Author Topic: Medical Treatment  (Read 18897 times)

Offline Taran

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Medical Treatment
« on: April 07, 2015, 12:13:50 AM »
Healing wounds and medical treatment is dealt with, pretty much, narratively in DFRPG.

You need 'an excuse to start the healing process' and, after that, consequences go away based on their severity and the amount of time that lapses (hours, days, weeks - or scenes, sessions, scenarios, milestones).

The doctor stunt lets you treat someone and give them 'an excuse to start the healing process' - but it doesn't actually heal wounds.

For the same refresh, you could take a recovery power or, for no refresh, you can take Wizard's Constitution.

I'd like to figure out a fair way to allow 'mundane' treatment affect consequences.  This thread is to brain-storm ways.



First off, I don't think it should be as powerful as a recovery power - or even equal to a recovery power - especially since you'll be able to use it on other people.

Off the top of my head, I'm thinking of a tiered stunt - or a stunt in conjunction with a skill roll with a difficulty based on the consequence.

I'm thinking that, instead of curing a consequence, maybe it down-grades it?  I'm not sure if that makes it more powerful.  Used in conjunction with a recovery power, it could be very useful. 

Should it even stack with recovery?  Or would you take the better of the two?

Something like this:

minor consequence: Example: treating minor bleeding; helping someone recover from being dazed; shooting them with a pain-killer:   as a full action, with a roll of 'x' you can totally cure a minor consequence on a person.  You can do this 1/scene/person.  The roll can be resisted or blocked by someone actively trying to prevent you from providing first aid.

Moderate consequence:  Example: minor surgery; resetting a bone; lots of stitches:  requires one scene and a roll of 'x' and reasonably calm surroundings. Down-grade a consequence to a mild.  The new consequence must indicate that it's already a wound that has been mended and cannot, therefore, be removed with regular medical treatment.  Only a recovery power or time can help.

Severe consequence: requires a scene, a roll of 'x' and medical facilities.  Downgrades to a moderate.  Down-graded consequence can't be fixed via mundane methods.

Extreme:  Example: reconstructive surgery.  Provides an excuse to heal or re-name an extreme.  (maybe let's you do so a bit sooner than usual?



I'm just trying to get the juices flowing...feel free to comment, critique or add whatever.


EDIT:

What about something like this:  it down-grades the consequence, but if you do something to risk aggravating the wound before it would fully healed, you have to make a scholarship vs (the attack?) or have it revert back to the more severe consequence....or something to that effect.
« Last Edit: April 07, 2015, 12:19:34 AM by Taran »

Offline sdfds68

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Re: Medical Treatment
« Reply #1 on: April 07, 2015, 12:42:40 AM »
How about, instead of a full downgrade, a successful Scholarship roll + Doctor stunt reduces the time of recovery somewhat, but not as much as it would by reducing the severity of the consequence?

For example, a moderate would be reduced from lasting until the end of the next session to three or four scenes. Still significantly longer than a mild consequence, but much better than going without medical attention.

Offline Haru

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Re: Medical Treatment
« Reply #2 on: April 07, 2015, 12:43:20 AM »
As you might know, I'm not a big fan of healing in Fate. It's easily adjusted for any given game by speeding up the general recovery rate, if it becomes an issue. In the Dresden Files especially, healing goes a bit against the feeling of the novels for me. It's a few days of getting your ass kicked until you finally get a good kick in yourself, followed by a long period of rest and recuperation. Healing kind of takes things out of that rhythm for me. Not to mention that I personally don't think healing scenes like this are all that interesting (unless they can be combined with something else, as Harry sometimes does).

That being said, I certainly see the benefit. However, I feel like downgrading a consequence is kind of powerful.

A consequence does 2 things: It gives an opponent an advantage against you and it lowers your ability to get hit in a conflict. I think the second part is part of the core pacing design that should not be messed with on this level, reasons above. The first part could work pretty well. So instead of downgrading a consequence, a successful roll against the consequence would allow you to "blank" the consequence. It would still be there and it would need to heal, but for a scene it can't be used (invoked or compelled) against the character in any way.
That's practically what I think happens when Butters patches Harry up and puts him on painkillers. Other things, like Thomas drugging Harry with sleeping pills, could be a way to induce a refresh and push the healing meter one tick further.

I'm not a fan of the doctor stunt myself. I usually allow people to treat wounds in first aid, as I consider fate characters competent like that. Instead, a doctor stunt could give a +2 on the above roll, for example.
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Offline Sanctaphrax

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Re: Medical Treatment
« Reply #3 on: April 07, 2015, 05:44:50 AM »
Brainstorming...

