297: Pills Here!

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Pills Here!

Medicine in videogames is practically miraculous; there is no wound so dire that it can't be cured with a handful of pills or a big wedge of pie.

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Lovely article, and quite true, too. Games wouldn't really be that interesting if you had to constantly worry about HOW and with what to heal yourself.
It's just much easier to eat a Sandvich, you know?

Of all the games I've played, the most realistic healing system was in Call of Chtulhu: the Dark Corners of the Earth. If i remember correctly, it had 4 types of wounds, and you needed 4 types of medical equipment to deal with them. If you fell from a high place, you'd break a leg and needed to use a splint to patch it up(though even that isn't as real as reality) If you didn't heal yourself up fast with a needle and some bandages, you'd bleed to death. And even if you managed to survive all those wounds, you'd still go crazy and shoot yourself if you looked at messed up things for too long.

I played the game quite a lot of time ago, and I was pretty damn impressed when i saw how it all worked and the little details, like a piece of bone sticking out of your leg. Your character was not pretty to look at after a long and difficult fight/escape, believe me. Though, to be honest, i had very little time to be impressed because most of the time i was really, really scared.

Also, i loved how you used the L4D meme for the article. I giggle every time Louis says those lines.
Obligatory Youtube video:

Love that you mentioned Thief food healing, I'm still convinced Garrett just rubs all the food all over his wounds. Call of Cthulu did have an interesting healing system without making it annoyingly realistic although that's not to say the game wasn't hard.

Far Cry 2 had an interesting take on it, and my favorite part is that tho in the campaign, where you have to go through hell and back in the same firefight and thusly can cram as much morphine (and I presume amphetamines) into your system before you need to do anything, multiplayer requires you to get out of combat and patch yourself up. It may not be realistic yet, and is pretty quick, but it's better than pretty much anything else.

Also, your character suffers from illness, which was definitely a nice touch

It's kind of noteworthy that Dungeons & Dragons, which introduced the concept of an abstract health meter/hit points, did have a table for the side effects of mixing magic potions since at least the late 1970s. And also noteworthy for how many DMs ignored it, if they even remembered it existed.

Healing is just another of those concepts like hunger, exhaustion, carrying capacity (in terms of weight, not number of objects) that is glossed over and abstracted by most games in the name of expediency. And usually for the better. Do you really want to go to the washroom in a game, The Sims notwithstanding?

I never thought about the unintentional marketing here. A lot of people already have blind faith in modern medicine. That's why the med commercials are required to list side effects, to make it clear to people that there are no miracle drugs. A lot of parents are quick to put their kids on anti-depressants, not even aware of the various long-term physical and psychological side effects.

Side note: Ironically, the pills in Left 4 Dead weren't really health items. They were pain killers, they didn't really give you any health, they just made you feel like you had more health for a short period of time. They are arguably more realistic. But then the game did have the magic med packs.

Kojiro ftt:
I never thought about the unintentional marketing here. A lot of people already have blind faith in modern medicine.

Blame TV and movies, first. They made CPR and a defibrillator into a magic spell more potent than any ingame medkit.

That goes hand in hand with waiting to call EMS when grandpa slumps over in his chair drooling, has facial droop, slurred speech, and right sided paralysis with neglect because the EMS providers will insist on interrupting the game to get information. Grandpa will be just fine for another hour and a half because (and I quote) "those neurosurgeons can just turn him back on, you know, like in that movie?" (actual EMS call when I was still an OT student and working as an EMT-B)

From http://forums.studentdoctor.net/showthread.php?p=4131273#post4131273 (best thread ever).


Ah, health powerups. We can't make a video game hero as bulletproof as an action movie hero or it'd be a boring game, and this is the concession. But not why I'm here.

I'm here for pills.

When it comes to pills I much prefer pigeon Manderley rapping (6 minutes in). I love the Malkavian Mod.

See you just explained why Fallout: New Vegas confused me. I am encouraged to get high as a kite on all kinds of varying medication and the only drawback is a chance of addiction.

