Game 533: Medical Center (1979)

 

        

Medical Center

United States

Independently developed and published

Released 1979 for PLATO educational mainframe

Date Started: 1 December 2024

Date Ended: 2 December 2024

Total Hours: 4

Difficulty: Moderate (3.0/5)

Final Rating: (to come later)

Ranking at time of posting: (to come later)  

     

Medical Center is one of two games written for PLATO that took the mechanics of The Game of Dungeons (1975) and put them in a hospital. Bugs and Drugs (1978) beat it by a year, and there are enough similarities that Center was probably influenced by Bugs, but Bugs may have no longer been available when Center was written.

     

The game puts your character in a 20-floor hospital, each floor specializing in an area of medicine, each crawling with diseases related to that specialty. As you wander the corridors, you encounter these diseases and have to decide whether to treat them with medication, fight them with your innate constitution, rely on a limited pool of immunizations, or refer the patient to surgery. You get experience points and money for diseases successfully fought and eradicated, but if you fail, the disease affects you, weakening one of your systems. The goal is to climb the medical hierarchy as far as possible, from intern to professor emeritus while simultaneously climbing the hospital to the twentieth floor.

     

I wonder how accurate this list is in its depiction of the hierarchy of medical positions.

     

Where Bugs and Drugs had a standard set of RPG character attributes (strength, intelligence, etc.), your character in Medical Center just has a series of percentages associated with his 11 systems. Eight of them are considered "vital": cardiovascular, respiratory, gastrointestinal, liver, urinary, central nervous system, blood, and skin. If any of your percentages drop below 0%, you die. Vision, hearing, muscular-skeletal, and reproductive systems are "non-vital," but 0% in any of them means that you functionally cannot play the game.

      

Nothing suspends disbelief more than an intern with a perfect liver and a positive bank balance.

      

The moment you enter Level 1, you start meeting gonorrhea, impetigo, nonspecific urethritis, acute cystitis, and a host of other conditions. If you can identify the right medicine, it's almost always successful. Sometimes the right choice is unsuccessful, just like in real life, but in such cases you lose, say, 0-3% of health in your related system. If you choose the wrong medication, you lose in the double digits.

       

My first encounter. Yesterday, I didn't know what "impetigo" was.

      

Naturally, Google helped a lot in identifying the right medicine, although not as much as you might think given that it's been 45 years. The search engine's most common answer was doxycycline, which isn't in the "formulary" list that you can bring up at any time. I learned that when doxycycline is indicated, tetracycline almost always works instead. Also, penicillin is a good default. Overall, this phase of the game is easier than in Bugs and Drugs because the earlier game put you on a time limit whereas Medical Center gives you all the time you need to search the Internet Archive for 1978 copies of The Physician's Desk Reference.

  

25%! This choice was definitely "wrong."

    

The non-medication options are iffier, and I didn't experiment with them much. Just "fighting" the disease hardly ever worked. Immunizations and surgery both seemed like traps; when I tried immunization, it inevitably turned out that there is no immunization for that disease. Surgery, when it works, costs so much that it can bankrupt you.

   

Yes, for some reason, when you order medication or surgery, the cost comes out of your balance. With medication, you generally recoup it with the amount billed to the patient, although the game is realistic in that there are separate "billed amounts" and "collected amounts." Your first couple of encounters can go poorly if you order a medication that's too expensive for your balance, since running out of money immediately ends the game.

    

This is a cutthroat hospital.

    

In addition to encounters with diseases, there are also lots of random encounters with letters, books, cabinets, medicines, and such. You might get a letter with payment for a past bill, or a check from some place for which you wrote an article or gave a lecture. You might find a medicine cabinet with a pair of glasses that increases your "Vision" or a pair of sunglasses that decreases it. You find bottles of medicine that boost your percentages.

       

That was a decent check for 1979.

       

You can find books that tell you outright what the answer is to the medication question--with the caveat that some of them are quite old and may reflect outdated practice. This is an in-game version of what I was going through with Google. Bugs and Drugs also featured such books (though without the possibility of them being wrong), one of the many similarities between the titles.

    

Each 20 x 20 floor also has a few fixed encounters, including stairs to the floors above and below, an elevator (which has restrictions based on your level), a pharmacy where you can buy immunizations, a lounge where you can rest, and the departmental offices, where you can get treatments specific to that floor. Your character has a specialty and receives "privileges" on the associated floor, including free treatments.

    

Family Practice is on the first floor, which is disturbing given the number of times I encountered gonorrhea and syphilis.

       

The goal is to achieve as high a rank as possible. No one has made professor emeritus since 1984. The current top scorer is only a chief resident (rank 6 out of 21). 

           

Everyone who has ever made professor emeritus.

    

In any event, I got my character up to "2nd year resident" (second highest on the current leaderboard) and probably would have been able to go higher except that I insisted on pushing upward in the hospital. I died on Level 6 when I ordered cephalosporin to treat bacteroides-peritonitis. For all I know, that was the right answer, but my GI system was at 0% from some earlier bad choices, so even a slight loss would have killed me.

       

That sounds like an unpleasant way to go. Not that there are any pleasant ones.

      

Medical Center was written by Dr. David E. Trachtenbarg, who attended the University of Illinois College of Medicine from 1971 to 1975. He is still practicing in Peoria, Illinois, and he has taught at the university since 1990. I'm not sure what his status was in 1979 when he wrote the game, but he presumably wrote it to help younger medical students. The title screen also credits Dr. Stephen C. Doughty as an "infectious disease consultant." I wrote to Dr. Trachtenbarg to see if he remembered anything about the game, but I hadn't heard from him at publication time.

    

These two medical games are some of the few truly educational RPGs that we've experienced, games where the player's knowledge (mostly) trumps random rolls and character attributes. I suppose this is not dissimilar to how the player's cleverness, not the characters', determines success or failure with the fairy chests in Betrayal at Krondor. There's a longer entry to be made here about the duality of player growth and character growth and what kind of balance a good RPG favors, but I wouldn't generally mind if occasionally an RPG rewarded a player's knowledge of history, geography, physics, physical sciences, humanities, or other knowledge sets, even if such rewards aren't the game's entire raison d'être.

       

One of the last diseases I eradicated.

       

However, purely as a game (rather than a teaching tool), Medical Center leans too far towards the player's knowledge to be an enjoyable RPG, as enjoyable as it was as a novelty. Bugs and Drugs had more nods to classic RPG tropes, such as being able to earn experience by finding money instead of just curing diseases. Medical Center was fun as a diversion, and to boost a little of my knowledge about diseases and drugs, but not something I'd want to play to the top level.

     

Thanks go to El Explorador de RPG for alerting me to the game along with a few others that history had mostly forgotten. I've since played all of them, so unless yet another one pops up, I have once again reached the end of the PLATO list. That feels sad to type. Even when they weren't superb, they delivered a level of competence above anything in the commercial CRPG market at the time, and Medical Center, although not the best of the RPGs on the platform, is no exception.