There are three levels of medical treatment possible.

The first, with difficulty 3 for moderate consequences and 5 for severe consequences, renames the consequence and starts healing. BROKEN LEG becomes LEG IN A CAST, EVISCERATED becomes STOMACHFUL OF STITCHES, and so on.

The second, with difficulty 6 for moderate consequences and 8 for severe consequences, speeds Recovery. Each consequence has two possible durations, one with this level of treatment and one without.

The third, with difficulty 8 for moderate consequences and 12 for severe consequences, suppresses the consequence. The slot is still full, but the consequence is gone. It can't be invoked or compelled, and the effects of earlier invokes/compels are generally ended.

Mild consequences are too minor to bother with this way. Extreme consequences are too unique to put standard rules on.

In order to do any of this, you need a medical facility and "Medical Treatment" trapping on the skill you're using. Doctor expands Scholarship's existing medical trapping into that, other stunts might add it to another skill.

It isn't possible to do this with thaumaturgy unless you have a Medical Treatment trapping on one of your skills.

Offline Lawgiver

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Re: Medical Treatment
« Reply #4 on: April 07, 2015, 02:36:17 PM »
Didn't sped a ton of time working this out but I think the basic seed is there:

Broken legs in a cast don’t let you run like normal. Broken arms in casts don’t let you lift and such like normal. A belly full of stitches is still vulnerable to a solid blow. There are signs of a person’s debilitation due to physical injury. I’m sure we can think of similar ‘signs’ for mental and even social damage. Prosecuting a ‘wound’ (whether physical, mental or social) can still affect the character – if the opponent knows to do it.  I would suggest leaving the consequence in place as is (that broken leg is still broken). Just allow the treatment to temporarily mitigate some of the negatives.

Treat a consequence as though it were one less for the purpose of dice rolls (a -6 Severe is treated as a -4 Moderate after treatment), but it’s still there until the proper time elapses. Opponents can still invoke/tag it for use if they know it’s there (obviously the guy that did it would but others might not). Some sign might show – limping, bloody bandages dangling out a shirt sleeve, the PC flinches or cringes in the presence of open flame bigger than a match, etc. The opponent can do an Assessment to figure it out and then prosecute the consequence.

If they manage to do stress/damage at all to the affected area (doesn’t even have to be deliberate, they could get lucky too – and it would have to be pretty precise – two stress to the shoulder won’t damage that wounded leg any further), the dice roll mitigation is lost (cast shattered, stitches pulled out, character has PTSD flashbacks, whatever) and the character reverts to full handicap at the appropriate level until further treatment can be received.

If the stressed area has not yet had time to decline to the next lower level, more damage now can (and maybe should?) bump it up to the next higher level – thus Moderate becomes Severe (simple fracture becomes compound, etc.). If it has had time to recover at least one level (Severe down to Moderate) and it’s damaged again, then it rises right back up to the appropriate level based on the ‘injury’ and recovery has to start over – and at better treatment than applied originally must be used to let it begin.

If the stress/damage to that already wounded area is enough to take the character out (a ‘knockout punch’ or equivalent) then it increases on the scale to the next higher consequence (severe becomes extreme) and the character would need even more intensive medical treatment to justify beginning recovery. If it was already an extreme consequence, well… double the healing time? Saddle the character with a second horrid aspect to haunt them? Perhaps make the debilitation permanent? Your call...

(Note: For those with a more ‘grimdark’ game style it might mean death (bleed out, suicide, etc., just sayin’)
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Offline Sanctaphrax

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Re: Medical Treatment
« Reply #5 on: April 07, 2015, 04:07:45 PM »
Treat a consequence as though it were one less for the purpose of dice rolls (a -6 Severe is treated as a -4 Moderate after treatment), but it’s still there until the proper time elapses.

...

If they manage to do stress/damage at all to the affected area...

What do you mean? Consequences don't affect dice rolls, and this game doesn't have hit locations.

Offline Theogony_IX

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Re: Medical Treatment
« Reply #6 on: April 07, 2015, 04:21:01 PM »
I think Haru's point is on the right track in affecting the aspect applied by the consequence and not necessarily the recovery time.  A doctor can't make your bone mend faster, he or she can only make sure it mends well and make you more comfortable while it does.  The same is true for other physical injuries.

Also, a stunt that applies a broad effect allows a +1 bonus.  Being able to affect any physical injury is pretty broad, so the magnitude should only be around +1.  With that in mind, what if any tagged consequence that has been treated only provides a +1 bonus or short-lived effect rather than a +2 or lasting effect?

