[DISCUSSION] Medical Pharmacy vs. Chemistry

[Agent reburG]

Is there a reason why the development team is so committed to this change? The stubbornness around this change has felt so frustrating as a player.

its been less than a week

But it's going to permanent right? 
At foremost, our developers are and have been going strong in so many ways and calling them important to this community is an understatement. 

But mistakes happen. 
And be honest, not making this a testmerge, having no prior community open discussion and immediately merging this wasn't the best move. 

The signal that this was just merged without any of this, meant expectations were clearly above average, but it was extremely rushed at the time, so people were disappointed (by the change, not the developers). 

And no steps back have been made currently, the progression is that's being beaten through anyways and everything will be corrected in hindsight. 

People are discussing, because most can't even invision a working future version of the change, but instead see (imagine; feel; to clarify that's not necessarily the truth) a suboptimal revision being rolled up the hill for no ones net gain. 
Telling people to stop doing that, feels counterproductive and kinda rash. 

If chemistry not supplying medical is the absolute underlying issue that these changes is targeting (which was not listed as the reasoning for the original PR), then my view is that I think the team is missing the fact that a large part of this issue stems from medical being overstocked at roundstart. I play doctor a lot, and most rounds I simply don't need to request chemicals from anyone at all because the three nanomeds, lockers full of medkits, port-a-nanomed, port-a-medbay, sleepers, and cryo tubes usually provide enough tools to keep the crew alive for an entire round. Most doctors start the round by printing multiple hypos and filling them with enough chems to tackle any situation, all without anything that a chemistry lab could provide. What chemistry and pharmacists currently provide are chems, that while better, simply don't warrant the extra effort to acquire because the starting supplies are good enough, and can be immediately acquired at roundstart without needing to wait for another player.

But I digress. I don't think making a PR and merging it within 3 hours without any kind of discussion was a healthy move for the game. Ideally there should have been a thread to gage the community's feelings on this issue first, rather than jumping straight to implementation of the development team's idea. Even a surprise testmerge would have felt better. Immediately merging what most players believe was an unfinished PR into main feels permanent, as if the team has already come to a conclusion and won't budge on it. And the request to only use this thread to discuss changes to the current implementation only exacerbated that.

I agree, we definitely could lower the amount of each, but not remove some. 
In the end, if some chemicals are removed from the start and medical not well enough equipped to handle some possible cases, that would only empower the cloner and make medical at this phase more reliant on it. 

And I absolutely loathe this overpowered piece of solve-all-shit (Besides Puritan, but it's rarer than you think at times). 
It already loomes above the necessity and usefulness of almost everything in medical like some hideous guillotine of life. 
But ahem, that's my opinion and not that important at the moment. 

Anyways, yes less of all but not less at all, buying more cartridges at cargo is absolutely acceptable even more, if medbay could get their own funds to buy such things. 

I have yet to see a sjngle satiasying pharmacist round. You cant be the dedicated chemist when botany & sci outperform you, you cant be the dedicated chemist if no one WANTS to touch your stuff

I mean the "noone wants your stuff" is the same problem botany, cargo and chemistry have. That's a systemic problem, not one specific to the pharmacist.

Thing is, 

1.Botany doesn't only supply medical and has incredible indepth game mechanic tied only them alone. 

2.Cargo, while not as gratefully mechanic-wise still has other things too they can accomplish, like hunting things (or people) for their requisitions. 

3.Chemistry, isn't a role, it's something scientist can decide to do, and isn't remotely bound to only creating requested chemicals, but to unholy mixtures of "F.U.N." and in case they get bored of that, can evade to the other fields of SCI. 

So it's mostly a systemic issue for the pharmacy at the moment, because they really do not have anything else otherwise going on for them.

[FireKestrel]

If chemistry not supplying medical is the absolute underlying issue that these changes is targeting (which was not listed as the reasoning for the original PR),

"Always seemed off to me that we added these whole pharmacy setups to every medbay when we have chemistry departments while expecting all doctors to be chemists. Now we have a dedicated chemical maker for medbay. Eventually maybe possibly we'll get rid of chemistry from science entirely but that's not what this PR is about." ?

other feedback noted, good points made

I don't think that really communicates the reasoning in a clear manner at all. It's certainly not how I read it, but nitpicking why exactly that's the case won't add much to this discussion.

[Lord_earthfire]

Telling people to stop doing that, feels counterproductive and kinda rash. 

Let's be honest, this discussion has stopped being productive 6 pages ago.

2-3 people (me included) are jut bickering at each other on points they won't move away. Someone stepping in and saying "stop discussing this, let's try to stay productive" isn't counterproductive. It's necessary.

With such sentiment, we will never get something done. At one point you have just do a change and then build upon it. There are enough concepts that have been discussed into non-existance. And if that PR wouldnt be merged, i assume the same would have happened.

