PDA

View Full Version : Medical Care in the Imperium



Wolfblade670
09-10-2009, 03:22
So what do we know about medical care in the Imperium, and the 41st millenium in general? Some of the Imperial Guard novels I've read indicate they certainly have knowledge of battlefield medicine. I'm more curious in info and speculation on care for the Average Joe, as opposed to the juvenants and bionics of nobles and Inquisitors.

PondaNagura
09-10-2009, 04:09
eh largely it falls under a section of the Adeptus Sororitas, they don't take up arms or wear power armor but have training in tending to soldiers and the general populace. each world will have different systems...low population worlds probably have more adequate facilities where as over-crowded hivecities might as well shovel those unfortunate enough to get maimed or sick into the underhive.

grissom2006
09-10-2009, 06:42
Plenty of worlds hove zero technology and are medival or feral on theses worlds a shamen witchdoctor or just some person who says he has a cure will commonly take up the position.

MajorWesJanson
09-10-2009, 07:11
Top end you have neuro-surgery, juvenat treatments keeping individuals active up through 400 years old, cloned and grafted organs, and sufficient synthetic organ systems that at least one individual was able to exist as slices of brain in an artificial body.

Argastes
09-10-2009, 07:16
Grissom: I think it's implicit in the question that we are to exclude consideration of worlds with a pre-20th-century level of technology; obviously a planet where society is still stuck in the bronze age will have a correspondingly poor standard of medical care, but that's probably not the answer that the OP is after.

It's not just Inquisitors and noblemen who get bionics; I can think of several examples of comparatively low-ranking IG officers (captains, for instance) receiving bionic body parts. They were also available to underhive gangers in Necromunda; not common, but still available. So bionic body parts (and thus comparatively sophisticated nerve-computer interfaces) are obviously not purely the province of the rich and powerful. Maybe not every Average Joe will have access to them, but neither are they limited only to Inquisitors and nobility.

Generally speaking though, as far as I know, not much has ever been said about the quality of "average" health care in the Imperium. On the average civilized world, I'd guess somewhere between what was available ~1900 AD and "in the near future". You can probably generally rely on the available of anesthetics and antibiotics of some sort, at least.

Condottiere
09-10-2009, 08:35
I think you have differentiate between civilian and military medical care, and even those would have tiers.

Marines being rare and valued, would have the best available, Grey Knights and Assassins probably more so. Since the military machine wouldn't function without hands to guide them, General Staff Officers would probably be the next tier, then field officers. Junior officers and rank and file probably have to make do with what's available, since the implication is that it's easier to replace them than care for them. Competent military commanders probably do ensure adequate local care, since they understand the impact on moral.

Lothlanathorian
09-10-2009, 08:56
Shoggy has bionic eyes. Was he an officer? (Gaunt's Ghosts series)

And I would think that it very much varies from world to world and warzone to warzone. Also, by regiment. Some might have very good doctors and chirugeons with them, others, well, not so much. Some worlds may have very high end care available to everyone and other worlds will have rocks for anesthetics (apply liberally to the head until pain subsides).

Iracundus
09-10-2009, 09:02
Certain areas of general medical care seem to have atrophied away, such as cosmetic considerations in surgery and wound care. One only need look at the atrocious facial scars sported by some characters. These scars could easily have been made less noticeable by even 20th century surgical techniques. So there seems to be a different attitude towards social acceptability of wounds and scarring in the general Imperium compared to the 20th century, early 21st century era.

Condottiere
09-10-2009, 09:22
Since cosmetic surgery is elective, perhaps your basic healthcare plan won't cover it.

Lothlanathorian
09-10-2009, 09:27
The more scars you have, the more badass you clearly are. In 40K, you want to be a badass, you go out and get yourself all kinds of blowed up.

