diff --git a/code/modules/surgery/gender_reassignment.dm b/code/modules/surgery/gender_reassignment.dm
index 37687cfc252..b9709c7c3d9 100644
--- a/code/modules/surgery/gender_reassignment.dm
+++ b/code/modules/surgery/gender_reassignment.dm
@@ -3,7 +3,7 @@
 //////////////////////////////////////////////////////////////////
 
 /datum/surgery_step/gender_reassignment
-	priority = 2
+	priority = 1
 	can_infect = 0
 	blood_level = 1
 	allowed_species = list("exclude", IPC, DIONA, PODMAN, VOX)
@@ -16,15 +16,15 @@
 	var/obj/item/organ/external/groin = target.get_bodypart(BP_GROIN)
 	if (!groin)
 		return 0
-	if (groin.open < 2)
+	if (groin.open < 1)
 		return 0
 	return 1
 
 /datum/surgery_step/gender_reassignment/reshape_genitals
 	allowed_tools = list(
-	/obj/item/weapon/retractor = 100, 	\
-	/obj/item/weapon/kitchen/utensil/fork = 75,	\
-	/obj/item/weapon/screwdriver = 50
+	/obj/item/weapon/scalpel = 100,		\
+	/obj/item/weapon/kitchenknife = 75,	\
+	/obj/item/weapon/shard = 50, 		\
 	)
 
 	min_duration = 110
diff --git a/code/modules/surgery/organs/brain.dm b/code/modules/surgery/organs/brain.dm
index 5df485613c8..4a9385216c0 100644
--- a/code/modules/surgery/organs/brain.dm
+++ b/code/modules/surgery/organs/brain.dm
@@ -52,7 +52,6 @@
 				oxygen_reserve = min(initial(oxygen_reserve), oxygen_reserve+1)
 			if(!oxygen_reserve) //(hardcrit)
 				owner.Paralyse(3)
-			var/can_heal = damage && damage < max_damage && (owner.reagents.has_reagent("brainheal?????")|| (damage < 30 && owner.reagents.has_reagent("inaprovaline")))
 			var/damprob
 			// Effects of bloodloss
 			if(!HAS_TRAIT(owner, TRAIT_CPB))
@@ -61,8 +60,6 @@
 						if(owner.pale)
 							owner.pale = FALSE
 							owner.update_body()
-						if(can_heal)
-							damage = max(damage-1, 0)
 					if(BLOOD_VOLUME_OKAY_P to BLOOD_VOLUME_SAFE_P)
 						if(!owner.pale)
 							owner.pale = TRUE
@@ -72,25 +69,25 @@
 						if(prob(1))
 							var/word = pick("dizzy", "woosey", "faint")
 							to_chat(src, "<span class='warning'>You feel [word]</span>")
-						damprob = owner.reagents.has_reagent("inaprovaline") ? 30 : 60
-						if(prob(damprob) && damage < 20)
-							take_damage(1)
+						if(owner.oxyloss < 20)
+							owner.oxyloss += 3
 					if(BLOOD_VOLUME_BAD_P to BLOOD_VOLUME_OKAY_P)
 						if(!owner.pale)
 							owner.pale = TRUE
 							owner.update_body()
 						owner.blurEyes(6)
-						damprob = owner.reagents.has_reagent("inaprovaline") ? 40 : 80
-						if(prob(damprob) && damage < 40)
-							take_damage(1)
+						if(owner.oxyloss < 50)
+							owner.oxyloss += 10
+						owner.oxyloss += 1
 						if(!owner.paralysis && prob(10))
 							owner.Paralyse(rand(1,3))
 							var/word = pick("dizzy", "woosey", "faint")
 							to_chat(src, "<span class='warning'>You feel extremely [word]</span>")
 					if(BLOOD_VOLUME_SURVIVE_P to BLOOD_VOLUME_BAD_P)
 						owner.blurEyes(6)
+						owner.oxyloss += 5
 						damprob = owner.reagents.has_reagent("inaprovaline") ? 60 : 100
-						if(prob(damprob) && damage < 60)
+						if(prob(damprob) && damage < 40)// without blood the brain begins to die
 							take_damage(1)
 						if(!owner.paralysis && prob(15))
 							owner.Paralyse(3,5)
@@ -99,11 +96,10 @@
 					if(0 to BLOOD_VOLUME_SURVIVE_P)
 						if(!iszombie(owner)) // zombies dont care about blood
 							owner.blurEyes(6)
+							owner.oxyloss += 10
 							damprob = owner.reagents.has_reagent("inaprovaline") ? 80 : 100
 							if(prob(damprob))
 								take_damage(1)
-							if(prob(damprob))
-								take_damage(1)
 
 	..()
 
diff --git a/code/modules/surgery/organs/heart.dm b/code/modules/surgery/organs/heart.dm
index 376698caaf1..e8749666690 100644
--- a/code/modules/surgery/organs/heart.dm
+++ b/code/modules/surgery/organs/heart.dm
@@ -34,6 +34,10 @@
 		handle_pulse()
 		if(pulse)
 			handle_heart_beat()
+			if(pulse == PULSE_2FAST && prob(1))
+				take_damage(0.5)
+			if(pulse == PULSE_THREADY && prob(5))
+				take_damage(0.5)
 		handle_blood()
 	..()
 
diff --git a/code/modules/surgery/organs_internal.dm b/code/modules/surgery/organs_internal.dm
index 3499645980f..2b234cede0b 100644
--- a/code/modules/surgery/organs_internal.dm
+++ b/code/modules/surgery/organs_internal.dm
@@ -5,7 +5,7 @@
 //////////////////////////////////////////////////////////////////
 
 /datum/surgery_step/organ_manipulation
-	priority = 1
+	priority = 2
 	allowed_species = list("exclude", IPC, DIONA)
 	var/obj/item/organ/internal/I = null