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I was thinking about all of this recently.  I try to arpee the pain in a no anesthetic surgery.  But there is virtually no downside to not using the tank (and some upside in terms of how long surgery takes), and that is patently ridiculous.

I agree that pain management needs to be a thing.  Heck, I wonder if we can add the title of "Nurse Anethestist" (sp?) for Medical Doctor.  I like the idea of heart attack chances for patients increasing due to surgery without anesthetic.  Hell, we even have that surgical computer that can let you know that a patient is flatlining (hard crit? I'm not sure what the IC heart attack is like) from a heart attack.  Maybe add some ominous sound effects?  Like the flatlining sound, or the computer calling out "Blue Blue Blue" to the surgical suite if a patient flatlines (Am I right about that medical reference).

I also agree about increasing the chances for failure without anethetics.  The low RP group here will not RP pain, so we need to make the action more "mechanically flavorful" for them.  It would just make sense by mechanics to use anethetics if we nerfed surgery w/o anethesia.

A decent counterpoint is that longer and more difficult surgeries will clog up malpracticebay even more, delaying or ending players' chance to return to the round. This needs to be kept in mind.  Personally, I think it is about time a third surgical suite was added to the Cyberiad.  We have the player base now to support a boost in roundstart allotted medical staff as well.  Honestly, we only need about half of the space in each current surgical suite, and the body scanners could even be placed outside the rooms to save space.  You could fit three suites easily in the space, four if you move the blood pack/recovery room starboard into the three unused exam rooms.

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