Idaan
09-10-2009, 10:15
There are usually two kinds of health service, as with most of Imperial services (Adeptus Arbites and the Enforcers etc).
There is "federal" Officio Medicae, probably a branch of Administratum tasked with providing care for members of Adeptus Terra and dealing with catastrophes like Zombie Plagues (references to Medicae quarantine on Subiaco Diablo during EoT campaign).
There is "local" medical care for regular citizens, financed by the governor.
And then there's Orders Hospitaller of Adepta Sororitas, adding some grimdark for people who think it's not grimdark enough.

madprophet
09-10-2009, 11:09
What few glimpses we've seen of civilian life in the 40k universe don't tell us much. In the Gaunt's Ghost novel Necropolis we see a reasonably advanced hospital set up to treat civilian as well as military casualties. On the other hand, we are told one girl whose hearing was lost would only hear again if she got sophisticated surgery 'up hive' which she would not get because she was too low caste.

Think the worst case scenario of socialized medicine - if you are rich and high caste, you have private physicians errr... I mean Masters of Physik at your disposal along with some pretty high tech medicine available. If you are a working stiff, you can get basic care and get stiched up if you need it but if something catastrophic happens you have (to quote Joe Biden and Cass Sunstein) "a duty accept your condition and to die". If you are a low caste hiver, you can get minimal care but basically you are on your own. Decisions on who gets what are made by the local Officio Medicae branch based on the world's technology base, available wealth, relative importance of the patient and the world's value to the Imperium.

I suppose on a low population agri-world, you may have a 'country doctor' and most people have access to at least basic care - we really haven't seen a lot of information on rural life in the Imperium. GW seems to prefer urban nightmares.

The economy in 40k (at least what we've seen) is communist - workers live and eat at their factories which are state-owned. Production is centrally planned by the local branch of the Adeptus Mechanicus. Governments are bureaucratic nightmares.

Naturally, the galaxy is a big place and there is room for all sorts of things - some world's may be the very model of democratic idealism with libertarian approaches to civil rights, well-ordered societies, with free market economies run on the principle of enlightened self-interest... but that isn't exactly GrimDark (unless you happen to be Karl Marx, Vlad Lenin or Joe Stalin...)

Vesica
09-10-2009, 13:03
So what do we know about medical care in the Imperium, and the 41st millenium in general? Some of the Imperial Guard novels I've read indicate they certainly have knowledge of battlefield medicine. I'm more curious in info and speculation on care for the Average Joe, as opposed to the juvenants and bionics of nobles and Inquisitors.


Not too sure, if you can find it i made a thread a while back asking about dental care in 40k and it had some good posts.

There is battlefield care in 40k O.o, i always imagined that for most IG, battlefield care came out of the end of the Commissars pistol.

Iracundus
09-10-2009, 13:07
The economy in 40k (at least what we've seen) is communist - workers live and eat at their factories which are state-owned. Production is centrally planned by the local branch of the Adeptus Mechanicus. Governments are bureaucratic nightmares.


Actually I would say it's more fascist rather than communist though both start having similar aspects when they get to their respective ends of the spectrum. The means of production tend to be controlled largely by cartels, guilds, or aristocratic families who employ the bulk of the workers in sweatshop condition like labor, while they themselves live in splendor. Central planning isn't necessarily unique or restricted to communist regimes. As a whole, there seems to be very little in the way of a consumer economy, (aside from luxury consumption by a tiny elite class) and most of the production shown seems to be to feed the military-industrial complex.



Since cosmetic surgery is elective, perhaps your basic healthcare plan won't cover it.

Making a wound look good isn't a separate procedure in itself. We're not talking cosmetic surgery like "tummy tucks" or adjusting eye lids and noses. When closing wounds, there are various techniques (like subcuticular stitching and Z flaps) that reduce the amount of scarring and result in better looking results in final healing. While one might argue this is "battlefield surgery" and hence they use quick brutal methods of closing the wound as quickly as possible, the amount of scarring for the facial wounds depicted in 40K would probably still be unacceptable by trauma surgeons today.

Also being heavily scarred is not a sign that you're tougher, only that you've gone through more. Scar tissue actually has less tensile strength than normal tissue so they are actually weakpoints, and the scar formation itself may cause further complications like tissue adhesions. In 40K's rule of cool, it seems scars, growing up in industrial wastelands with malnutrition, pollution and violent childhoods make you stronger mentally and physically. In real life, all the above actually result in more problems both mentally and physically, making you weaker.