Another way to handle invokes for effect would be an opportunity to oppose the effect with an Endurance roll that you might not have gotten otherwise (the difficulty being the severity of the consequence invoked).  Changing the name of the consequence aspect would be a good way to keep track of what's been treated and what hasn't.

This begs the question, whether a hospital would provide the same effect.  I think there is some wiggle room there.  You can give your PCs something special in only allowing this to apply to their medicine, or you can apply it to all medical treatment.  If you want to keep it for your PCs or certain NPCs then the justification would be that these individuals know you're doing some rough activity and prepare your wounds for it, while a hospital does the minimum required for bed rest.

Offline Taran

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Re: Medical Treatment
« Reply #7 on: April 07, 2015, 05:04:10 PM »
Quote from: Haru
As you might know, I'm not a big fan of healing in Fate. It's easily adjusted for any given game by speeding up the general recovery rate, if it becomes an issue.

I don't necessarily want to speed up healing...I just want to have some kind of mechanical advantage for actually seeking medical help: whether that's going to the hospital, psychologist, paramedic, first aid.

I like the idea of getting rid of the ability to tag/invoke the consequence.  tags only happen in the scene the consequence is created (usually) - although, I'd allow someone to tag a consequence in a later scene if they hadn't already tagged it.

Invoking consequences with Fp's almost never comes up.

Quote from: Theogony
Also, a stunt that applies a broad effect allows a +1 bonus.  Being able to affect any physical injury is pretty broad, so the magnitude should only be around +1.  With that in mind, what if any tagged consequence that has been treated only provides a +1 bonus or short-lived effect rather than a +2 or lasting effect?

This is a good idea - and it's simple.  There's already a stunt that does this.  You could even include times when enemies tag for a re-roll and lock down one of the dice.  It doesn't really affect 'invokes for effect' but if you re-name the consequence, there'll be less leeway on what you can 'effect'.

Didn't sped a ton of time working this out but I think the basic seed is there:

Broken legs in a cast don’t let you run like normal. Broken arms in casts don’t let you lift and such like normal. A belly full of stitches is still vulnerable to a solid blow. There are signs of a person’s debilitation due to physical injury. I’m sure we can think of similar ‘signs’ for mental and even social damage. Prosecuting a ‘wound’ (whether physical, mental or social) can still affect the character – if the opponent knows to do it.  I would suggest leaving the consequence in place as is (that broken leg is still broken). Just allow the treatment to temporarily mitigate some of the negatives.

Treat a consequence as though it were one less for the purpose of dice rolls (a -6 Severe is treated as a -4 Moderate after treatment), but it’s still there until the proper time elapses. Opponents can still invoke/tag it for use if they know it’s there (obviously the guy that did it would but others might not). Some sign might show – limping, bloody bandages dangling out a shirt sleeve, the PC flinches or cringes in the presence of open flame bigger than a match, etc. The opponent can do an Assessment to figure it out and then prosecute the consequence.

If they manage to do stress/damage at all to the affected area (doesn’t even have to be deliberate, they could get lucky too – and it would have to be pretty precise – two stress to the shoulder won’t damage that wounded leg any further), the dice roll mitigation is lost (cast shattered, stitches pulled out, character has PTSD flashbacks, whatever) and the character reverts to full handicap at the appropriate level until further treatment can be received.

If the stressed area has not yet had time to decline to the next lower level, more damage now can (and maybe should?) bump it up to the next higher level – thus Moderate becomes Severe (simple fracture becomes compound, etc.). If it has had time to recover at least one level (Severe down to Moderate) and it’s damaged again, then it rises right back up to the appropriate level based on the ‘injury’ and recovery has to start over – and at better treatment than applied originally must be used to let it begin.

If the stress/damage to that already wounded area is enough to take the character out (a ‘knockout punch’ or equivalent) then it increases on the scale to the next higher consequence (severe becomes extreme) and the character would need even more intensive medical treatment to justify beginning recovery. If it was already an extreme consequence, well… double the healing time? Saddle the character with a second horrid aspect to haunt them? Perhaps make the debilitation permanent? Your call...

(Note: For those with a more ‘grimdark’ game style it might mean death (bleed out, suicide, etc., just sayin’)


I don't quite understand where you're going.  That said, I like the idea of having a treated wound getting worse.  I'm just not sure how best to do it without piles of bookkeeping.  If you use the method mentioned above, you could revert a consequence back to being tagged for a regular +2.

Brainstorming...

There are three levels of medical treatment possible.

