I have only played this a few times and I already have a love-hate relationship with it. I’m mad that the doctors all go down the list of every single diagnostic procedure like automata, even the super pro specialist doctors; it’s annoying that I can’t move the ambulance stop point; I think it’s weird that patients only have one condition at a time; the campaign seems weirdly paced… it feels just not done, I left a shitty review on Steam… and then I flipped over to Sandbox mode and I played something like 10 more hours obsessively. (Yeah, I will fix my Steam review.)
Then I had one patient die, for the first time, after spending all of this time trying to assemble basically the ideal hospital, lots of staff, single-patient rooms, all the trimmings, TV to watch in bed and a little dresser for your stuff… and this patient, a woman in her 50s, I think her name was Alice, presumably otherwise healthy (especially in this game), had some stomach pain, came in, collapsed in the hallway. Rushed to the trauma center and stabilized - ruptured pancreas - scheduled for an operation asap, but it was 7:55pm, day shift ends at 8pm. The surgery nurse wasn’t available to start, so “asap” was going to mean the next morning.
I furiously watched the surgeons pack up in the general surgery on-call room and head home. Alice was checked into the general surgery HDU (high dependency unit) as the day staff filtered out. This wasn’t a very big hospital. The brand new ambulance-ready trauma center annex had just been opened, a little rushed and over budget. In the general surgery department – used to overnight stays, routine surgery – there was only one nurse on nights for 10 beds, along with an intern to help with pushing stretchers around, not qualified for patient care. There was no night operating team. There had never been a need for one.
I flipped over to management mode and spent thousands of dollars trying to find qualified operating staff to come in for the night shift. I found some, and they came in… and they sat there. Right. Operations need surgery nurses, and there’s only one in the department, and she’s busy doing regular rounds on 10 beds. Ok. Let’s have another nurse come in and take over so she’s free.
Time passes. I stare at Alice’s chart again waiting for a doctor to show up. Or something. Where is at least the basic on-call doctor for the ward? She seems to be fucking around on her computer? Writing reports, I guess it says. What the hell is wrong tonight? Is it the shift change? I have a haunting vaguely bad feeling about something my ex-girlfriend the CCU nurse said about incidents at shift changes…
Somehow the operating room still isn’t set up. Or something. Her status says “waiting for surgical team”. I literally don’t know what to do. I am waiting for someone to do something. I want to yell at this simulated hospital staff. Was she assigned to the day surgeon? Is there some schedule you guys have that I don’t understand or know about? Do you see this says “pancreatic rupture”? What the fuck?
Minutes pass. Hours. I watch the nurse intern push a few stable patients around for some basic exams. I start wondering if there aren’t enough stretchers, or enough interns. He comes and sits at his desk. No, it’s not that. Is the game bugged? How would I know?
I stare longer. It starts to sink in that Alice isn’t going to get operated on until the morning and there’s nothing I can do about it. Ok. Well maybe they know what they’re doing, but this doesn’t look right to me. I hit the ICU button. At least then she won’t be one of ten on a general ward with only occasional checks, in an apparently dysfunctional department. The notification goes through to the scarlet-scrubbed ICU nurse in charge on the night shift. She starts the walk over to the elevator and gets about halfway before the code is called and she has to break into a run.
Alice is fast-transferred onto the stretcher by the ICU nurse and whoever was walking by, rushed down the hall and into the ICU. The ICU doctor on tonight is the head of the unit, a brilliant 67-year-old woman critical care specialist, and she sprints to Alice’s side. Septic shock. Alice’s system is shutting down. And somehow basic drugs to allay the fever, intense pain and nausea hadn’t been prescribed or delivered since the trauma unit visit. Antipyretics, analgesics, antibiotics all get pushed into the IV line. Alice is intubated, the short casual medical term for the last-ditch painful process of inserting a respiration tube into a patient’s airway to keep enough oxygen in the bloodstream (and CO2 coming out) when patients’ bodies become too weak to do it themselves.
Now it’s about 3 in the morning. Every half-hour, an ICU nurse walks the 20 feet over from their station to Alice’s side and checks her. The doctor visits a couple of times to do regular examinations to make sure nothing has gotten worse.
Around 5:30, it’s still dark, though the sun should be up soon. Day shift starts at 7. The alarms start going off. Alice is crashing. The ICU team sprints over. The doctor grabs the defibrillator paddles. Medicine is pushed. They try what they need to try. It only takes a few minutes. Alice is dead.
The lead ICU nurse, in her scarlet scrubs, in the bright tiled red and white ICU room, walks slowly, almost glacially, across to the water cooler and fills up her paper cup with some water. She hasn’t had anything to drink or eat in hours.
A notification pops up, canned text that twists the knife as if it was written just for me: “A patient has died. Would this have happened at a more efficient hospital?”