Where to get it: drivethrurpg
The thing I enjoy most about reading a new Colin Fredericks rpg is that I never have to wonder "why does this exist" or "what's the point." It's always very quickly obvious that I'm seeing something with a unique point of view and a strong central thesis. Sufficiently Advanced was about far-future sci-fi, where technology had grown so powerful that virtually anything was possible. Sorcerously Advanced was that, but with magic (and somehow, despite that 100% accurate description, managed also to be better than the original). And Monster Ambulance continues that tradition. It's a high-stakes medical drama as your predefined team - paramedic, EMT, driver, and dispatcher - race through the city streets to save lives, but it's also a comedy because your patients and coworkers (and maybe you yourselves) are monsters and you all work for Grendel's Mother's Memorial Hospital.
Chef's kiss. Perfect pitch. No notes. Netflix, offer this guy a series already because this is exactly the sort of premise that we would all pretend to be heartbroken over when it's cancelled after two seasons, but would secretly agree lived up to its potential after precisely 20 episodes, and thus would binge watch approximately a hundred times.
That might have come off a bit snarkier than I intended, but I really do mean it as the highest praise. A given group is only ever going to get one campaign out of this game, but it's going to be a campaign they'll talk about for the rest of their lives. It's just so tight a setup.
You've got your emergencies, which take place in the ambulance and primarily use your career attributes. And then when you're back at the hospital, you've got situations, which involve drama, romance, and light comedy with your coworkers (and key off of relationships, which work a lot like attributes) and that's it. You're only ever saving lives from bizarre, nonsense medical conditions or trying to talk your weird monster coworkers into taking their pants off. Everything else fades to black and you just alternate between the two types of scenes. It would take actual, active work (or maybe just a really dull GM) to have a scene that wasn't both interesting and relevant.
But I can't speak for its longevity. Monster Ambulance seems to me to inhabit an awkward limbo where a one shot isn't quite long enough - you want to establish the slow-burn sexual tension between the rookie EMT and the immortal gorgon who works the reception desk, or the rivalry between the brilliant, but troubled paramedic and the cyborg chief of surgery whose human brain lost out to her for valedictorian in medical school - but a full campaign might seem to drag - the basic setup is 1)medical emergency, 2)interpersonal drama, 3)goto 1.
Then again, ER ran for 15 seasons.
The system is dead simple - roll dice based on your attributes (career + drive + hallmarks for emergencies, relationship + drive + hallmarks for situations) and then compare that to what the scene rolls on its dice pool (set by the GM, based on difficulty and pacing). If you win, the scene's dice become weaker, if you lose then either the scene becomes stronger or one of several countdown tracks advance (exhaustion, insecurity, [vehicle] breakdown) and in an emergency, you're trying to avoid being knocked out before drawing the hospital card from the map deck and in a situation you're just trying to reduce the dice pool to nothing, only failing definitively if it gets too powerful.
It's super bare bones and thus faces the same dichotomy as all other bare-bones systems - there's no conceivable scenario where this system can't work, but also it's so abstract that you might come to feel that you're playing the dice rather than playing the story. If you've been in this hobby any length of time, this is something you've already come to terms with - you either enjoy rules-lite or you don't. I know some people don't like scene-resolution mechanics, but given the game's emphasis on teamwork and ensemble drama, it's as well-justified here as it's ever been.
Overall, this game was a delight. Probably one of the few that feels legitimately exciting even without a combat system, and perfect for people who are keen to really sink their teeth into the medical procedural genre. And while its fun and goofy atmosphere amuse the hell out of me (one of Monstropolos' other hospitals is called "Behemoth Israel," heh), it would also be easy enough to adapt this into a straightforward, modern-day hospital soap opera game. Once again, it's a thing with a strong reason to exist. That's the highest compliment I know how to give.
Ukss Contribution: I loved most of the colorful cast of suggested NPCs like the Chupacabra psychologist or the Fair Folk radiologist, but the one that was easiest to adapt was Unlight, the mimic health inspector. Oversight in the form of an untraceable shapeshifter who could be watching even at this very moment is a concept broad enough to work in almost any genre.