The first, with difficulty 3 for moderate consequences and 5 for severe consequences, renames the consequence and starts healing. BROKEN LEG becomes LEG IN A CAST, EVISCERATED becomes STOMACHFUL OF STITCHES, and so on.

The second, with difficulty 6 for moderate consequences and 8 for severe consequences, speeds Recovery. Each consequence has two possible durations, one with this level of treatment and one without.

The third, with difficulty 8 for moderate consequences and 12 for severe consequences, suppresses the consequence. The slot is still full, but the consequence is gone. It can't be invoked or compelled, and the effects of earlier invokes/compels are generally ended.

This  kind of also touches on sdfds68's comment.

Would you create a longer recovery period from the books (when you don't get medical treatment)
Or shorten the current recovery period (if you do get medical treatment). 

The former would mitigate some of the pacing issues Haru has problems with.

Mild consequences are too minor to bother with this way. Extreme consequences are too unique to put standard rules on.

I think you should be able to mitigate the effects of a mild consequence.  In fact, they seem the easiest to do.  Even if  you don't heal it, you could always replace "fatigued" with "hopped up on adrenaline"  or something.  It also seems the most useful since, as I said, most consequences don't get invoked in later scenes - they just fill slots preventing you from soaking damage.  being able to prevent(or limit) a tag on a mild consequence seems like it would be useful but not game breaking if it didn't actually cure the consequence.

I agree with the Extreme, though.

In order to do any of this, you need a medical facility and "Medical Treatment" trapping on the skill you're using. Doctor expands Scholarship's existing medical trapping into that, other stunts might add it to another skill.

It isn't possible to do this with thaumaturgy unless you have a Medical Treatment trapping on one of your skills.

I especially like the thaumaturgy rule...it's basically a skill replacement ritual but you still need to have medical knowledge.  But scholarship automatically has that.

Offline Lawgiver

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Re: Medical Treatment
« Reply #8 on: April 07, 2015, 05:09:12 PM »
What do you mean? Consequences don't affect dice rolls, and this game doesn't have hit locations.
What is the -6 of a Severe consequence apply to if not a dice roll at some point? If you're going to negotiate a barrier (like a fence or wall) that -6 goes against some appropriate skill/ability (like maybe Athletics). If you're at Good+3 that -6 puts you at -3 out the gate and it will take at least +3 on the dice to succeed.

With aid, that -6 Severe could get treated as a -4 so, in the above example,  your Good+3 is only at Poor-1 (pain has been reduced, range of motion improved, etc.) and the dice roll to succeed is a lot less onerous.

The character doesn't heal faster... he/she just doesn't suffer the full range of the negatives while recovering because of the treatment. If reinjured in that area the full range of the negatives are again applied (perhaps even increased if sufficiently nasty).

Harry's been through much of the same any # of times, an injury has him acting at reduced capacity (sometimes on the edge of complete debilitation). Treatment (stitches, painkillers, mental techniques, whatever) have restored a degree of competency he'd be without otherwise. But he's also been reinjured (another blow to the head after he's already concussed) and suffered further and sometimes worse debilitation as a result.
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Offline Taran

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Re: Medical Treatment
« Reply #9 on: April 07, 2015, 05:16:08 PM »
What is the -6 of a Severe consequence apply to if not a dice roll at some point? If you're going to negotiate a barrier (like a fence or wall) that -6 goes against some appropriate skill/ability (like maybe Athletics). If you're at Good+3 that -6 puts you at -3 out the gate and it will take at least +3 on the dice to succeed.

With aid, that -6 Severe could get treated as a -4 so, in the above example,  your Good+3 is only at Poor-1 (pain has been reduced, range of motion improved, etc.) and the dice roll to succeed is a lot less onerous.

That's not what the -6 applies to.  The severe soaks up 6 stress from an attack.  After that, it works like an ordinary aspect.  So it could be invoked for effect to prevent you from climbing a fence, but it doesn't actually give you a numerical penalty to any skill rolls.

Or the effect could be to get a-6 to a roll - but it's still the realm of a compel.  So if that's how you want to negotiate the compel, you can do it that way.  But if you pay a FP to do that, the person gets a FP for their trouble.

The character doesn't heal faster... he/she just doesn't suffer the full range of the negatives while recovering because of the treatment. If reinjured in that area the full range of the negatives are again applied (perhaps even increased if sufficiently nasty).