However there is actually a quest in the game where one option is to kill the NPC by spiking his supply of Jet with some Psycho. This causes him to die immediately on taking some. You character previously even says to the quest giver (if your medicine skill is high enough) that a little bit of psycho added to the guy's jet stash is fatal.

I stood over his corpse and tried the exact same thing to see what would happen (possibly not too bright here I know) and I didn't even get addicted to the stuff.

"Random pills, that's just like food!"

Taking things to their logical conclusion gets really hillarious in some games. I'm playing through Pokemon Black right now and now I'm wondering if there are berries to cure things worse than burns and frostbite. Have cancer? Just eat some fruit.

I think health/sheilds works well in the gaming universe. It is one of the things that I prefer to be as far from realism as possible. I would hate to think that if my character is shot in the leg, I have to go to A&E, wait in a room full of injured and diseased people before seeing a nurse, then waiting in another room on a sterile, uncomfortable bed for a doctor that couldn't care less. Then after I am all patched up, there would be physiotherapy, counselling, local law enforcers...

Fallout: New Vegas does have hardcore mode, where health is restored over time and you also have to eat, drink water and sleep regularly too. The problem is it all gets in the way of playing the game, in my opinion. It's nice to have a bit of realism but we must draw a line somewhere, and I think the health in most games straddles that line quite well.

When thinking about food as a healing item, I remember the way food was treated in Oblivion. As you increase your alchemy skill and reveal the higher properties of the ingredients scattered about the land and present in food, I noticed that some items have some weird side effects. For example, the item of food whose property that I don't understand is strawberries.

In the real world, strawberries are delicious and nutritious at the same time. However, in Oblivion's world, strawberries have a tertiary property when you eat them or add them into a potion that damages your health. I don't know why the developers decided to give a fruit a property that would damage your health if eaten. If you are planning on poisoning someone in battle and happen to be near a farm, then you will most likely find a large amounts of strawberry plants with which to gain an advantage. But if you were looking for a delicious snack? You'd better look elsewhere.

Owlslayer:
Lovely article, and quite true, too. Games wouldn't really be that interesting if you had to constantly worry about HOW and with what to heal yourself.
It's just much easier to eat a Sandvich, you know?

Of all the games I've played, the most realistic healing system was in Call of Chtulhu: the Dark Corners of the Earth. If i remember correctly, it had 4 types of wounds, and you needed 4 types of medical equipment to deal with them. If you fell from a high place, you'd break a leg and needed to use a splint to patch it up(though even that isn't as real as reality) If you didn't heal yourself up fast with a needle and some bandages, you'd bleed to death. And even if you managed to survive all those wounds, you'd still go crazy and shoot yourself if you looked at messed up things for too long.

I played the game quite a lot of time ago, and I was pretty damn impressed when i saw how it all worked and the little details, like a piece of bone sticking out of your leg. Your character was not pretty to look at after a long and difficult fight/escape, believe me. Though, to be honest, i had very little time to be impressed because most of the time i was really, really scared.

Also, i loved how you used the L4D meme for the article. I giggle every time Louis says those lines.
Obligatory Youtube video:

Eh, I had some problems with Dark Corners of the Earth. Immersion is generally great, but some things, like an enemies' guns dissapearing into thin air rather than you being able to pick them up, are blatantly immersion destroying attempts to increase difficulty. The devs wanted to restrict your ammo and weapon availability, so they simply make the guns of enemies dissappear when they die, and force you to look in safes and closets for guns. Another example would be some areas where enemies infinitely respawn. There are also immersion reducing things that result in less difficulty- for example, you can carry several metric buttloads of guns and ammo. There is no canonical explanation for these events. The removal of a hud and the multiple stage healing system and such all add to the immersion, but these are overshadowed by the various things that reduce immersion. So in some ways the game is more immersive, in others, it is actually less immersive than other games.

