Game 474: Bugs and Drugs (1978)

 

      

Bugs and Drugs

United States

Independently developed in 1978 on PLATO educational system at the University of Illinois

Date Started: 4 November 2022

       

One of the things I've never made explicit is how my views of this hobby have evolved over the near-13 years I've been writing about it. I started this blog--or, rather, the project that became this blog--in a fit of self-hatred. It was the equivalent of resolving, having decided that I had a drinking problem, to drink myself to death. I meant "addict" quite literally, and darkly, and I obsessed frequently about how the hours I spent on my hobby were detracting from every other aspect of my life. 

   

How my view changed is an interesting story, perhaps one I'll analyze later, but not the purpose of this anecdote. Suffice to say, I wasn't in much of a mental space to fully evaluate the claim that Matt Barton made in Dungeons & Desktops that CRPGs are "possibly the best learning tool ever designed." I made fun of him for the quote in an early entry, although in a slightly later one, I did allow that I had learned a few things from RPGs. Still, it was a long distance from Pirates! having taught me the meaning of "broad reach" to Barton's hyperbole. I couldn't readily accept CRPGs as anything more than a waste of time.

      

Diseases that you can encounter on the first level of BND . . .

       

Someone should have told me about Bugs and Drugs. Here, in 1978, we have a game that provides such a good learning experience that I'm not sure it's even playable without a couple of semesters of medical school. I've barely gotten anywhere in the game, and already I've learned enough to be dangerous. For instance, high-dose penicillin may not always be the best choice, but it's rarely the wrong choice.

      

A year ago, it seemed likely that we would never see Bugs and Drugs. I included it among a list of games for which I compiled all existing information and thought that was it. But last month, Camelot author Josh Tabin alerted me that I could find the game on a reconstruction of PLATO maintained by Dale Sinder at the University of Illinois. He has some lessons not found on Cyber1, including this one. It just goes to show that you should never lose hope. Alas, I tried typing m199h into Sinder's system and still got nothing.

    

. . . and the medicines that you use to treat them.

     

Bugs and Drugs is a clever game. When I heard about its existence, I assumed it would be a simple reskin of The Game of Dungeons (dnd) with medical terminology--simplistic, obvious, and shallow (cf. GayBlade from 1992). Instead, it's a clever, difficult, and educational game that goes beyond Dungeons in many of its mechanics.

    

The things I've learned in my few hours with Bugs start with the first menu option: the Hippocratic Oath. I now know that this credo a) does not contain the phrase "first, do no harm," although it does have a similar sentiment; b) requires med students to give their teachers money if they need it; c) prohibits the oath-taker from aiding abortion or suicide; and d) is not really used anymore, having been replaced by other codes of ethics and oaths particular to certain regions and schools.

  

Gameplay superficially begins like Dungeons. The character starts as a pre-med student with rolled values for strength, IQ, constitution, and dexterity. While strength, constitution, and dexterity exist in the typical D&D range of around 3-18, IQ goes up to 250. In place of mage and cleric spells, each character also starts with a certain number of Type I and Type II meds. Gold pieces are replaced with "pearls of wisdom." You choose a name for your character and then a "group" from names like "Bedpan Commandos" and "Osler Marines" (after William Osler, 1849-1919, creator of the first residency program). I don't think the group has any impact on gameplay.

     

I hope most doctors have a higher IQ than this.

      

The game begins in the corridors of a 12-level hospital, each level 16 x 16. Your goal is to use your knowledge to fight infectious diseases, gain experience, and ultimately retire at a high enough level to knock someone else off the Hall of Fame roster. A winning game also requires you to find Leuwwek's microscope and pass Koch's Postulates. Antoine van Leeuwenhoek (1632-1723) was the "father of microbiology" and Koch's Postulates are a set of four criteria that Robert Koch (1843-1910) believed were necessary to link a microbe and a disease.

       

Level 1 of the hospital.

       

Where Dungeons had monsters roaming the hallways, Bugs has viral and bacterial infections, including chlamydia, leprosy, histoplasma, and influenza. You can try to generically (f)ight these enemies (interpreted in-universe as your body fighting off diseases on its own), but as in Dungeon, physical combat is a recipe for rapid death. For sustained success, you have to apply the right treatment to the right disease. Here, the complexities of the game reach heights we haven't seen in other PLATO titles. When I first heard about the game's premise, I thought the pairs would be relatively easy for anyone with rudimentary medical knowledge--penicillin with bacterial infections, Dramamine for nausea, and so forth. But it turns out that almost everything you encounter in this game is a bacterial infection (excepting some viral ones) and almost every drug in your bag is an antibiotic. Thus, success means having much more specific medical knowledge, like gentamicin works best against endocarditis but doesn't work at all against chlamydia. The response of an "enemy" infection to a drug is probabilistic rather than binary, so even if you relied on trial and error, it would take you a number of tries against the same infection to establish a success rate.

      

Meeting h. influenzae in the hallway. I now know this stands for "haemophilus" influenzae, which is a bacteria. It has nothing to do with influenza, a virus; it got its name because it was incorrectly associated with influenza by a German physician in 1892.