Sai-Lauren
09-10-2009, 16:15
eh largely it falls under a section of the Adeptus Sororitas, they don't take up arms or wear power armor but have training in tending to soldiers and the general populace. each world will have different systems...low population worlds probably have more adequate facilities where as over-crowded hivecities might as well shovel those unfortunate enough to get maimed or sick into the underhive.

You mean the Orders Hospitalier of the Adepta Sororitas - I'd say they'd run some hospitals, but they'd mostly be involved in refugee care, disaster aid and such, and some travel as part of campaign armies - many a guardsmans' last sight has been the face of one of the Emperors ministering Angels ;).

As for the original question - pick a world. Some worlds may be hyperadvanced, others probably couldn't work a sticking plaster.

Average world: You're probably looking at just post-20th century. Most viri will be immunised against, and there is a level of bionics if needed, but only the rich would be able to afford true replacements, the average citizen losing an arm in an industrial accident might just about get something that gave them a manipulator.



Certain areas of general medical care seem to have atrophied away, such as cosmetic considerations in surgery and wound care. One only need look at the atrocious facial scars sported by some characters. These scars could easily have been made less noticeable by even 20th century surgical techniques. So there seems to be a different attitude towards social acceptability of wounds and scarring in the general Imperium compared to the 20th century, early 21st century era.

More likely, people would be having cosmetic surgery to ADD scars, not remove them ;).



The economy in 40k (at least what we've seen) is communist - workers live and eat at their factories which are state-owned. Production is centrally planned by the local branch of the Adeptus Mechanicus. Governments are bureaucratic nightmares.

Nope. The AM would at best make sure that the appropriate rites are performed for the machines, but they don't run every single factory in the Imperium.

Corporations, either independant or state owned, would run virtually anything that's not on a Forge World. Communist, no. Corporate Feudalism, yes.

As for living in the factories, I prefer something similar to the Victorian mills - the workers live in terraces/ blocks in the streets around the factory, the houses themselves are probably owned by the factory, and the "rent", food etc is taken from what they would consider wages (or they work for nothing, but get accomodation, food and some entertainment from their employer).

Vaulkhar
09-10-2009, 17:33
There is battlefield care in 40k O.o, i always imagined that for most IG, battlefield care came out of the end of the Commissars pistol.

Depends on the regiment. Most take the line that, whilst a Guardman's lasgun is more valuable than the Guardsman, it is nevertheless a waste of the Emperor's resources to chuck away all that training and experience if it can be saved.

guillimansknight
09-10-2009, 18:22
On the subject of scarring

It must be NHS standard healthcare then

Iv had one wound fixed up at hospital ( one iv done multiple times)
and it's got quite a lot of scar tissue thanks to their methods, I should have stayed at home like I had when I done it before and I wouldn't have any scaring.

Argastes
09-10-2009, 18:43
There is battlefield care in 40k O.o, i always imagined that for most IG, battlefield care came out of the end of the Commissars pistol.

Don't be ridiculous, there are plenty of instances in the fluff where we see IG medics giving care to wounded soldiers. The Cadian and Catachan command squad boxes even include medics with first-aid kits, bandages in their hands, etc.

Condottiere
09-10-2009, 18:54
You just have to hope there's someone sympathetic in triage.

guillimansknight
09-10-2009, 20:20
You just have to hope there's someone sympathetic in triage.

Or you have to hope you can fiddle with their servitor programing

HK-47
09-10-2009, 20:42
I was actually thinking about starting a thread like this expect only dealing with how the Imperium deals with people how have a psychosis or have mental disabilities.

I was thinking with how everyone is afraid of chaos, people who are mental unstable are put down or turned into servitors for fear that they might fall to chaos. It seems extreme but the Imperium isn't known for being nice or caring.

Iracundus
10-10-2009, 15:53
Don't be ridiculous, there are plenty of instances in the fluff where we see IG medics giving care to wounded soldiers. The Cadian and Catachan command squad boxes even include medics with first-aid kits, bandages in their hands, etc.

