Part 24: - Black Thursday

Sorry about the delay. This update ended up being longer than I expected.

24 - Black Thursday

(Music: On the Cutting Edge of Medicine.)





"Secretary Anderson is getting weaker every day. It seems hopeless. But, I don't think he'll die. I've never seen anyone fight so hard to stay alive... So, all we can really do is destroy the GUILT that's killing him from the inside. Don't think about anything but the operation. This is serious. Victor, please explain our plan of attack."

"Okay, pay attention..."

(Music: Patient Profile)



"Last time, we found that a single core unifies the cells. Even if most of the tissue is lost, the core can just reboot everything. ...But even when we destroyed the core, it just restored itself. A meme for core regeneration must exist in each of the cells. In other words, this GUILT has a contingency plan... So, I thought up a contingency plan for us, too. -Use the nanomachine to lure out the core, just like last time. -Use the new laser to destroy the core as it tries to rebuild tissue. Yeah, not that different from before. It should be easy."

"Victor... How sure are you that this new laser will work?"

"It leaves less than 1% of the core protein behind. ...A lot less. It's guaranteed to work, even against this damn thing. But... the laser will also cause serious damage to any human tissue. You're going to have to be really careful about that."

"Understood. There's not much time left... You can do it, Derek."

Have you noticed? Most don't. To lose 34 pounds in only a week...



(Watch This Operation: Mission 4-10, S Rank.)

(Music: Gangliated Utrophin Immuno-Latency Toxin (GUILT))



"This is our last chance... We have to succeed."

"I know you can do this, Derek. ...Don't let me down. Are you ready? We're going to crush that bastard, this time!"

The vitals are capped at 85...







"We did it! Ha ha ha! Take THAT, you little punk!"

"Something's... Not right..."

"If we've defeated the GUILT, why isn't the tissue receding...?"

"...Uh oh..."



"It's behaving erratically... We're in trouble, Derek!"



What's tha-



HOLY SHIT



Pempti acts FAST. It has three main attacks that it uses randomly. This is the first: small Pempti bodies appear, which then jump into the lung and cut it sort of how Kyriaki does. You must laser them before too many are made.

"This must be an adaptable mutation..."

"What does that mean?"

"It's a line of defense that lower organisms develop, if they're lucky."

Science Bullshit: The theory of Adaptive Mutation is against the modern theory of evolution. Instead of mutagenesis occurring randomly, and the most fit chosen by natural selection, according to Adaptive Mutation organisms actively change their genetic code in response to selective pressures. An experiment done in 1988 showed starved E-Coli mutated significantly faster than should be possible and brought about this belief, but it was later found to have a Darwinian explanation after all. Still, interesting that GUILT was designed to do this.

"Some bacteria can alter their tissue as protection against heat, cold... They can adapt to pretty much any extreme environmental condition. Adaptable mutation is all just a theory, though. Until now, I guess."

"Except this isn't a defensive mutation, it's offensive..!"



No matter what, if you have to suture up wounds during this operation, you will get a Bad.





Here is the second attack: a line of Pempti bodies appear, the gel inflates, and they create polyps down the wall of the lungs. You must laser them before that happens. If you happen to have your laser on one as it begins to make tumors, 90% of the time a random Pempti body along the line will not make tumors, like you can see here.

"Damn it! What's going on?!"



Pempti's third and most dangerous of its attacks: The Wheel. A circle of Pempti bodies spin around the core, taking a huge hit to the vitals with every rotation. Most players keep their stylus in one position as they circle round, so they all hit as they cycle, and it takes three cycles to kill them all. This is fine for this operation, but not later ones. The best way to deal with them is to keep your laser on the core at all times before this attack begins. It will kill them as they begin to appear and do very little damage. Whether this is a glitch or not, I'm not sure.

"Wait... If the Pempti is reacting this drastically, then... We must have it cornered!"

"...The laser's working!!"

"Keep pumping the laser into it as you defend against each attack!"

The rest of the operation is random from here on out.



