AKA: How Medicine is a useless skill in vanilla, especially in hardcoe

Stimpacks. The all-purpose healing agent. What you go to when you're hurtin'. Their effectiveness is governed by the Medicine skill, and can heal up to 90 (or 15HP/Sec * 6 secs for the hardcoe game).

Super-stimpacks. Extra healing, for the cost of some physical weakness. For when the "Oh S$#@" threshold is reached and you need to not be nearly dead NOW.

Doctor's Bags. For when you want to remove that rather unsightly piece of shrapnel from your leg.

So why do they feel absolutely useless in the face of the Survival skill?

Do you know what Science and Medicine does in the real world when some natural curative is discovered? It figures out how and why and what specifically is happening, distills it, and makes it even more potent. What happens in FONV? A freakin' bass-ackwards tribal remedy, the Bitter Drink, outperforms the stimpack! FOOD outperforms it! Even one of the most basic prepared food, the Bloatfly Slider requiring all of 20 survival skill to concoct, outperforms a stimpack in healing, to say nothing of anything higher. And the only ways to deal with poison aren't even in the Medicine category.

At least there's Doctor's Bags... OH WAIT, Hydra outperforms doctors' bags! And it heals over time so you can just down one and not worry about being crippled when fighting someone bomb-happy (looking at you, powder gangers in early game). Once you hit the skill to mix up Hydra yourself, doctors' bags are useless now too, unless you have zero Fixer pills on you and are bound damned and determined not to ever get addicted to Hydra. And once you hit Honest Hearts, you get Daturana, which really heals a lot and doesn't even have an addiction factor!

And then there's perks. How many perks rely on Medicine? Three. How many for Survival? Six, and once DLC is factored in, it goes up to twelve.

And here's the kicker... Apparently Josh Sawyer wanted to cripple Medicine even more than it already is, as evidenced in his "JSawyer" mod by the nerfing of Stimpacks, the insertion of "expired" stimpacks, and the inability to make your own stimpacks (also replaced with an inferior "homemade stimpack"). What happens to food? Some raw foods get their detrimental effects tied to not having Lead Belly, the Sunset Sarsaparilla's absurd healing factor gets nerfed, and... that's it. Even the Bloatfly Slider isn't touched.. Food is an even more potent as a healing agent than a fictional drug specifically intended to accelerate tissue regeneration in the JSawyer.esp module. He even crippled Doctors' Bags so they're even more pointless in the face of Hydra and Daturana. If he really wanted to make it harder to heal, he should have removed the healing effects from *all* the food and left the Stimpacks completely alone.

What can Medicine do that Survival can't do better? Nothing. What can Survival do better than Medicine? Everything. Obsidian had it out bad for Medicine. They should have just sent it out to pasture as BGS did with Mysticism in Skyrim instead of leave it in its pathetic state.

It could be counter-balanced by some crazy addiction or long term toxic effects for the 'survival' skill remedies. Say, for instance, your charisma drops three points and your speech skill 20, due to all your teeth falling out and developing horrid lesions on your lips from swilling home made healing brews too often.

Honestly, I agree that in terms of aid items Medicine is worth far less than Survival. However, let's look at a hidden cost - Survival takes interfacing with the crafting system as most Survival items cannot be found or purchased in sufficient quantities. Medicine, on the other hand, buffs Stimpaks available at basically every merchant.

In short, if you don't want to think about healing, Medicine is superior. If you enjoy playing with the crafting system (I do) then using Stimpaks is more of a debuff than not using them.

How about no? Just balance the amount of healing points Medicine can do, especially Doctor's Bags (should've healed limbs by 25-50% at 100 medicine, not this small % crap). That, and perhaps Chems should be within Medicine, granting the medicine user longer-active chems (or slightly stronger chems) while the Survival user gets large health giving items, but jack crap in the Chems department.

You could...but, would you trust no side effects from the crack factory bathtub down the road, or a patented medication?

My suggestion is simply to reflect potential side effects from the use of 'home made' remedies, although I'd hardly suggest that even stimpaks would be pharmaceutically safe.

Usually, Stimpaks seem to be some kind of adrenaline, Morphine, steroid medication all rolled-up into one mean syringe. Of course Idk if that's in Fallout, but many other games write it off as that (I'm looking at you, Starcraft and Area 51). What I mean is chems are essentially medical drugs that are abused or items refined into a different, addictive item. Perhaps with a high Medication, you'll also get a low chance of getting addictefd? Ehhh? Good stuff right?