Though from the 4th ed. IG Codex glossary, the medics are equipped with fibrillators (as opposed to defibrillators). No wonder their resuscitation success rates are so dismal.

Wolfblade670
10-10-2009, 15:59
Though from the 4th ed. IG Codex glossary, the medics are equipped with fibrillators (as opposed to defibrillators). No wonder their resuscitation success rates are so dismal.

Hahahaha, wow, someone at GW really dropped the ball on that one. :D

AndrewGPaul
10-10-2009, 17:02
In comparison to the depleted deuterium rounds, that's a small mistake. :)

Wolfblade670
10-10-2009, 17:16
In comparison to the depleted deuterium rounds, that's a small mistake. :)

<looks up deuterium>

...

Holy crap.

guillimansknight
10-10-2009, 17:25
GW just look up cool sounding words and don't look up what they mean

Vesica
10-10-2009, 23:52
Depends on the regiment. Most take the line that, whilst a Guardman's lasgun is more valuable than the Guardsman, it is nevertheless a waste of the Emperor's resources to chuck away all that training and experience if it can be saved.

True, but nothing makes the men fight harder than shooting a 'weaker' person :D


Don't be ridiculous, there are plenty of instances in the fluff where we see IG medics giving care to wounded soldiers. The Cadian and Catachan command squad boxes even include medics with first-aid kits, bandages in their hands, etc.

*cough* command squad *cough*

the IG is like pre WW1 armies where the only soldiers that are cared for are those from the rich families.

Its cheaper and more efficient to execute a injured soldier than it is to waste time healing him, and as i said above nothing makes guardsmen fight hard than a execution.

Vesica
10-10-2009, 23:53
I was actually thinking about starting a thread like this expect only dealing with how the Imperium deals with people how have a psychosis or have mental disabilities.

I was thinking with how everyone is afraid of chaos, people who are mental unstable are put down or turned into servitors for fear that they might fall to chaos. It seems extreme but the Imperium isn't known for being nice or caring.

You'll be surprised how many 'illnesses' can be cured with a laspistol

madprophet
12-10-2009, 00:47
You'll be surprised how many 'illnesses' can be cured with a laspistol

In the grim darkness of the far future there is only Obamacare :p

ntin
12-10-2009, 00:58
<looks up deuterium>

...

Holy crap.

Gas bullets are more grimdark?

Wolfblade670
12-10-2009, 01:19
In the grim darkness of the far future there is only Obamacare :p

BWAHAHAHAHAHA



Gas bullets are more grimdark?

Oh absolutely.

Pooky
12-10-2009, 02:22
I believe the amount of 'medical' treatment an average citizen recieves very much depends on what part of the Imperium you are focussing on. Are you talking about Holy Terra, a feral world, a civilised world, a death world, an agricultural world, etc. The world we are looking at would have its own culture, beliefs and levels of technology. These would be the areas which would basically dictate what would happen if someone needed/ what kind medical treatment they would receive.

If we are looking at Terra I would say that the medical care would be somewhat decent. If someone had a limb cut off then I believe a prosthetic/ bionics would be attached. If someone had a running nose then I believe the average citizen would just pray harder the the Emperor to get past the cold. Basically if it's something small/ non-life threatening the average Terran would just pray to the Emperor and major medical treatment would be quite sophisticated.

On a feral world I think there would be little if any 'medical' help available. I believe it would be based more on beliefs and culture. Perhaps something like "If you have an arm torn off then it's your own fault".

Iuris
12-10-2009, 06:44
In comparison to the depleted deuterium rounds, that's a small mistake.
<looks up deuterium>

...

Holy crap.
Gives a whole new meaning to "light gas gun", eh?

Anyway, the wonderful Dark Heresy RPG materials offer a magnificent insight into the matter.

-civilian medical care varies from world to world. A feral world shaman might offer some weird plant extracts to combat infection and ease pain, while a high tech hive world would have ultra advanced medical facilities. Of course, you go a few floors, and you'll see hive scum having access to little more than the fungus on the wall.

