High-Tech: Surgery

"The old sawbones" uses a great deal of technology to ply his trade, some of which is valuable to adventurers in general. These items and procedures call for Surgery rolls, unless noted otherwise.

Surgical Tools

Backyard Docs and Body Shops

Adventurers in trouble might not have the option of seeking legitimate medical help – often because they're short on cash or wish to avoid trouble with the authorities. Enter the "backyard doc." This might be an unlicensed dentist operating out of a filthy tenement and preying on the poor ... or a hotshot surgeon treating celebrities at a private mountain resort. Costs can run from cut-rate to exorbitant; quality, from first-class to quackery.

The best backyard doc is an able former professional with a troubled background. Perhaps he lost his license after a messy court battle, or was set up by a vindictive employee. Maybe he's an immigrant whose foreign credentials aren't officially recognized. He probably has a white-collar day job – but on the side he runs a tidy little medical practice, doing favors for licensed doctors in exchange for equipment and supplies, and providing services to those in the know at 10% of the going rate. He’s likely to have clean facilities and modern tools, but a limited supply of drugs. He might even have a key to a licensed doctor friend's clinic in case some serious need crops up. It's estimated that thousands of unlicensed doctors operate such businesses in the U.S., avoiding taxes and regulation, and gaining clients by word of mouth.

There are seedier options, of course. A washed-out alcoholic with shaky hands may be the only doctor who will treat a gunshot wound at 3 a.m., no questions asked. The risks are high: dirty, obsolete tools, antibiotics (if any) well past their expiration date, and a slug of whiskey as "anesthesia." His sutures might look like the work of Dr. Frankenstein. He can, however, save a life and keep his mouth shut.

The consequences of failure make improvised equipment especially undesirable for the Surgery skill. Surgeons normally work with the best tools they can lay their hands on. See Surgery for rules governing this hardware.

Basic Surgical Tools (TL5)

These kits constitute basic equipment for Surgery – a minimalist setup that can fit into a large case or a backpack. Each has a built-in TL-dependent skill modifier. This is cumulative with Equipment Modifiers, but note that high-quality tools use the prices under Surgical Theaters instead of 5× or 20× cost.

A well-maintained surgical kit can last a lifetime. Certain supplies – needles, scalpel blades, suturing material, sponges, etc. – require replenishment after each surgery, however. This costs 10% of kit price at TL5, rising to 20% at TL6-8.

Surgical Kit (TL5). Contents include scalpels, saws, chisels, shears, tweezers, sponges, retractors for holding wounds open, and a primitive rotary saw powered by pumping the grip. Many parts are crafted from wood, ivory, etc., rather than metal, making sterilization nearly impossible. Suturing material is "catgut," made from bovine intestine; removal is unnecessary, as human tissue absorbs it. -2 to skill. $300, 15 lbs. LC4.

Surgical Kit (TL6). Instruments include precision locking forceps, small and specialized scalpels, and other allmetal tools that are easy to clean and sterilize. The reusable needles and scalpels require occasional sharpening. The included suturing material is sterilized. $300, 15 lbs. LC4.

Surgical Kit (TL7). These light, ergonomically designed instruments allow lengthy procedures that don't fatigue the surgeon, and include micro-tools for dealing with tiny vascular problems. Many components are disposable; needles and scalpels, sharpened to a keen edge at the factory, are discarded after a single operation. Everything is hypoallergenic and easily sterilized. +1 to skill. $300, 15 lbs. LC4.

Surgical Kit (TL8). As TL7, but adds micromanipulators for handling nerves, plus scalpels and scissors with micronthin cutting edges. Rechargeable batteries power a sizable portion of the tools, allowing quicker, less labor-intensive, and more finely tuned work. Many items are constructed from titanium and exotic alloys. Interestingly, catgut is still used for suturing. +2 to skill. $300, 15 lbs. LC4.

Surgical Theaters (TL5)

Sometimes a surgeon needs more than just a bone saw and a scalpel. Generally, treating a major wound or performing reconstructive surgery (e.g., repairing a crippled limb) demands a surgical theater. Such equipment requires external power at TL6-8.

Operating Theater (TL5)

This is an entire room full of specialized gear – including the best anesthesia equipment (see Anesthesia) for the TL. It gives +2 (quality) to Surgery. $200,000, 1,000 lbs. LC3.

Portable Surgery (TL5)

This complete surgical setup typically travels in a utility vehicle, a trailer, or a large hospital cart, and includes portable anesthesia equipment appropriate to the TL. The military often uses it as a mobile field surgery. Packing or unpacking it takes at least five minutes; half an hour is more typical. It gives +1 (quality) to Surgery and +2 (quality) to First Aid. $50,000, 500 lbs. LC3.

