Between the medical and healing capabilities within Union, it's all right for Birthday to retain his general background with some kind of a high-risk operation that saved his life. Union generally has access to antibiotics and new advances in medicine aren't uncommon, it's an area they place a lot of resources into due to their general outlook on the importance of human life in a world where humans have greatly dwindled in number.

In terms of medicine access, it's socialized and available for everyone, again due to how the culture plays out. Pills and other medications are certainly becoming more prevalent, but in general everyone uses the same basic care structure which is typically seen as quite exceptional.