-the system allows for both AdMech, Sororitas and lay medical personnel. So, you can find everything, from nun-style WWI hospitals to scary ultratech labs to friendly family doctors.

-military has its own medical systems, which will deviate from the normal world tech. Even feral world regiments would probably get additional medical gear and training.


As for scars and cosmetic surgery: the artwork is there for the rule of cool. However, we must realize that military medical care may well be limited due to circumstances. Too many wounded means triage. A hospital coming under attack may well count itself lucky for being able to evacuate half the wounded alive... Scars will abound.

And after things cool down, THEN it's an issue of cosmetic surgery.

Sai-Lauren
12-10-2009, 13:09
the IG is like pre WW1 armies where the only soldiers that are cared for are those from the rich families.

Ever heard of Florence Nightingale? ;)

Soldiers in WW1, the Crimea, Africa and even way back in the Napoleonic era got organised medical care, the French army had carts with springs to smooth the trip - the very first Ambulances ;), but those who could afford it got the best, and everyone else got what they could.



Its cheaper and more efficient to execute a injured soldier than it is to waste time healing him, and as i said above nothing makes guardsmen fight hard than a execution.

And sooner or later, the Commissars wind up getting Catachan'ed.
Fight hard? No, they won't fight at all, they'll be looking to save their own skins. :rolleyes:

A Guardsman isn't just his equipment, he's also his training, his psycholgical state and his influence on the rest of his unit.

2 examples here - back to the Napoleonic Era, British Soldiers trained regularly firing their weapons, most other nations just drilled and rarely fired - some regiments were routed by the noise of their own first shots. Similar equipment and psychology, but different training.
Also, in Desert Storm, Allied armoured forces regularly engaged in live-fire excercises, whilst the Iraqi armoured forces only fired a few rounds a year because their guns had a low lifespan - 120 rounds for the T-72 compared to at least 1000 for the Abrahms. The Allied forces were also highly motivated, whilst the Iraqi forces, bar the Republican Guard, had low morale.

Psychology of the troops is extremely important - if Guardsman Bob's injured, gets med-evac'ed out, spends a week at a MASH, then comes back with tales of pretty nurses and an impressive scar the length of whatever, then the rest of his squad will be happier, and will fight better, knowing that if they too get injured, they stand a good chance of being patched up.

If the Commissar walks over and executes Bob for staining his Emperor-granted uniform with blood, they're more likely to be looking to desert, or take revenge on the Commissar and then desert.

To quote Bernard Cornwell via Richard Sharpe: "A flogging only tells a soldier one thing, how to turn his back."
Commissars are not just about discipline, they're there to inspire the troops as well. If that means they're going into enemy fire on their own to retrieve a fallen soldier, or ordering the platoon medic over to make a mortally wounded soldier comfortable for the last few moments of his life, so that his squadmates will hold the line and prevent a retreat turning into a rout, they'll do it. Shooting one of them may hold them, or it may mean they turn their guns on him and hope his death is viewed as enemy action. If not, well, they've survived a few days longer than they would have done.

Yes, guard keep their medics in the command section (IMO, mainly to keep the officer active so that the troops stay focused and keep fighting under his commands/influence), but there's almost certainly going to be one or two people in the platoon who've had basic first aid training, enough to treat minor injuries and get the trooper fighting again, or stabilise the wounded so that they stand a chance of surviving until the battle's over and getting evac'ed.

Grimdark it may be and simple fanaticism may allow the commanders to get away with more, but quite simply, a force as callous as you describe would never have evolved, the first moves towards it would have seen it fall apart, and there's absolutely no way you can just arrive there.

Mental Health: That's a good question.

I would suggest that it depends on their particular condition and how severe it is. An autistic savant might be used in the Imperial Code Breaking service, or their brain removed and used in AM logis engines, a schizophrenic might become a crusading saint (think Joan of Arc) or hunted down as a heretic, depending on which way the voices tell them to act and so on.

spetswalshe
12-10-2009, 14:41
In the grim darkness of the far future there is only Obamacare :p

Really? I would say rich people getting the best treatment and poor hive-scum getting bleach and a staple gun is more akin to what the US has right now. But then I live in Britain, where we share the load, as it were.