Not because the idea is bad. On the discord people are, as far as i am aware, in favor of something changing. The reason would be mostly because some few loud people dominate the discussion.

On topic:

I personally think work-wise pharmacists is functioning. You got barrels and most chemstations. You can make 95% of chems chemistry can, and in the few exceptions you are just hard rate limited and these are most often not medicine anyway.

Goal-wise we are still struggling with the medbay/pharmacy-relationship.

I think the next step is revising the list of chemicals in medbay available at round start. There are a lot of niche- or high-tier-chems medbay can live without for half a round until the other departments have cought up.

Let me pull up a few from the NanoMed i think need something said about:

• diphenhydramine & atropine: these are two niche chems. However, they fullfill kinda important tasks. Diphenhydramine is a life saver for hyperallergic people. Atropine is important against nukies to combat saxitoxin. I think medbay needs these two purging mechanics.
  
• filgrastim: This chemical honestly requires a rework PR. It's very niche and most often outclassed by just putting a blood bag onto someone. I think that can go.
  
• heparin: The use of this is maybe a funny poison for doctors. besides that, cholesterol is most often fixed by the dialysis machine and heart surgery. That can go out of the vendor.
  
• Proconvertin: Like with filgrastim, mostly unnecessary. Bandages are much more effective against bleeding. Maybe needed once we add internal bleedings?
  
• Robustissin: Mostly a counter against lungrot. This is maybe a chemical that could be a fun task for pharmacists. If someone is using lungrot (doctors or botanists most likely) a pharmacist or chemist is the only job that can effectively create the cure. I wouldn't remove all of it, but i feel removing it out of the NanoMed and putting a single bottle in the MD locker would do well. Add it to the special medical cargo crate at well.
  
• synaptizine: Simply put: i don't like atrop/synap at round start in medbay. Removing this Chem wouldn't help pharmacists, however. Maybe we can move the saxitoxin purge to this chem and remove atropine from the vendor?
  
• omnizine: It shouldn't be at roundstart available in the MD locker. I had a few MD's going into my pharmacy and making SR while ignoring me working in there. If botany white-weed bombs medbay, at least i am the first to get my hands on that stuff.
  

I feel locking the synap/atropine combo away behind pharmacist is the best way to go. Remove atropine from the vendor, move the saxitoxin purging mechanic to synaptizine because of nukies. The reference doesn't exist anymore because atropine was used against sarin in that movie, and that chem got a rename.

The alternative to synap/atropine still exists in cryoxadone. Cryotubes causes the same effect as synap/atropine, so doctors don't necessarily need a handheld version of that at round start.

[Agent reburG]

https://github.com/goonstation/goonstation/pull/25944

"pgmzeta
commented
3 hours ago
The list of medical chemicals in the NanoMed is under review, which may affect this PR."

I just read this and came here to raise some concerns, but what Earth_fire just posted is now genuinely concerning to me. 

Are you actually going to nerf medical like that, like I would get why the quantity could need cut or two, but are you un-ironically make pretty vital chems unavailable till someone does the underdeveloped role. 

Nah, this will raise the next generation of "Just Clone Bro" and I'm not in for that. 

I see where the access to the pharmacy is debatable, but removing almost basic medical chems out of their reach on top just to get this remotely to work? 
Naaaaaaaah, I genuinely beg of you, we just want to keep people alive without using the cloner, please.

[glowbold]

but removing almost basic medical chems out of their reach on top just to get this remotely to work? 

Not remotely what i said in that PR comment and hyperbole like this is exactly why this thread is being unproductive.

[Agent reburG]

but removing almost basic medical chems out of their reach on top just to get this remotely to work? 

Not remotely what i said in that PR comment and hyperbole like this is exactly why this thread is being unproductive.

That's what Earth_Fire is saying

And they are an active contributer to the codebase, which itself is respectful, but concerning for me at the moment. 

Also is the Nano Med chemical list under review to possibly remove some entirely? 

I'm just feeling a bit paranoid when hearing Nail-Rhetoric when people who wield the Nerf-Hammer talk about my all-time favorite role.

[glowbold]

anyone can make a pr

[Lord_earthfire]

Are you actually going to nerf medical like that, like I would get why the quantity could need cut or two, but are you un-ironically make pretty vital chems unavailable till someone does the underdeveloped role. 

Well then. Look at the list i have given out and say which of these chems is "vital".

Maybe we can have a discussion on how some can be changed and where some can be improved (and i'm honest, many of these need some love so they are actually worth using). That would be a productive discussion.

[Agent reburG]

anyone can make a pr

Those who can code by themselves can, I could barely do that with the help of AI and I think no one would want that.

And is the Nano Med chemical list in review to remove some from it?