RelexCryo:

Eh, I had some problems with Dark Corners of the Earth. Immersion is generally great, but some things, like an enemies' guns dissapearing into thin air rather than you being able to pick them up, are blatantly immersion destroying attempts to increase difficulty. The devs wanted to restrict your ammo and weapon availability, so they simply make the guns of enemies dissappear when they die, and force you to look in safes and closets for guns. Another example would be some areas where enemies infinitely respawn. There are also immersion reducing things that result in less difficulty- for example, you can carry several metric buttloads of guns and ammo. There is no canonical explanation for these events. The removal of a hud and the multiple stage healing system and such all add to the immersion, but these are overshadowed by the various things that reduce immersion. So in some ways the game is more immersive, in others, it is actually less immersive than other games.

I have to admit, i played it quite a long time ago ( it was available on a PC in 2006), and i don't remember that much. Only the most memorable parts got burned into my memory (aka most of the scary parts). So i don't really remember infinitely-spawning enemies.
Oh, and yeah...right now, when i finished typing the last sentence, i remembered something that really did agitate me when i was playing and ruined the immersion: the last part of the game, where you had to run, it was god-damn impossible.
But overall, i really liked it. Though, i supposed if i would play now, i might have a different opinion, but alas, i will not. Don't want to ruin good memories :P

The STALKER series tends to show a fairly realistic healing system. Sure Medical Kits are insta-heal but only by so much and you have different sets that not only heal you but come with meds to cure radiation. Then of course there are the bandages that you have to use to stop bleeding because Med Packs only heal you. The artifacts that automatically heal you can be explained because the radiation some of them give off a specific (but not real) kind of radiation that messes with your body, causing it to mend itself up.

And in Dead Space 2, we have no idea what's in those med packs. It's at least a century into the future (I think more than one) and it could legitimately work that fast. Pills on the other hand are, well, pills. By definition they don't work as soon as you take them.

Good stuff.

I tend to not care much about unrealistic healing either. As you hint at towards the end of the article, having to stop and preform some kind of surgery-sim in the middle of the action would completely destroy the flow of gameplay, not to mention not being very fun for people who like action-based games (you can go play Trauma Center on Wii if you want that).

You mentioned MGS4, but I think a game that deserves more mention in this article is MGS3. MGS3 introduced the "survival viewer," where among other things, you had to mend Snake's wounds with various specific medical items, depending on the type of injury (such as splints, bandages, ointment, styptic, sutures, etc). There was no real skill involved with this, however, as it just required selecting an item and pressing a button while in a pause menu. It was pretty obnoxious during events like boss fights where you'd constantly be pausing and going through a minute-long healing process a bunch of times. It upset the flow of the game.
Furthermore, it failed at its own intent.

When you try to use more "realistic" means of healing in a game, but allow the player to do it almost unlimited times and at their own leisure, it in turn winds up feeling MORE unrealistic than just hitting a button to use a magical medkit. I mean, what, are the enemies just standing around twiddling their thumbs while you bandage your chest and set a fractured humerus? On top of that, having the player visualize the wounds realistically -- bone fractures, gaping wounds, burns, etc -- makes it feel even more unrealistic, as all those things require lots of healing time. You can't just stick a splint on and go running off hunkey-dorey in a few seconds.

So yeah. Medkits are a trope I don't mind having around for a long time. Its benefit to gameplay far outweighs its silliness.

ps: good mentions of Call of Cthulhu by other posters. It also attempted a more "realistic" healing process similar to that of MGS3 that wound up feeling less realistic in the long run.

Make developers aware: The Red Cross on white background is a copyrighted symbol owned by International Red Cross, and it happens more often than not that attribution for this effect is not paid in proper.

Shown: Copyright Infringement
Shown: Copyright Infringement

I enjoy the "magic bandage" of Action Quake 2 -- quite possibly the first "realistic shooter", the game strives for "movie realism". In that game, there are no healthkits, but bandaging will stop any bleeding and splint your leg if necessary, and takes six seconds.

randommaster:
Have cancer? Just eat some fruit.

I'd swear I've seen at least one newspaper headline suggesting this.