Specialized Operating Theater (TL6)

As Operating Theater (above), but dedicated to a single Surgery specialty; e.g., neurosurgery or heart surgery. It gives +TL/2 (quality) to that specialty but counts as basic equipment for other purposes. $1,000,000, 1,000 lbs. LC3.

Suturing Kit (TL6)

Commonly found in paramedic bags and crash kits, and sometimes sold as a "surgical kit" by military surplus stores, this gear counts as basic equipment for simple applications of Surgery; e.g., stitching non-major wounds. It's improvised equipment – giving -5 (quality) – for all other purposes, including treating major wounds. The GM decides which tasks are "simple." $20, 1 lb. LC4.

Surgical Laser (TL8)

This multi-purpose tool can cut flesh, debride a burn, or administer cosmetic surgery (p. 225), and counts as fine quality surgery equipment. It inflicts at most 1d-3 tight-beam burning damage. $100,000, 200 lbs., external power. LC3.

Anesthesia

After 1850, anesthesia for surgery was commonly available in Europe and the U.S. – including at most American Civil War field hospitals, contrary to popular myth. Inhalant anesthetics are volatile, and require storage in airtight containers until shortly before use. It takes about a minute to put a cooperative patient under, or three to five minutes for an uncooperative one. If the roll to administer anesthetic fails, Surgery skill is at -2, just as for no anesthetic (see Surgery).

These rules cover general anesthesia. Local anesthetics for minor surgery are available after 1885, and are included in medical kits that need them.

Chloroform or Ether Mask (TL5)

Make a Physician roll to use this device to administer chloroform or ether. Each dose costs $5. $50, 2 lbs. (plus anesthetic). LC3.

Portable Anesthesia Machine (TL6)

Make a Physician roll at +2 for this gear. A tank ($150, 25 lbs.) lasts four hours. $2,000, 40 lbs. (plus tank). LC3.

Antisepsis

Cleanliness wasn't strongly emphasized in medical care until the germ theory of disease gained acceptance, thanks principally to Louis Pasteur and Robert Koch's work in the 1860s and 1870s. After 1870, antiseptic use greatly reduced mortality. The first widely used antiseptic was carbolic acid, an aqueous solution of phenol, with which Joseph Lister covered his operating theater in the mid-1860s. Alcohol, iodine, and hydrogen peroxide soon followed. In 1887, Robert Wood Johnson and his brothers created a small company, Johnson & Johnson, to produce the first antiseptic bandages.

Antisepsis is especially relevant to surgery: operations that were usually fatal in 1840 were routinely successful in 1900. Surgery in a non-sterile environment counts as "infected matter in the wound"; see Infection. Surgery with properly sterilized equipment and antiseptic technology won't normally result in infection.

Antiseptic (TL5)

Prior to antibiotics, the only direct treatment for a contaminated wound was to flush it with antiseptic. Cleaning a wound with antiseptic removes -2 from HT rolls to avoid infection and requires no skill roll. A 10-use container of phenol, iodine, etc., as appropriate for the TL: $5, 1 lb. LC4.

Elective Surgery

Surgical body modification is beyond the scope of High-Tech. If it's vital to the campaign, GURPS Bio-Tech is indispensable! Still, some procedures common in reality and fiction merit mention. The GM may wish to charge character points for beneficial changes; see Body Modification.

Cosmetic Surgery (TL7)

The aim of cosmetic surgery – often called "plastic surgery" – is to alter one's looks. Recovery takes from weeks to months, depending on the level of nip and tuck desired. Such operations aren't without their dangers. Possible complications include infection, irreparable nerve damage, and one or more levels of reduced Appearance.

Removing Fingerprints (TL6). Bank robber John Dillinger dipped his fingers in acid in an effort to remove his fingerprints. Removing the skin from the fingers is effective ... but leaves scars that are just as distinctive. It's easier to wear gloves! In a cinematic game, surgically removing fingerprints costs $1,000 per hand. LC2.

Changing Body (TL7). Surgically removing fat tissue through such techniques as liposuction – or grafting it onto the body – can safely alter build by one step in either direction. Allowed levels are Very Fat, Fat, Overweight, normal build, and Skinny, in that order. After the operation, adjust weight accordingly. Recovery takes a week. $5,000. LC4.

Improving Appearance (TL7). Starting in the 1950s, a variety of procedures – collagen injections, facelifts, etc. – can improve Appearance to Attractive (TL7, $4,000), Handsome/Beautiful (TL7, $8,000), or Very Handsome/Very Beautiful (TL8, $12,000). Each step is its own operation! Recovery takes a week per operation. LC4.

Improving Vision (TL8)

Laser surgery on the eyes can cure Bad Sight. This costs $2,000 per eye. Recovery takes a couple of days. LC4.