Learn Hardcore Finnish: Tabletti auttaa, mutta potilas tarvitsee silti paljon lepoa. - The pill helps, but the patient still needs a lot of rest.

tabletti can mean “a tablet” or “the tablet” depending on context.
potilas can mean “a patient” or “the patient”, again depending on what has been talked about before.

If you really want to specify, you use other words instead of articles, for example:

se tabletti = that/the tablet
tämä potilas = this/the patient

But in your sentence, the bare nouns are normal and natural; context tells the listener which tablet and which patient you mean.

What exactly does silti mean here?

silti is an adverb meaning roughly “still, nevertheless, even so”.
It marks a contrast with the previous clause:

Tabletti auttaa = The tablet helps
mutta potilas tarvitsee silti paljon lepoa = but the patient still / nevertheless needs a lot of rest.

So silti emphasizes: “in spite of what was just said, this is still true.”

Common English equivalents in this kind of sentence: still, yet, nevertheless, even so.

How is silti different from kuitenkin? Could I use kuitenkin instead?

Both silti and kuitenkin can often be translated as “still / however / nevertheless”, and here you can say:

Tabletti auttaa, mutta potilas tarvitsee kuitenkin paljon lepoa.

The sentence is grammatical and natural. The nuance:

silti is a bit more direct and simple: “still, even so”.
kuitenkin can feel slightly more formal or “textbook-like”, and is very common in written Finnish and in more careful speech.

In everyday spoken language, silti is extremely common in this exact “X, mutta silti Y” structure.

Why is there a comma before mutta?

In Finnish, you usually put a comma between two independent clauses, even when they are joined by a conjunction.

Here you have two full clauses:

Tabletti auttaa (The tablet helps).
potilas tarvitsee silti paljon lepoa (the patient still needs a lot of rest).

Because mutta joins two full clauses, the comma is standard:

Tabletti auttaa, mutta potilas tarvitsee silti paljon lepoa.

This is similar to English comma usage with “but”, although Finnish is even stricter about it.

What is the difference between mutta and vaan, since both can translate as “but”?

Both often translate as “but”, but their use is different:

mutta = “but, however” in general contrast:
- Tabletti auttaa, mutta potilas tarvitsee silti paljon lepoa.
  The tablet helps, but the patient still needs a lot of rest.
vaan = “but rather / but instead”, and it is normally used after a negative first part:
- Tabletti ei paranna sairautta, vaan vain lievittää oireita.
  The tablet does not cure the disease, but (rather) only relieves the symptoms.

So in your sentence (no negation in the first clause), mutta is the correct and natural choice; vaan would be wrong here.

Why is tarvitsee used without a pronoun? Who is the subject?

The subject is potilas. Finnish does not require subject pronouns when the subject is otherwise clear:

potilas tarvitsee = the patient needs
There is no hän (he/she) because potilas already tells you who.

So the structure is simply:

Tabletti (subject) auttaa (verb)
mutta potilas (subject) tarvitsee (verb) silti paljon lepoa (object + adverb).

Having hän as well (mutta hän tarvitsee…) is possible if you want to refer back to a known person, but with potilas right there, it’s not needed.

Could I say “…mutta hän tarvitsee silti paljon lepoa” instead of “…mutta potilas tarvitsee silti paljon lepoa”?

Yes, that is grammatically correct:

Tabletti auttaa, mutta hän tarvitsee silti paljon lepoa.

The difference is:

potilas is a noun; it sounds a bit more neutral, clinical, or descriptive: “the patient needs…”
hän is a personal pronoun; it feels more personal and assumes the person is already clear in the context.

You might choose potilas in a medical report or when first introducing the person as the patient. You might use hän more after the person has already been clearly identified in the conversation or text.

Why is lepo in the form lepoa here? What does the -a ending mean?

lepoa is the partitive singular of lepo (rest). The -a/-ä ending is one of the typical partitive endings. In this sentence, lepoa is part of the object phrase paljon lepoa.

So:

lepo = basic dictionary form (rest)
lepoa = partitive form (some rest, a lot of rest).

The partitive is used for unbounded or indefinite amounts, and rest is treated like a mass/uncountable noun here.

Why does paljon require lepoa (partitive) and not just lepo?

In Finnish, the quantifier paljon (a lot, much) almost always takes the partitive case:

paljon vettä = a lot of water
paljon rahaa = a lot of money
paljon aikaa = a lot of time
paljon lepoa = a lot of rest

So the pattern is:

paljon + [noun in partitive]

Using the nominative (paljon lepo) would be ungrammatical in standard Finnish.

Is the word order with silti fixed? Could I say “…mutta silti potilas tarvitsee paljon lepoa”?

You can move silti around a bit, and all of these are possible:

…mutta potilas tarvitsee silti paljon lepoa.
…mutta potilas silti tarvitsee paljon lepoa.
…mutta silti potilas tarvitsee paljon lepoa.

Differences are mainly in emphasis and rhythm:

Version 1 (your original) is the most neutral and common.
Version 2 emphasizes tarvitsee (the needing).
Version 3 puts strong contrast right after mutta: “but still, the patient needs…”, a bit like English “but still, the patient needs…”.

All are grammatically correct; choice is stylistic.

Why doesn’t auttaa have an object here? Shouldn’t it be auttaa potilasta or something?

auttaa (to help) often does take an object:

Tabletti auttaa potilasta. = The tablet helps the patient.
Lääke auttaa päänsärkyyn. = The medicine helps (with) headache.

But it can also be used without an explicit object when the context makes it clear what or whom it helps:

Tabletti auttaa. = The tablet helps / works / is effective.

In your sentence, the focus is on the contrast with the need for rest, not on specifying exactly what the tablet helps with, so leaving the object out is natural.

Why are auttaa and tarvitsee in the simple present, not something like “is helping / is needing” as in English?

Finnish does not have a separate continuous/progressive tense like English “is helping”. The simple present covers both:

Tabletti auttaa.
= The tablet helps.
= The tablet is helping / is effective (now).
Potilas tarvitsee silti paljon lepoa.
= The patient needs a lot of rest.
= The patient is still needing / still needs a lot of rest.

So whenever you see a Finnish present tense, you choose between English simple present or present continuous based on what sounds most natural in English, not by changing the Finnish form.