---

Are you actually going to nerf medical like that, like I would get why the quantity could need cut or two, but are you un-ironically make pretty vital chems unavailable till someone does the underdeveloped role. 

Well then. Look at the list i have given out and say which of these chems is "vital".

Maybe we can have a discussion on how some can be changed and where some can be improved (and i'm honest, many of these need some love so they are actually worth using). But right now, you are just contrarian and the only thing you have is the empty argument that the role being undeveloped.

Alright, I was quite overwhelmed and I apologize for not reasoning for my choice of words. 

• diphenhydramine, doesn't seem vital considering you only need it for hyper allergic people in conjunction with Epi and the Dia. But you really need it then to speed up the progress or the patient sits up to 10 minutes there, you could nuke it with Calomel, but that's very aggressive considering the needed amount. Also, hyper allergic isn't that rare, at least among patients that appear in medbay. 
  
• atropine, really important for remote deep crit situations, nothing can cure cardiac failure besides it below -65 health and not having the Atropine Synaptizine combo means patients are more likely to die outside of medbay resulting in less attempts to treat it outside, resulting in RNG gambling to rush them to medbay, resulting in more cloning in case you lose. Also atropine has this saxi purge effect based on real life usage, don't just randomly chuffle something like this. 
  
• heparim, can be used as decent OD poison for doctors, no pharmacist would give you it in pre-sight without suspicion. 
  
• Filgratim not as vital as the others, I admit could definitely use a rework, possibly scaling with lost blood amount. 
  
• synaptizine, again important for deep crit even without Atropine, because Mannitole
  was nerfed for higher brain damage making this the only reliable one currently, which is a nice specialisation as long it actually is available and you aren't rendered hopeless without alternatives. 
  
• Robustissin, very reliable and often used to treat food poisoning, I don't understand it, but it's ever has been handy for mass cases of this or lungrot. Somewhat removable, but not recommended. 
  
• omnizine, okay 30u mostly used for SR, but painful, very very painful to get at times, especially during lowpop, I see why, but it's only directly accessible for the MD, Captain and Pharmacist currently. 
  

Not all were totally unjustified, but some were also really concerning.

[Vandry]

Let me pull up a few from the NanoMed i think need something said about:

Before I list out my thoughts on this I'll just say that every single department on the station is self sufficient to do their job at a basic level without help from their lead/head or an external department. On what 'basic' is in medbay is up for interpretation but for me it's to be able to treat someone that's come in that's not in critical and have them leave healthy. The chemicals required to do a 'basic' job should always be available in the NanoMed in lieu of any scientist, pharmacist or director not being present or functional.

I'm also going to chime in on this list so here goes.

• Diphenhydramine: This is basically a required chemical on any shift. There are many hyper-allergenic crew who will not be fixed solely by epinephrine and the dialysis.
  
• Atropine: This is generally an advanced chem, used in combination with synaptizine to keep critical patients alive. Or in niche cases remove large amounts of saxitoxin. Not required for basic care.
  
• Filgrastim: Generally just used to get people out the door faster when they're low on blood in combination with saline or blood bags. Luxury chem but also I genuinely doubt a chemist or pharmacist would make this chemical due to it being a pain to make and how low impact it is.
  
• Robustissin: Required chemical. If someone has lungrot there's no other way to fix it. 
  
• Heparin: As someone who takes doctor RP fairly seriously, surgery (especially a heart one) is always a last resort compared to giving someone a blood thinner.
  
• Proconvertin: Not required, honestly more harmful than anything half the time!
  
• Synaptizine: Required after the brain damage rework, atropine is generally pretty harmful on it's own to treat brain damage so this is the go to for higher levels. 
  
• Omnizine: Not required, SR is a luxury most times.
  
• Salicyclic Acid: Not on your list but honestly it's one of the ones that should be. Mostly used to make perf quickly or speed up cloning and there's FOUR bottles of it in each NanoMed.
  

[Vandry]

We want to try a thing out before reverting it, and there have been several patches already to address things brought up. The underlying problem of chemistry not supplying medical with chemicals is unresolved. Some of the issues in this thread need to be resolved regardless of whether we keep or ditch the pharmacist.

I think labelling all this as stubborn is over the top. Equally as frustrating is attempts to shut down changes before they have been given a chance to settle.

If chemistry not supplying medical is the absolute underlying issue that these changes is targeting (which was not listed as the reasoning for the original PR), then my view is that I think the team is missing the fact that a large part of this issue stems from medical being overstocked at roundstart.

I've seen this sentiment that medbay is overstocked from some people and honestly? Yeah sometimes. But only sometimes and that's kind of part of the dilemma. Medbay being well stocked or not just depends on the situation. Active antags, population count, the amount of doctors on staff, what kind of patients are coming in, admemes, etc etc. With a busy shift on high pop the NanoMeds will get restocked several times while on a slow shift or lower pop I'll barely pull out my mender sometimes.

