"You possess the gift of the Healing Touch... yet you refuse to use it effectively. Are you content with just saving people's lives? Have you ever considered what lies beyond that? I have. I'm about to change the world! Reformation is impossible without firm belief!" -Patrick Mercer
"I don't care what vision you have for the future! I'm determined to keep saving lives!" -Derek Stiles

Nous (Greek for "mind") is the first discovered Neo-GUILT, known as "the Malignant Side of Wisdom." It creates spore like Nous-tumors that must be treated in the order they appear.

The first person infected with Nous was Emilio Juarez, who was infected during a liver transplant.

Unlike other Neo-GUILT, Nous is not explained as being a performance enhancing organism; however, based on the belief system of Patrick Mercer, it is likely that Nous did have a beneficial effect at some point. Judging from its name and the title of mission X-4, it is possible that it is some sort of learning agent. This would also explain why Nous' original host (the donor of Emilio's liver) became brain dead.


Stage Information

Nous lacks a traditional Pre-GUILT stage: the operation on Emilio has you transplant the liver before confronting Nous.

In X4, Nous skips the transplant and goes directly to treating Nous.


A number of Nous-tumors will appear in the organ, followed by Nous. The Nous-tumors must be drained and excised in the order they appeared. If the Nous-tumors are treated out of order, all of those that appeared before the one treated will explode, dealing around 30-35 damage to the vitals.

From the moment that the player can do anything to Nous or Nous-tumors, an unseen timer starts. If this timer reaches zero, a "miss" is declared by the game, Nous retreats into the organ without taking damage and any remaining Nous-tumors instantly explode. If the player attempts to treat Nous prior to the removal of the Nous-tumors, all Nous-tumors explode, often causing enough vital damage to kill the patient.

If the player succeeds in draining all of the Nous-tumors, they may then attempt to drain and excise Nous directly. Success in doing this before the timer expires counts as a "hit," 5-6 of which are enough to defeat Nous and succeed in the operation.

Aletheia Nous Any appearing Aletheia Nous will dive into the heart after some time, and release a single Nous-tumor that must be excised.


Attack Information
Tumor Creation Nous will appear, along with a varying number of Nous-tumors. These Nous-tumors must be treated in the order they appear, with Nous last; otherwise, the untreated Nous-tumors will burst.
Dive Nous will dive into the organ, causing a "miss" and rupturing any Nous-tumors.

Nous OperationsEdit

Episode Patient Organ Type of Nous Other GUILT Present
2-6: Rebirth Emilio Juarez Liver Nous None
7-7: Mother of Sins Reina Mayuzumi Heart Aletheia Nous Aletheia
X-4: Nous Unnamed man Liver Nous None
X-7: Aletheia Unnamed woman Heart Aletheia Nous Aletheia


  • If Nous is threatening to dive into the organ, ignore treatment of the other Nous-tumors and attack Nous itself. While doing so will cause all untreated Nous-tumors to burst, this will happen regardless if Nous successfully retreats. It doesn't count as a Miss, but the Chain will break and potentially hurt the player's rank.
  • Nous-tumors that have been cut out but not removed with the forceps will not burst if ignored to treat other Nous-tumors. This can be used this to an advantage to save bits of time that would otherwise be spent on switching tools.
  • In 2-6, the convulsions that occur with Nous's appearance will drop the patient's vitals to 50 if they are above that number. Keep this in mind to avoid wasting time raising vitals during the transplant so that more time is left for Nous.
  • While Nous is generating tumors, take the opportunity to raise vitals. Remember to keep watch on the order to treat them in.
    vde Diseases and Conditions
Common Conditions AneurysmAppendicitisBurnCardiac ArrestCholelithiasisForeign ObjectHemorrhageInflammationLacerationTumor
GUILT KyriakiDefteraTritiTetarti (Diverticulum) • PemptiParaskeviSavatoBliss
Stigma CheirSomaOpsOnyxBrachionCardia
Post-GUILT Syndrome Post-KyriakiPost-TritiPost-PemptiPost-Savato
Neo-GUILT NousBythosSigeAletheia
Other Rosalia Virus (Twisted Rosalia) • Costigar DiseaseVaimahse Fever
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