To be fair, the JSawyer mod doesn't really represent what Josh wanted to add to the game, it was made as an extra-challenge mod where he can add content without having to worry about what the majority of players will think about it. It seems that most of the mod's purpose was to make the game extremely challenging to keep experienced players on their 3298th playthrough interested in doing a 3299th playthrough -- numerous, weightless, and (fairly) potent healing items like stimpaks make the game less challenging and therefore had to be nerfed. Most food items that are effective weigh a decent amount and have to be crafted, and with the JSawyer mod's severely cut max carry-weight, I think that helped to balance food items a bit.

While I agree with you that Medicine was kind of useless compared to survival, I still raise it to around 70 in most playthroughs. Why? Well, 1.) because stimpaks are extremely common, weightless, and a great item to hotkey, and 2.) because the Living Anatomy Perk is one of my favorites (I know it's not that useful, but knowing an enemy's stats before attacking them can save your life in a DiD run), 3.) because there are a decent number of skill checks that require the medicine skill, and 4.) because having RadAway work well comes in handy in a few locations (Vault 34 comes to mind but I'm sure there are others as well).

I guess that's how the devs tried to balance it, and although it didn't turn out to be balanced all that well, it's also one of those things where, 'what else would you do?' Put stims, doctor's bags, and the effectiveness of other medical drugs under survival? Use survival to pass skill checks when trying to heal patients in a medic's tent? How would you RP a doctor character if there wasn't a medicine skill?

The crack factory bathtub, especially since most "patented" medication is addictive as hell. Even today, opioids are an epidemic plaguing this country.

As far as the topic goes, I guess I never paid attention. In my games, I don't carry stimpaks at all, because I'm quite proud I can say, "Zero stimpaks and zero deaths." I strive to play a game as though I am trying to survive it, and finding 200+ year old medicine is something I'd never take, no matter how refined it is.

I tend to carry at least 10Wg in water on me at all times, and I'll drink irradiated water because I know I have the ability to cleanse the radiation.

While I do realize I can craft better meds, I often just stick with the raw ingredients, because they're lighter and it's more realistic I'd chew on a guave plant than I'd run home to brew me up some swamp juice to heal my Rickets.

I suppose it's all a matter of how you look at it, but meds should be weaker than science, since I'm not buying a Courier is going to have the knowledge to make purified medicine in the first place. Even if I suppose they're in school, this level of expertise sure as hell wouldn't have them as a courier for their job. They'd be working in a clinic.

I usually run with Project Nevada set to remove all food healing from the game. Food is for reducing hunger, and that's it. Prepared food restores more hunger than raw food (by a factor of 3 or 4), and raw meat tends to carry stat penalties when eaten. Survival based remedies still work, but the ingredients you need for those are rare enough that Medicine becomes MUCH more valuable than Survival. I wonder if they were trying to compensate for how useless food was in FO3 where it healed for a pittance and weighed way too much to be worth collecting outside of quests.

Nah, rather they should've made it more "essential". Fix, don't ditch.

Rename it (to, say, doctor) and give the ability (and necessity in case of cripples) for manual healing, for one example.

The problem with medicine is that Stimpacks are cheap and weightless, so I really don't care if I have to inject four rather than three, since I have eighty.

How many skill-checks require medicine?

How many skill-checks require Survival?

Also

Doctor's bags are relatively easy to make: the materials are relatively easy to acquire. Stimpacks are even easier: It's basically the same recipe as Healing Powder plus an Empty Syringe, which isn't very hard to find, even if you ignore muggy in OWB (otherwise you'll be swamped with them). Hell, between muggy and the biological research station you're almost guaranteed never to run out of them. And since you can reach Big MT before Zion, well... it goes without saying.

On the other hand, Healing powder is crap, first of all. And second of all Hyrda requires some pretty rare ingredients to make (unless you're playing Honest Hearts.) Even healing Poultice is not easy to make outside of Zion.

Truthfully I NEVER level up the survival skill unless I'm using Imp's More Complex Needs, since I could actually say the same of Survival.

Agree. It's should be all about extra abilities that you cannot do otherwise by yourself, and paired with higher prices with Doctors (e.g like Repair, which could be a significant sink if you don't do it yourself) Medicine would be way more valuable.

Exactly! Carrying 80 filled syringe on a regular is beyond crazy, same for the idea that you just pump a few into yourself when in trouble and suddenly everything is okay. Perhaps surgery (thus Medicine) should play a bigger part in the game...