You may notice that the core is no longer greyed out. It is time to attack this thing head on. Deal with its attacks, and then keep your laser on it at all times. Unique to Pempti operations, the laser will never, ever run out of energy.



So keep it aimed at that thing for the rest of the operation! Never lift your stylus off the screen - the Pempti bodies are hurt by the laser as they exit from the core this way. If you need to deal with a Pempti body, slide it over and back again. There's no risk of cutting flesh as long as you stay within the gel.



The challenge in Pempti is that all three of its attacks are powerful, fast, and have random patterns. There is barely any time whatsoever to raise vitals as it switches to its next attack, even in the first Pempti operation.



You only need to laser the active core for about thirty seconds total after the first three attacks to win the operation, though the core goes away for a moment while it chooses its next attack.

"...Is it over...?!"







"*sigh*... It's about damn time. Finish treating him and close him up, Derek."



"Barely within limits, but they've stabilized."

"Hang in there, Mr. Secretary... We've won the war."



"You never know when the next patient is gonna pop up."

"We all did a great job...!"



That message has never felt so satisfying. In the video, I S-Rank the mission. It's the most boring S-Rank video you'll ever see because at this stage in the game, it's easy to kill Pempti before it has a chance to do anything. In fact, you should aim to do this in all Pempti operations, including the X Mission.



"Mr. Secretary did all the work. I'm surprised he held out for so long."

"Victor!"

"....What? I was just being honest."

"Well... we all fought hard, Secretary Anderson included."

"I'm taking off. My work here is done."

"...................."



"I don't know. It's a miracle in itself that his body could withstand 3 operations! Apparently this Pempti strain attacks the nervous system first. Can you imagine what kind of pain Richard must have been in?!"

".........."

"But, pain killers would have interfered with the test results... so he hid the pain. He fought against GUILT all by himself."

"Is he going to wake up?"

"God only knows. There's nothing we can do but pray."



"3 days later..."

"Chief! Secretary Anderson has regained consciousness...!"

"What? I'll be right there!"



Yes! We did it! He's going to be okay!

"We were worried, Mr. Secretary. There was a chance you would never regain consciousness."

"I'm sorry I caused you all so much trouble. Sidney, please do me a favor. Could you call in Robert Hoffman? ...There's one last thing I need to discuss with him."

I... But... what...?

"..Mr. Secretary...? What are you saying...?"

"Angie, contact Dr. Hoffman. Also, please assemble the GUILT team."

(Silence.)



"...With your experience and knowledge, Angie, you should already know. That last operation took quite a toll on his body."

"But... we found the cure... It's not fair..."

(Music: Despair)



"I'd almost forgotten to ask you about that request."

"That's right. You mentioned it to me before."

"I'm... leaving Caduceus in your hands."

"...What are you talking about?!"

"Is that okay with you, Sidney?"

"Dr. Hoffman was a very skilled surgeon... But-"

"Exactly! I was! I haven't performed an operation in years! I stopped... taking responsibility. What good is a useless doctor like me to Caduceus?"

"Why did you... stop operating...?"

"........"

"You told me that your greatest joy was being able to help patients. You're the last person I would expect to give up operating."

"...My hands. They're too heavy for me... I can heal people. There's no doubt about that. The Healing Touch let me save patients that nobody else could. ...But it's impossible to save every single patient."

For the rest of the series, we never find out exactly what it is that Hoffman did. All we know is that he made a mistake which lead to the death of a person.

"The burden is too great. ...I can't bear it."

"Still trying to do everything alone. You haven't changed at all. Can't you see all the doctors and nurses supporting you? Doctors like Derek and Greg... You don't have to fight alone."

"That may be, but I..."

"Have you forgotten already? The patient is fighting, too."

"....!"

Hoffman has no family, no spouse or children. Maybe his mistake killed one of them.



"...as an ally in that battle. Even if they became a casualty! Nobody understands that more than I do. Some people may be disappointed that you couldn't save their loved one. But nobody is pleased that you stopped trying."

But, do you remember the conversation Derek had as a child with the Doctor who allowed his patient to die when he came up against an incurable disease?

"Richard..."