OT: I'd like to see more use of health items as a risk/reward calculation. Similar to, for instance, Jedi Outcast, which has you stand still and defenseless while Force-healing at low level. Introducing a potential drawback to popping pills (a side-effect, if you will) encourages players to think more carefully about whether to use them.

What's that? Another chance to plug Earthbound? Why yes, I do believe I'll take that one...

The above mentioned game takes an interesting approach to food--condiments! Condiments make everything better, used correctly, and will amplify the effects of food. And food, well, food is a magical item that restores health! And, no just health--puddings, cakes, pies, truffles, and other delicious desserts will supply Psychic energy, revitalizing you! Who knew??
Then there's the Gauntlet strategy, of offering different levels of food. Fruit? Well, if you have a papercut, sure, go get some fruit. What? Ham? Well, you better be missing a leg, ya hear? Eh? What's that? You're almost decapitated, you've stepped in spring-launched spikes, your arm is on fire, and you're more than a bit peckish? Well, you best get a meal then--hop to it it kiddo!

Perhaps the concept of consumption for either medicine or food is just a sign of our nation as a group of consumers, blindly grabbing and devouring what we think we need, without having any time to think of the side effects, or to look back at what happened.

BehattedWanderer:
What's that? Another chance to plug Earthbound? Why yes, I do believe I'll take that one...

The above mentioned game takes an interesting approach to food--condiments! Condiments make everything better, used correctly, and will amplify the effects of food. And food, well, food is a magical item that restores health! And, no just health--puddings, cakes, pies, truffles, and other delicious desserts will supply Psychic energy, revitalizing you! Who knew??
Then there's the Gauntlet strategy, of offering different levels of food. Fruit? Well, if you have a papercut, sure, go get some fruit. What? Ham? Well, you better be missing a leg, ya hear? Eh? What's that? You're almost decapitated, you've stepped in spring-launched spikes, your arm is on fire, and you're more than a bit peckish? Well, you best get a meal then--hop to it it kiddo!

Yeah, Taskmaker and Tomb of Taskmaker had that... TOT's highest (best) healing item was a can of spinach. "I'm hero the sailor man..." Okay, maybe not. And then you had everything from iron rations to apples and steak for your healing needs, plus potion of healing. Avernum goes this one better. Not only do you have all sorts of food and potions to heal with, but bandages as well!

You forgot to mention that junkie Lara Croft. She chugs more pain medication than Dr House! I wonder who leaves all this medication lying around? Especially in tombraider. She's going into a tomb where no where has entered for thousands of years, but then who left all these weapons, ammos, and medipacks about??

Redneck Rampage:
Has gauges for intoxication (where you want to be sightly drunk at all times) and for how full you are. Both eating and drinking improve your health, and eating reduces your level of intoxication. When you are too full you fart, which alerts everyone to your position, but also drags the gauge back down.. It also has a key for taking a wee (worth 2% health if you actually need one). When you drink too much it becomes impossible to move straight. If you keep drinking, you fall over and the screen goes out of focus.

The game that springs to mind is Max Payne.
Health in that game was basically painkillers.

I never use the pills on Fallout other than radaway and stimpacks. I hate when my guys get addicted to anything.

I once got addicted to radaway. I should have taken a screenshot.

Beware pills because they can cause severe damage due to side effects. Mention Findrxonline that the majority of tablets to calm the pain use acetaminophen and their reactions are dangerous for our body.

Personally I wouldn't mind so much that pills heal all wounds regardless of how severe they are, so long as the game told me so from the beginning. Simply introduce the pills, have a character explain to me that in this game world, science has advanced to produce pills to heal wounds, repair and regrow limbs, all whilst having no side effects from overdosing, and I'll be happy. It's their world and if that's what they say pills do, that's what they do. However, without that context, I'm just chugging Ibuprofen to grow my spine back.

Your article had a great topic, but you were overly cutesy in places. "So let's doff our caps in humble celebration of the continuing legacy..." do you really talk like that? It's not very conversational.

