Re: Character concepts that cry out for GM Vengeance
Sorry, I may have misconstrued your question when I answered it.
In the case of Jake accidentally pulping the drunk's cranium, the MedTech let it slide (so Jake lived to be killed by Mike's ex-Mafioso with the orbital crystal cyberarms and the impact-triggered forearm spike) - I think he would have happily punched the drunk's nose through the back of his skull, too - especially since the drunk, the wounded woman, the car load of people the drunk had hit, and the accident itself were all based on a real event at which the bloke who was playing the MedTech and I were first on scene.
Where the game digressed from reality was in the actions performed by the players.
IRL, the bloke who was playing the MedTech was not a paramedic but he was a first aider, as am I, so we rendered assistance as best we could and waited for the ambulance to arrive. IRL, we had to render assistance to the stupid drunk who had trashed a car full of young people returning from an office party (the driver of the second car was a designated sober driver) - fortunately none of whom were injured - and had seriously wounded a passenger in his own car - teeth through lip, broken shin-bone protruding through skin of leg. The drunk had suffered only superficial lacerations when he went through the windshield, owing to being so drunk that he flopped like a rag doll, but we had to tend to him and help the Ambos get him into the back of the ambulance - despite wanting to just "accidentally" drop him on the pavement.
I suspect a bit of the player crept into the character, enabling the MedTech to let Jake survive "just this once".