Part 9: PGS

He complained of stomach problems and was immediately hospitalized after his examination. Unfortunately, tumors have been detected. We looked into his medical history and discovered that three years ago, he had contracted GUILT.



You can tell from that generic description that she's irrelevant to the story.

Has he had any other illnesses since being treated for GUILT?
No, none at all. He's led a pretty normal life since then.
It's the typical case for those who develop Post-Guilt Syndrome, the onset of it is very sudden. As you can see by comparing the X-ray we took here with the one from the hospital the tumors in his stomach are growing larger by the day. There are signs of vasculogenesis as well. This may make treatment problematic.

Vasculogenesis is the formation of blood vessels from circulating cells.

As to how it relates to tumor, I can't tell you because I don't understand the medical journal Google pointed me to




What's the patient's condition, Ms. Sears?
He's stable for now, but we can't let our guard down.
We're discussing treatment options with R&D, but an operation is inevitable. Derek, I'm counting on you to perform it.
R&D... You mean the research division?
Yes. Dr. Niguel is currently assigned to working up the analysis.





Dr. Niguel? Victor!
Will you shut up!? Can you not see that I'm busy right now!?
Oh, sorry...
Man! How many times do I have to tell you not to disturb me while--
If you're busy, I can--
Oh... It's you. Long time no see, Dr. Stiles.



He's the guy who developed the cure for 2 strains of GUILT (Tetarti and Pempti). Definitely the NPC who contributed the most in UtK/SO.

He's also the guy responsible for that GUILT-Stigma operation in NB (along with those surprise Savato).

You look busy with your research, as usual.
Yeah, and this chat is eating up my valuable time.
Sorry to bother you while you're so swamped, but--
It's about PGS, isn't it? I've already heard from Hoffman. Give me an hour. We'll have a meeting about it.
Alright, I'll see you--



Mr. Matthew's condition has worsened!
What!?
Is that the patient with PGS!?
We need to operate immediately! Please hurry to the conference room!
Alright, let's go!
Wait, Derek! I'm coming too! Don't start that operation until I get there!
Wha-- Why!?
PGS tumors have some irregular characteristics. Even with your skills, doing it the normal way isn't going to work.
But, you're in luck! With the sedative I'm currently working on, ANY surgeon could complete the operation! Just give me a little more time, and I'll have it for you!

This is pretty inaccurate. The tumor is special, sure, but the sedative is related to all PGS, not that particular tumor.

...Alright. Just hurry it up! Let's go, Angie!
Right!

*Both of them leave*

Man, things are about to get even busier...



Victor, there you are... Now that we're all here, please begin the briefing, Ms. Thompson.
Yes, sir. It should be noted that our patient suffered through a GUILT infection three years ago. He was admitted here last week, and the test results show numerous tumors in his stomach. The main objective of this operation is:

• Excise and extract the tumors inside the stomach. But...

Since the tumor outbreak is caused by Post-GUILT syndrome, we'll need to be careful.
Derek, this will be your first operation on a Post-GUILT Syndrome patient. Victor is going to guide you through this.
I appreciate it. I'll follow your lead, Dr. Niguel.
Damn straight. I'm gonna have to explain some things about the way Post-GUILT Syndrome works, so listen up.
Got it...



Operation Video


This operation marks the first operation of the remixed GUILT music, which is amazing. It's one more reason why you should watch the operation videos.

Let's begin the operation. Dr. Niguel, we'll be counting on you.
Yeah yeah, let's do this. Hurry up and open him. Are you gonna work your magic, Derek?
I don't know yet. It depends on the situation.
Dr. Stiles, please don't use the Healing Touch unless you're sure you need it.
I understand, Angie. I've only got one chance; I'll make sure it counts. Let's get started!

Doing the usual initial incision...



The organ's turned black...!? I've never seen anything like this!
PGS patients tend to develop toxicosis, which will nullify the effects of the stabilizer. Since the patient's vitals are crucial, we need to do something about the toxicosis first. That's why I had to get this sedative for the toxicosis ready.



