20 seconds left!



The appendix has burst and pus is seeping out. It's causing inflammations... Let's extract the appendix while we treat the pus and the inflammations! First, we need to get that pus above the appendix out of the way. Please drain it.

The inflammations won't take nearly as much vitals as the gallstones and the pus won't obscure anything in the same continent like the earlier blood pools, so we can mostly ignore them.





Injecting and cutting. Nothing really new.

Now, we need to tie two wires to the appendix. One will go around the base of the organ, and the other around the appendix itself.



Now we have something new. The new tool is a wire, and this is the only time it's going to be used.

We just have to put the wire on the pointed spot and then drag the stylus away from it. The game doesn't really make it clear, so I spent my first playthrough pointlessly spinning it around.



After that we just have to remove the appendix and patch everything up. This second half is very easy if you know what you're doing.



Nevertheless, it's still a mean surprise.



This is a nice surprise, though. I really didn't expect that



Good job, Derek. I can't say it went smoothly, but you did get through it, didn't you?

Not my fault that there's suddenly another patient

It's all thanks to you, Mary.
I don't know what would have happened if I had operated alone...
*smile*
...?
You know, you really haven't changed much since we parted a few years ago. You seem so lost; I can't possibly leave you alone. It's just like it was back then.
Wh-What!? I've improved a lot since then!
But, I...
Dr. Kasal told me everything. Even though you've been through a lot, you still need to be patient.
...Huh?



They start to lose their way... But when you're so buy thinking about something you can't change, you get blinded by it... What I mean is, the past isn't nearly as important as the future. You've got to keep looking ahead.
......
When things don't seem to be going your way sometimes you can get back on track if you just concentrate on the task before you. That's why I want you to be patient, and take things one step at a time.
I-I understand...
Haha, you really do need my help, don't you?
Heyyy, it's been three years, and you're still on my case!

Don't you feel GUILTy for plagiarism?



3-1 A Special Assignment

I already mentioned the differences. Not so easy without the Healing Touch, huh, Opendork?



4-1 Money Talks

The second half is also plagiarized. The NB version also has two operations, but both of them are appendicitis. The first half has no pus or inflammations, but the second half has way more than this operation.

All in all, I still think this operation is much harder. At least you have Healing Touch for both operations in NB.