Part 2: - Committing Fraud

02 - Committing Fraud

Chapter 1
Mission 2 - Standard Procedure 2.

(Music: Routine)





"It's benign, but you should be prepared for anything. Any questions, Dr. Stiles?"

"...Huh? Oh... Yeah, I'm fine. Thanks anyway."

"Are you even listening?!"



"Are you getting enough sleep? You need at least six hours a night! Don't you remember med school? The patients depend on you!"

"Derek, don't forget our follow-up with Mr. Jenkins this afternoon. Have you read the report?"



"You need to shape up-- this is real life."

"You've been here three years, Derek. We shouldn't still be babysitting you. Maybe we need to open an investigation...'

" 'Dr. Stiles' impaired medical and social development!' "



"Harsh... Cut me some slack, Mary."

"You're not a resident Doctor anymore, Derek. You know that."



"Thank you very much."

"Wait, you spoke to the director? ...About what?"

"Don't worry. It's none of your business!"

"It's a personal matter. Just forget about it."

"Are you going on vacation or something? ...I wouldn't mind a nice long cruise, myself. ...Sun, the sea-"

"Okay, okay. That's enough. Let's get back to the operation."

We now know a few more things about our main character. We've learned he's an easily distracted, nosy slacker who doesn't take anything seriously. Also we know that he probably committed fraud to allow himself to complete his residency in just three years. Lazy shit.

(Music: Patient Profile)



Today's patient is named after Hugh Laurie, the actor for House. Get used to House references. There will be a lot of them. Also this episode makes it easy to notice the big-ass spoiler in the interface. As well as something they didn't bother to translate.

"In tests from two years ago, it was small and benign. However, it's grown rapidly and started to hemorrhage. At this rate, it might become malignant. After talking with Mr. Laurie, we've decided to remove it."

"There is one objective in this operation: Excise and remove a tumor from the distal stomach. That is all. But, you'll need to use the Powell Procedure to remove the tumor. First, drain the tumor's cytoplasm to decrease its size. Then, when you excise it, the cells can't metastasize, resulting in a smaller incision. There seems to be a trend toward this type of removal. It's a good idea for you to learn it."

"Now, begin the operation! Work quickly, but stay calm!"



Medical bullshit: Cancer requires something called angiogenesis in order to grow. It basically highjacks your blood vessels and makes them grow inside itself instead of where they are supposed to. Without oxygen from blood, cancer cells will die. This means tumours can bleed just like any organ in your body. This is also how cancer spreads, as cancer cells unanchor themselves from tumours and use the blood vessels they've made to travel around.

Stomach cancer in particular is often caused by Helicobacter pylori, the bacteria that causes ulcers, and approximately 50% of the world is infected with it.

(Music: Precision)

(Watch This Operation: Mission 1-2, S Rank.)



"This will be a laparotomy. You'll need to open up his abdomen. You've done this before, so remember to stay calm."



No matter how many times they tell me Derek has done this before, I do not believe it. Anyway, once we're inside, vitals begin to drop like a rock.



"Hmm... His vitals are dropping. Select the syringe on your right. We need to stabilize his condition."



The syringe tool. Each pump of medicine, or "mountain dew" as it is affectionately named, will increase the patient's vitals by 10 points. You may use up to 5 pumps at a time. You might think it is an instant win button at the moment, but there will be many situations where repeatedly increasing the vitals won't work.

"Vitals are... stabilized. Now we can begin. At first glance, it looks like nothing is wrong. However, yesterday's test revealed something in the lower stomach. We'll need to use the ultrasound."



Hidden dialogue. Finding the tumour on your first try is required for the S-Rank. The ultrasound tool is simple, you just tap the screen until a black shadow appears.

"Now we expose the tumor... Incise down the center."





"As Dr. Kasal explained, we'll be using the Powell Procedure. We'll use the drain first, pick it up."



The drain is the worst tool in the game. Atlus couldn't have something be easy, and so you have to slide the cytoplasm up the thin tube yourself. The best change in Second Opinion was making the drain automatically suck things up, you know, like a real drain.

"We've completed the first step: draining the cytoplasm. But, cytoplasm will continue to ooze out if we don't do anything."



"Good job excising the tumor. Now, just extact it."



"Well done. You're doing well so far. But, removing the tumor is only the beginning. You need to apply a synthetic membrane to stop the bleeding. Grab a membrane with the forceps and place it over the incision."



"That's good. Now let's affix the synthetic membrane. First, apply antibiotic gel over the membrane, to disinfect it."

After a quarter can..

"That's enough gel. The membrane is beginning to meld with the tissue. It's made of protein, so there's no chance it will be rejected. Give it a gentle massage to help the process along."



You need to apply gel and then rub the membrane on - there are five pixel-perfect locations you need to hit, randomly generated each time, and you need to do it in less than two circular rotations. It's way easier to do on a DS than an emulator so I will probably mess this up frequently.

"I think it's melded in nicely. He should be just fine."



Yay, organs!



Bandage and done. Operation complete!





Close enough! I'll skip over the rankings in the screenshot operations from now on, they're pointless without viewing how I did it.

In the video, I S-rank the level. The membrane gave me a lot of trouble on the emulator so I just cheated by making sure the vitals were above 72 at the end with the gel. If you can't get a "Cool" on the membrane and don't do this, you'll be a mere 5 points short of an S-ranking.

[Music:Routine... again.)



Hahaha you're kidding, right?

"Just remember that the patient's safety always comes first."

"You're getting better every day. Keep up the good work!"

Next Time: One last tutorial mission, and we are introduced to the best character in the game. Spoilers, it's not Angie.