In response to "Kill Billy" from The Escapist Forum: Great article - but I have felt remorse for charaters in other ways.
I find that if there is something incredibly simple, like a name, attatched to a character, then you feel like they have their own life, their own stories, and you've just heartlessly killed him - a main game for this is Morrowind, where you can go into a random house and begin the slaughter for no reason, and often with no repercussions.
It looks to me like that point is that Killing the Goat happens on an internal morality scale, whereas most games use an external one.
With the external one, you get told "this is right, this is wrong", and you feel the need to assert your own views if it disagrees with you. Doing "evil" isn't wrong, you're just sticking it to the man. Take that, Karma!
With the internal one, your conscience gets engaged. No one comes to yell at you for killing the goat, no omniscient deity knocks you down the moral-o-meter. You have no man to stick it too, no one to argue the logic of morality with, only yourself and a goat carcass. Thence the guilt.
In response to "Gaming Isn't Brain Surgery" from The Escapist Forum: I have had a job where I spent almost the same amount of time at work, away from home and my computer, but when I did get the time it did feel all the more enriching. A job like being a surgeon requires true dedication and sacrifice. I sometimes wonder if I have the character for such a responsibility. I am glad though that there are people like Rich who do have the character and devotion to such a job, and yet they don't forget fun. Even if they might forget to think about it now and then.
The hectic schedule of many occupations, creates a need for instant responses, and prohibits people from doing research or thinking of creative solutions to the immediate problem at hand, thus decreasing their chance of finding the actual optimal solution. Exploring your problem space takes time. The final "Eureka!" moment is just that, a moment. However, describing the problem you are trying to solve based on different solution spaces and dimensions, interpolating and extrapolating on each of those, and then formulating a final solution all take time. Sometimes, your brain might even need new inputs, nudges in the right direction that serve as inspiration for a new approach, like the proverbial Newton's apple. Obviously the timing of these guiding events is not under your control, and it is very likely that you will miss them when they occur if you are trying to handle too many other tasks at that same moment.
From personal experience, I have learned that creative thinking and multitasking under pressure are two states of mind that are impossible to combine. When you are multitasking under time pressure, you are always trying to achieve the most obvious and immediate solution that springs to mind. If you are well-read, experienced, and knowledgeable, the best solution you will achieve will be a minor deviation from the standard text-book solution. You will go for the local optima! On the other hand, if you are given time, and you think creatively, you will be able to come up with solutions that are much closer to the global optimum. Any thinking machine needs time to simulate multiple possible solutions before homing in on a "great" solution, and humans are no exception.
While I deeply respect you for your dedication, I don't think the system you are working in, has the possibility to offer the best possible help to your patients. While "good enough" is certainly better than none, and in some cases the problem at hand dictates immediate action, I can't help wonder what kind of collective effect the onset of such an "instant action" strategy to solve problems will have on the people who constantly engage in it. We know that we are training our brains to perform in a certain way whenever we make use of them. How then, will a lifetime of making decisions under time and resource pressures as critical as those in an emergency room.
I think that certain types of games, especially those that allow you to pause and plan before carrying out actions, can help people in lines of work similar to yours to re-train their decision-making process, and that this mental change, is in fact at the core of the pleasure you can derive from playing such games, not just as a way to escape the reality of the world as you start to perceive it, but also as a new way of doing things. Maybe, we should all pay more attention to how our minds work, and maybe this will help us understand what sort of games we SHOULD play.