Toxicosis means illness caused by poison. It's the gimmick of all PGS operations. Injecting the stabilizer when the organ's purple black will cause a Miss, while injecting the sedative will make the organ normal for a while.

The organ's condition has returned to normal! Now we can continue the treatment.
That's right, but keep in mind, this is only a temporary solution. Unless you treat all of the affected areas, the toxicosis will keep rising again. Inject the sedative every time there's an onset. Now, about that stupid tumor...
It doesn't look like an ordinary tumor. Our normal procedure may not work.
Exactly. After you drain the tumor's cytoplasm, you'll need to completely sever the veins.

There will be a hidden timer in PGS operations. After a while, the organ will turn purple, which has no effect. If more time passes, the organ will turn dark purple black and will cause the stabilizer to Miss. Injecting the sedative will reset this timer.

Injecting the sedative when the toxicosis is in full effect is more efficient, but I like to do this the safer way.



Meanwhile, this tumor is special. Its cytoplasm won't reform, but it'll take a lot longer to cut. And it'll drain more vitals as we cut its veins. All the while it will make those small tumors that will cut through our vitals.

They don't require any membrane to be placed and removing one is easy enough if you're fast. However...

That's everything... Are we done then?
No... Not yet!



*gasp* I've confirmed the presence of another tumor!
Thought it could hide, huh!? Derek, hurry up and treat it!



We need to be even faster to remove these two because we won't be able to keep up the vitals if we take too long. As a nasty surprise, the tumors will reform if there's still one left. So we have to cut off all the veins of all the tumors before taking them out.

Removing both of them is still not that hard if you're quick and know about the surprise beforehand. Of course, the game won't let us off that easily.



...Again!? There's four of them! Two of them was bad enough!
Don't give up, Derek! Show those tumors who's boss with your power!
That's right! I know you can do this, Doctor!



Since Derek has done the concentration exercise, we can now use Healing Touch once per operation. Just touch the bottom left icon and draw a star.

If you've used the Healing Touch before this part...well...sucks to be you!



As advertised, Derek's Healing Touch stops time, which makes this wave actually much easier to handle than the last one. Vitals lower more slowly and less small tumors will be formed.



Let's talk about tools durability. If we use a tool too much, its durability will run out until eventually we can't use it anymore. The game will tell us by the icon turning yellow and then red before putting an X on it. Of course, the Healing Touch is excluded due to its single-use nature.

Not using the item will regenerate its durability slowly if there's still some left. Using it all the way will take longer to have the durability recover, but it will recover all the way to maximum. This mechanic can be a massive headache on later operations.

Anyway, dealing with everything will automatically removes the toxicosis, so all we have to do is close the patient up.





If you do everything correctly, you won't even get your combo to 100. That is why I let the patient bleed for a while in the video.

Yeah, some special requirements are counterintuitive and you have no way of knowing what it is unless you got it or you look it up. It's very stupid.



If it wasn't for you, things may have gotten out of hand.
Yeah, I know.
But this is a real problem. I can't believe the toxicosis rendered the stabilizer useless...
Yeah, those damn bacteria don't know when to give up!

...Bacteria?

Anyway, I'm outta here. Great work though, guys!
Are you... going back to the lab?
Yep, it'll be another sleepless night... *leaves*
Seems like Dr. Niguel is as busy as always...
Yeah, but it kind of looks like he's enjoying it.
You think so?
I'd say.
Hm.
It's hard to say how many PGS-related symptoms could appear in the future. We need him to keep doing the best he can.
That goes for us too, right, Doctor?
Definitely!

Don't you feel GUILTy for plagiarism?



7-1 The Rose's Thorns

The toxicosis gimmick might be unique to this game, but the tumors are not. There's a darkness gimmick in NB, but obviously not here. We'll get that darkness gimmick later. Hoo boy do we get that



The tumor was actually first introduced in SO. It's also the operation that showcases Naomi's god-mode Healing Touch.

There's another operation with these tumors later on in SO, but it only has two of them so that doesn't really count.