"You know, I'm quite disappointed that nobody's tried changing their sex five times yet. I wrote a lovely long description of the Doctor sobbing over the twisted mass of scar tissue and pointing-out-hair that passes for the player's genitalia, and nobody's actually seen it yet. Harrumph."
Doctor Paprika shakes his head sadly. "I am sorry madam, but your records say you've already had 5 Gender Changes. Since the tissue down there can only withstand so much. . . Hang on, 5 sex changes? Really? Oh, my word. What have I done. . . There's no possible way I'd be able to do anything with you. Your genitals are an unrecognisable mass of scar tissue, stitches and oddly-placed hair. Do you understand? No, please don't start crying. . . Oh, pull yourself together! Get off me! For God's sake, LEAVE MY SURGERY, and take that cacky hermaphrodite abomination between your legs with you!"
You find FIVE HUNDRED CIGARETTES, apparently left by scared villagers.1) 2)