A few games address your points: Farenheit will kill you for mixing alcohol and painkillers. Pills in L4D are temporary fixes; they only work for so long, and afterward you're back where you started. Painkillers in Max Payne work best when you give them time; one shot will give you some health and slowly regenerate more. If you pop 5, you'll get maximum healing, but that's four heals you're sacrificing down the road.

Dr. Mario had a great example. If you put the wrong pills on the virus, you'll lose the level.

Formica Archonis:

Blame TV and movies, first. They made CPR and a defibrillator into a magic spell more potent than any ingame medkit.

It goes back further than that. Once upon a time first aid training videos would show someone come around and be fine after 10 minutes of CPR. That just doesn't happen. Although I agree that defib is over used in TV, I cringe when I see defib used in completely inappropriate situation on "serious" films and TV. Thankfully it seems to happen less often as medically trained consultants are now on most shows... Either that or I now watch less TV now and am missing the gaffes.

I found metal gear solid interesting as you would catch a cold from being outside too long. It didn't affect your health but the regular sneeze (or was it a cough? I've not played it in years) would seriously hamper your stealth.

Asscreed brotherhood also does interesting things in multiplayer. All the hits are a one hit kill so there is no health. There are throwing knives which injure and slow your opponent and what seems an almost magical quick acting poison, another win for the pharmaceutical companies.

I found this interesting read, having been a paramedic in a past life.

Are you implying that PEEEELS have side effects? At least pills in L4D don't magically heal you; they just give you temporary relief.

Games would be a lot more boring if you had to worry about side effects. "Oh no, those bottles of pills were out of date *keels over and dies*"

Deshara:
Far Cry 2 had an interesting take on it, and my favorite part is that tho in the campaign, where you have to go through hell and back in the same firefight and thusly can cram as much morphine (and I presume amphetamines) into your system before you need to do anything, multiplayer requires you to get out of combat and patch yourself up. It may not be realistic yet, and is pretty quick, but it's better than pretty much anything else.

Also, your character suffers from illness, which was definitely a nice touch

Your character seems to be the only character who can keep injecting himself with morphine. Have you ever tried having one of your buddies get incapacitated more than once in the same fight? When you go to rescue them they keep wanting more morphine injectings, until they die. It was actually kind of powerful and unexpected.

That said, I think Far Cry 2 has the best kind of "extra life" when you die, namely the buddy rescue system. Die, and your buddy will come save you, drag you away from the hot spot, and help fight off the opposition. Die again before your buddy is rescue-ready and it's game over.
It keeps the "story" going rather than ending it and loading from a previous spot.

One thing I never understood about the pills in Left 4 Dead:

Those are some HUGE bottles of pills. We're talking the 200-count type. Yet you can only use a bottle of pills once. Is the character sucking down the whole bottle at once? Or are they so unlucky that every bottle they come across only has two or three tablets left in them?

Brainstrain:
"So let's doff our caps in humble celebration of the continuing legacy..." do you really talk like that? It's not very conversational.

I was born in 17th century England.

While I believe that this was a very interresting article indeed, I have to disagree with it in one big point- that no one wants to play a quick time event to heal a character during a game. I could see a war game working out quite well were every time you sustained damage you had to duck down under cover, and instead of waiting for that red annoying stuff to get out of your eyes, (cuz come on we are all macho unstoppable american super soldiers here) we pull out a bandage, wrap our arm up and continue on. Then when we take to much damage, we have to restart the level. Yes it might get annoying to some people, but it is much more real than the crap that happens in shooters nowadays. We could even implement Yahtzee's idea of a luck system to avoid bullets. I think this would work out quite well.

Anarchemitis:
Make developers aware: The Red Cross on white background is a copyrighted symbol owned by International Red Cross, and it happens more often than not that attribution for this effect is not paid in proper.

Copyright lawyers take note: The red cross on a white background was by the Knights Templar, who can't sue because they were killed off, disbanded, and live on in secret as organizations such as the Illumanati, Free Masons, and International Red Cross.

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