I don't think reducing the amount of individual things or quantity of them in the NanoMed will fix the problem of doctors being over prepared in situations where not a whole lot is happening because the system just isn't that deep, which is kind of the core problem of medbay in my opinion. And like you said there's multiple ways to deal with certain situations and I think that's more of a problem than the amount of things in one of them. Which is also the reason why the pharmacist generally just doesn't have a lot to do because the majority of care is extremely basic while having occasional niche cases to solve. In general I feel like taking away too many essential resources from doctors so they have to rely on a singular pharmacist, who may not exist or be doing their job, would absolutely be a mistake. 

With that said I think a possible idea to give pharmacists more to do would be to empty out some of the Port-A-Med, possibly make injectors creatable by the pharmacist (only with chemicals from the whitelist obviously) and let them use that as another outlet to put in their custom made goodies to be used. The Port-A-Med is mostly used for mobile or on site treatments in other departments, which would enable for the pharmacist's goods to be used more often than they have been so far.

[Kotlol]

We keep going around in circles and the way to improve this keeps shifting and we also see more issues with each new revelation.

We nerf medbay to compensate for low pop, it effects high pop.
We keep it on high pop demands, low pop is boring.
We cannot scale decide this either.

Again it's obivious that the best way to improve this is to weaken normal menders "BUT" allow pharmacists/scientists to add a chemical to the menders to IMPROVE them again.

That's the stuff we need...

But I think what we need more is work on UNDERLYING PROBLEMS insted of fixing something that has been fixed several times...

There are many ways to improve ways of antags dealing with medbay without overal touching it.
Remember this, nerfing medbay is nerfing the entire station.

OR maybe we need more ways for PATIENTS to do something in medbay to keep them there insted of being bored.
OR something for doctors to do in medbay outside of patients.

Now I think this PR and topic has lead us down many paths and I think we should consilidate this all in a seperate topic....
Maybe an overal state of medbay topic. Cause otherwise we keep doing this song and dance all day.

We been throwing more alternate suggestions that all relate to the Pharmacy problem as well... but right now... I think it's clear we all need to discuss the state of medbay in general since so many suggestions lately have been: "Medbay needs this new thing."

Is this a fair assesment? Cause the Pharmacy/Chemistry problem is clearly a sign of problems surrounding medbay.

[Solenoid]

I just wanna say thank you to Kotlol for bringing up lowpop and highpop, I'm not sure what perspective many of you guys who are arguing to massively nerf the medchem lists, cloners, etc. are posting from, but as someone who plays almost explicitly lowpop, these sorts of "harmless" changes massively affect servers with less people where you don't have 6 med docs at all times. I would really like this to be considered before any chemicals are removed or changed or whatever. The pop split is already a bit of a pain point for me(why do we have a server with like 7 people and a server with >40 sometimes, when we could have 2 25-30 player servers?), but I think it just gets worse when changes aren't made with it in mind.

If any changes are made to medbay to account for the pharmacist, ideally have alternatives that don't involve having to break into the pharmacy. Maybe an expensive(~25,000cr) cargo crate with a few small(20-30u) bottles of specialized med chems or something with a medical access lock. 



Back on topic for what Pharmacist is lacking, I'd like to see the auxillary chemistry counter be added to all pharmacies. That's the one with condensers, a bunsen burner, etc. which is nearly required for efficient acetone and phenol production. Earthfire has messaged me some cool tricks on how to make these chems more readily, which I appreciate, but I think if we could keep chemistry intuitive for new players, it would be ideal. Also, Pharmacopia needs a rewrite! Much of the information is extremely outdated(pre-rework), so if we want pharmacist to be a job where people can learn how to do medical chemistry, we should also probably make sure the guidebook is actually useful.

I'd be willing to help with that, but I'm not sure how you'd write a book for a PR. If anyone is interested in PRing a "Pharmacopia 2nd Edition" or something for helping with chemistry and especially pharmacists, please reach out! I'd love to help you out and research/write for it.

[Vulwin_Gilran]

Feels like most of this thread is just back and forth arguing

Somethings that I will say from playing pharmacist a few times.

It would definitely be nice to get a few of the condensers and drippers like how chemistry does, because i generally just find myself going over and asking for the ones they have, as if you are trying to make alot of oil or phenol which are both very important medical precursors if you dont have split condensors or normal ones it becomes alot more tedious to do.

This feels like a small change which might not help but, giving pharmacy a chem interlink AND making it so that when things are added to the interlink it sends a pda message to medical saying the name of the bottle deposited. As sometimes it feels like things get made and just never get used because even if you yell them to use it over the radio they never notice it.

I've seen other people mention it, but some way to make autoinjectors would be very neat.