Mental health, in my opinion, would have much the same result - a noble family could get advanced neurosurgery, hive-scum might at best be able to pay to send their wayward child to Bleak Hospital, where he comes back with a scar on his head and a tendency to drool and scream at night. But he can probably still work carrying anvils from the furnace, and maybe one day save up enough to get a lobo-chip to stop that drooling, at least.

madprophet
12-10-2009, 16:06
Really? I would say rich people getting the best treatment and poor hive-scum getting bleach and a staple gun is more akin to what the US has right now. But then I live in Britain, where we share the load, as it were.

And what, precisely, would you know of the U.S. system? For your information, in the U.S. it is currently illegal for a hospital or clinic to deny care based on ability to pay - every state has an uncompensated care fund that reimburses hospitals and clinics for charity care. Furthermore most poor folks (even the working poor) are eligible for existing state subsidized coverage such as CHP (Child Health Plus) or FHP (Family Health Plus) or Medicaid or HealthyNY (equivalent plans exist in each of the 50 states). People with incomes up to $60,000/year (or 500% of poverty level) are eligible for some of these programs. Medicare (the federal indigent care program) will even cover illegal aliens and legal visitors if they fall ill while in the United States.

Under Obamacare, the government would have the power to deny care based on 'cost effectiveness', so-called 'social justice' and 'return on investment' criteria which is more like the Imperial system. If you are a democratic member of congress, no expense is spared but if you are a stay-at-home mom of three, well, we all gotta go sometime. If you don't belong to the 'politically correct' social demographic you are more likely to be denied care - a practice that is currently illegal. :skull:

I work for my state's medicaid system and we've already received briefs of the pending bills - all currently include this particular provision. I am not an expert on the British NHS but I have noticed a fair number of well-to-do Brits and Canucks coming to the USA for critical care that was denied or rendered unavailable by the powers that be back home.


Mental health, in my opinion, would have much the same result - a noble family could get advanced neurosurgery, hive-scum might at best be able to pay to send their wayward child to Bleak Hospital, where he comes back with a scar on his head and a tendency to drool and scream at night. But he can probably still work carrying anvils from the furnace, and maybe one day save up enough to get a lobo-chip to stop that drooling, at least.

Hell, that's pretty much Obamacare... except if he can't tend the furnace well enough, we'll just give him the Chosen One's Mercy.:chrome:

The Highlander
12-10-2009, 17:11
Can we keep the discussion of real world healthcare out of this thread before the mods jump on it!

Sai-Lauren
13-10-2009, 10:41
Can we keep the discussion of real world healthcare out of this thread before the mods jump on it!

Well, the political/religious parts certainly - they may be topics for other parts of the forum, or other forums, but not 40k Background.

The other parts we can probably work with though :) - I saw yesterday that they've managed to part-build a jawbone from stem cells. Which leads me to the question, what do people think would be the state of organ transplants - primarily augmetics, harvested donor organs, or implanted vat grown replacements?

heretics bane
13-10-2009, 18:59
The whole "the richest will get the best" will always be the case. The imperium is no utopia.

And im sure the imperium would have some neat medical tech with lasers etc. i can see Cadians getting wounds cauterized with lasers from their medic and grizzely Catachans useing flares to do the same.

Ramius4
13-10-2009, 19:19
It's a simple fact... Soldiers with no prospect for medical care or aid will be demoralized and no longer fight. It's a rediculous notion to think that the IG don't have adequate medical care.

Much as an enemy force who knows you don't take prisoners will fight to the last man. People want more than anything to survive...

Condottiere
15-10-2009, 14:52
Disease used to kill off more soldiers than the enemy. I presume tht most of those have been cured by now.

MajorWesJanson
15-10-2009, 16:51
It's 40K. As soon as they cure one set of diseases a soldier faces on the battlefield, either a new one shows up or they transfer to an all new battlefield. Or Nurgle comes along.