       

You may be thinking that if you played this game, you'd just have the game window open on one monitor and WebMD on the other, but it's almost like the game anticipates this. You only have a short time to choose an action before the infection gets to, well, infect you, with consequent losses of hit points and attributes. And while Googling may correctly match a few of the infections and their best treatments, I found most of the time, what the Internet told me was the best treatment wasn't one of the options in the list, or it just said "antibiotics" in general. Another issue is that this game was written 44 years ago, and some of the most effective drugs didn't exist yet or weren't yet understood to be effective. For instance, the Internet gives doxycycline as the most effective treatment for about half the diseases you encounter, but it's not one of the medicines in your bag. I believe this is because the antibiotic was embroiled in a patent dispute not resolved until 1983.

    

If all of this weren't enough, you also sometimes get quizzed about your medical knowledge in other ways. For instance, a "mugger" occasionally stops you in the corridors and demands the answers to questions not easily Googled. If you get his questions wrong, he steals your pearls, medicines, experience, or attributes; get them right, and you get rewards in the same categories. You also need to answer a question every time you use "viral therapy" as a medical option. The authors created a clever way of crowdsourcing these questions. If you find the "journal club" on the eleventh floor, you can write your own question. But if the creators deem that your question is "bad," they threaten to automatically destroy your character.

     

A question from the Google-fu black belt exam.

      

Still, part of me wonders if the questions are really that difficult, or if they would be something that almost every first-year medical student would know immediately. I would ask any of my readers with medical training: if you had the list of diseases and treatments shown here, would you be able to pair them in your sleep, or would they require some thumbing through a desk reference?

   

Beyond the difficulty imposed by the theme, Bugs offers a typical CRPG sense of risk and reward. As in Dungeons, exiting the hospital heals and restocks you, so things are safest near the entrance. Mortars and supply cabinets take the place of treasure chests, and masks, gloves, and gowns take the place of armor. Where Bugs goes beyond Dungeon is in its inclusion of a number of special rooms on each level of the hospital, each providing some benefit to the player. You can rest and restore your hit points in call rooms. Lounges let you spend your pearls on coffee, food, study, and sleep, all of which increase your attributes. Labs let you browse the diseases seen on the floor so you can prepare your responses. A cashier will give you your pay in pearls one time per hospital entry. There are both elevators and stairs for moving up and down through the floors.

       

The game enjoys its med student in-jokes.

       

Some other notes:

   

• Intelligence is a key statistic for correctly applying medications even if you choose the right one, but it also comes into play in other situations. You can be so dumb you can't even operate the elevator, for instance.

• Some of the objects you can find are creative. A beeper allows you to automatically page yourself to different floors, but with the downside that you can be randomly paged from floor to floor. You can find "Brilliance" (an inventory item), which lets you automatically assess the resistances of various infections.

• In addition to the diseases that you fight like monsters in the corridors, you can become suddenly seized with a particular condition, with various consequences such as confusion, panic, slowness, and blindness. Sometimes, you can treat these diseases with the right medicine; other times, you have to answer a quiz question to get rid of them. Still others, you have to wait out.

      

I feel like I should just go home.

       

• To balance the random diseases, there are what the manual calls "good surprises," including relic rooms with high-powered items and the aforementioned formularies, library keys, and hormones. Hormones will automatically resuscitate you if you die.

      

Finding a "relic room."

     

• Death is accompanied by an amusing screen in which you're buried in the hospital churchyard. Markers indicate the last few hundred characters slain. 

       

In some ways, this is the most morbid death screen I've ever seen.

       

As with Dungeons, you get far more experience through treasure than through actually defeating the diseases, so finding pearls is key to leveling up. It takes 4,000 experience points to go from Level 1 ("pre-med") to Level 2 ("medical student"). From there, the experience requirements double for each level. You hit "senior resident" at Level 4 with 32,000, "attending" at Level 8 with 512,000, and "Nobel laureate" at Level 11 with over 4 million. The minimum number required to knock someone off the "Hall of Fame" as of right now is over 1.6 million.

         

The Hall of Fame. It indicates that 83 people have won this game in 42 years.

     

In about four hours with the game, I couldn't even get a character to Level 2. But I can see a way forward, if a long one. You occasionally find "formularies" as you explore, and each of these can be used one time to look up the optimal medication for each disease. Similarly, you can find library keys that let you look up answers to the miscellaneous questions you might be asked at various points in the game. With these resources (which are rare) you could very slowly build up a knowledge base that would allow at least some level of success.

     

Learning the answer to 1 of 147 mugger questions.

       

Even with this, it would probably take dozens of hours to win. I don't know if it's worth doing, but I am interested in how the meta-strategy changes at higher levels. It clearly isn't the same as The Game of Dungeons, where wealth attracts higher-level monsters. There also seems to be more fluid movement between the levels. I wonder if Nathan Mahney of "CRPG Adventures" and Ahab of "Data Driven Gamer" wouldn't want to partner with me on this one. We could share a login and jointly build the knowledge base. Alternatively, someone with an M.D. could come along and save us all. I'll leave it "open" for now, as much as it pains me given the number of other games currently "in progress."

 

An article about the game in Southern Illinois University's Daily Egyptian, 22 October 1982.

 

   

Whatever Bugs and Drugs' virtues as an RPG, I like to think it was a solid learning tool for medical students. It seemed to work for the creators. Mike Gorback became a pain management specialist in Texas; David Tanaka practices internal medicine at the University of Colorado [Ed. I might have the wrong person on this one]; and Paul Alfille is an executive at Massachusetts General Hospital. If someone would write an RPG that would help with my terminal degree, I'd be a happy man.

     

Time so far: 4 hours