This scene implies it was Hoffman.

"I remember something you told me when you were in college. You said that people should never have to be told that their condition is "an incurable disease." It's the same way Derek feels now. ...But, perhaps you have changed."

"I...!"

You could call it a gamble to centre so much weight of the story on two old men like Anderson and Hoffman.

"Tell me, then. If you no longer feel that way, I understand. But... if you still want to help save the unsaveable... I want you to take over Caduceus for me. Cure the injured. Save the weak."

Indeed, it's rare to see a main character even around the age of forty in video games, when, statistically, the majority of gamers are around 37 years old.



He may be older than most video game characters, but Hoffman is still relatable. Maybe you were once someone with a bright future. Someone everyone thought would succeed. Maybe you are that person right now.

"Caduceus is a group of people who refuse to accept that some diseases are incurable."

"Stop it! We should discuss this after you've recovered and left the hospital!"

"I... Won't be leaving. My place is here, with Caduceus. ...I hope you'll stay as well. I... will... stay...."

But somehow your life slips away from underneath you and five, ten, forty years later, its passed you by and you've accomplished nothing. It's a truer story than most want to admit. More than Derek, more than Angie, Hoffman could be you.

(Music: Anderson's Epitaph)

We heard this music once before, when Hoffman and Derek may have spoken for the first time. But please listen to it again.

"...Ahh... The sunset is beautiful..."



"I remember everything. And I still feel the same way. Nothing's changed."

"...What have I been doing?!"

"I'm glad to hear it."

"I knew you hadn't changed, Robert! That's why... you recommended Derek. You knew that he... could help Caduceus."

"..."

"Robert?.... Please....take care of... Caduceus..."

"..........."

"... My friend... I promise. I'll work hard to bring our dream to life."








BONUS 6 - Stranger than Fiction, Armoured Bacteria Pempti

...Wait..."Bacteria?!" God damn it, Trauma Center...!

(S.O. Version:)

Pempti, or "Thursday" in Greek, is the most dangerous GUILT yet. It preys on the nervous system, creates tumors, regenerates damage to itself, as well as fills the lungs or other organs with an undrainable fluid. The body can do nothing to fight it while it slowly eats away at the brain, causing extreme pain, fatigue, loss of motor control, weight loss, difficulty breathing, and eventual deterioration.

Does it seem a little far-fetched to you? Well, start worrying, because its amoeba-like appearance and tenacious behavior is, in fact, very reminiscent of...


(Image Source)

Naegleria Fowleri is a brain-eating amoeba with a 98% case fatality rate. Symptoms begin with a headache and changes in appetite, fever, vomiting, and stiffness, before progressing to confusion, inability to concentrate, ataxia, seizures, and meningoencephalitis. It is a tough bastard, forming cysts when faced with starvation, cold, or dryness that will quickly awaken when conditions become ideal.

It is ubiquitous, living in almost all parts of the world with warm bodies of freshwater. It lives in your lake. It lives in improperly chlorinated public swimming pools. It lives in most tap water in the United States. It probably lives in the soil in your backyard. Fortunately, N. Fowleri does not infect humans by being consumed, and can only be caught by contact with the inside of the human nose. Did you accidentally breathe in water through your nose during your last shower? Did you remember to wear a noseplug the last time you swam in a lake? Or have you ever used tapwater for clearing your sinuses with something like a Neti Pot? If so, symptoms begin to show in one to seven days.

There is no treatment that has shown to have an effect in humans. For 98% of those infected, death occurs around two weeks after infection. This month, a 9 year old boy in Minnesota died only three days after contracting the parasite. After Oprah advertised Neti Pots on her show, many died from an N. Fowleri infection after purchasing them on her recommendation. To be fair, Neti pots do specifically instruct the buyer not to use tap water.

Be sure to read the directions next time you use something. You never know when a brain-eating parasite will be raring to kill you.

...Also, don't forget to check out this Bonus by Jeek on tissue regeneration in Pempti and real-life organisms!

Next Time: Chapter Five: the rest of the GUILT and "THAT FUCKING LEVEL."