Setup

Separate the deck into MEDICINE and PATIENTS. Deal each player 2 of each type.

Then combine all cards into one deck.

• Place a row of 6 cards in the middle of the table.
• Fairly deal the remaining cards over all players.

Any leftover cards are shown and discarded.

Objective

The game ends as soon as a player’s hand is empty. They win.

Gameplay

From start player, take clockwise turns until done. On your turn, either PLACE or SWAP.

Place

Placement happens following pyramid rules (or “staircase”), both above and below the starting row.

• Place cards between those from the previous layer.
• Each layer contains one fewer card than the previous one.

A MEDICINE card can only be placed if the numbers are right.

• Check the cards on the previous layer that “support” this card. (There must be 1 or 2. You can’t place a card disconnected from the previous layer.)
• Your number must be higher than all or lower than all.

A PATIENT card can only be placed if …

• There is a path through the pyramid, starting from the patient card
• Which passes through all required medicine (for this patient); nothing more and nothing less.
• And never travels backward. (You can’t go up and then down again; or left and then right.)

Playing a patient is hard! And so you are rewarded.

For each requirement on your patient, pick a player who must show you a hand card.

Swap

Swap two cards that are already in the pyramid.

Some restrictions, however, apply.

• Reveal a hand card to all other players.
• If it’s a patient, you can only swap cards of types they want.
• If it’s medicine, one of the swapped cards must be of that type.

Upgrades

Played the game a few times and ready for more challenge? You’re in the right place! Try any of the expansions below.

Operations

This expansion adds special cards.

Their placement rules are the same as for medicine. Once placed, they instantly trigger their action (written on them).

Intensive Care

This expansion adds more unique medicine and patients.

It also adds wildcards (numbers, medicine, requirements that can be any type you want). These are always represented by question marks (?).

Because of the increased deck size, also increase the starting row to 8 cards.