Harry's been through much of the same any # of times, an injury has him acting at reduced capacity (sometimes on the edge of complete debilitation). Treatment (stitches, painkillers, mental techniques, whatever) have restored a degree of competency he'd be without otherwise. But he's also been reinjured (another blow to the head after he's already concussed) and suffered further and sometimes worse debilitation as a result.

Yeah...but these have been compels.

But you've made me think of an excellent way of doing this!

Medical treatment creates a maneuver aspect that sticks with the character.  They can tag the aspect to pay off a compel on an invoke of a consequence.  The quality of the maneuver must = the consequence.  Extra shifts(like every three shifts) could go towards extra tags

Offline Lawgiver

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Re: Medical Treatment
« Reply #10 on: April 07, 2015, 05:27:30 PM »
Or the effect could be to get a-6 to a roll - but it's still the realm of a compel.  So if that's how you want to negotiate the compel, you can do it that way.  But if you pay a FP to do that, the person gets a FP for their trouble.
I think this is more where I was trying to go. Sorry for muddy explanation(s). I'm not concerned if they get a FP, that's part of the game play anyway... and they're likely to need it if the bad guy is exploiting an injury for gain.

But you've made me think of an excellent way of doing this!

Medical treatment creates a maneuver aspect that sticks with the character.  They can tag the aspect to pay off a compel on an invoke of a consequence.  The quality of the maneuver must = the consequence.  Extra shifts(like every three shifts) could go towards extra tags
Actually that looks good; simple... almost elegant. I'll look into using that to see how it works out. Keep us posted on your own outcome(s).

And... you're welcome and...thank you?  ???

(I think I just got slapped with the Law of Unintended Consequences...)
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Offline Sanctaphrax

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Re: Medical Treatment
« Reply #11 on: April 07, 2015, 05:34:43 PM »
Invoking consequences with Fp's almost never comes up.

As long as you're houseruling, you could remove the rule which gives you the FP that other people spend on invoking your Aspects against you. It's a terrible rule anyway, which serves only to prevent people from invoking each other's Aspects.

This is a good idea - and it's simple.

I don't think so. Tags have to be used almost immediately, so you'll never get treatment for that broken leg before the tag is gone one way or another.

Would you create a longer recovery period from the books (when you don't get medical treatment)
Or shorten the current recovery period (if you do get medical treatment).

Not sure. Maybe a bit of each.

I think you should be able to mitigate the effects of a mild consequence.  In fact, they seem the easiest to do.

By the time you get to the hospital or whatever, that mild consequence will be gone.

I think this is more where I was trying to go. Sorry for muddy explanation(s). I'm not concerned if they get a FP, that's part of the game play anyway... and they're likely to need it if the bad guy is exploiting an injury for gain.

Even if the Aspect is compelled, the numerical rating of the consequence doesn't affect anything. You can give a -13 penalty for a mild consequence, if you want, or a -1 for a severe.

Medical treatment creates a maneuver aspect that sticks with the character.  They can tag the aspect to pay off a compel on an invoke of a consequence.  The quality of the maneuver must = the consequence.  Extra shifts(like every three shifts) could go towards extra tags

Eh, I don't like the idea of adding yet more Aspects to everyone's sheet. And in the best-case scenario this rule would make nothing happen, which is kinda boring. But I guess it would work.

Offline PirateJack

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Re: Medical Treatment
« Reply #12 on: April 07, 2015, 05:51:55 PM »
I like the idea of making the consequence only give +1 when invoked/tagged.
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Offline sdfds68

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Re: Medical Treatment
« Reply #13 on: April 07, 2015, 08:27:40 PM »
Medical treatment creates a maneuver aspect that sticks with the character.  They can tag the aspect to pay off a compel on an invoke of a consequence.  The quality of the maneuver must = the consequence.  Extra shifts(like every three shifts) could go towards extra tags

That does seem like a solution in keeping the theme of DFRPG, but I feel like if a good alternative to wizards con and recovery powers isn't put into effect beyond maneuver aspects, we'll just wind up seeing more people putting those into their builds.

How about first aid specifically, just a Scholarship roll with no stunt required, provides maneuvers like the ones discussed, but a character with a stunt related healing is capable of doing something outright better, as long as they have some kind of operating theater and tools? That would make the Stunt worthwhile, and could actually fit in with the stunt rules as is by providing a new trapping for Scholarship.

Offline Theogony_IX

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Re: Medical Treatment
« Reply #14 on: April 07, 2015, 10:51:12 PM »
This is a good idea - and it's simple.
I don't think so. Tags have to be used almost immediately, so you'll never get treatment for that broken leg before the tag is gone one way or another.

Okay, so theoretically it makes sense, but maybe it doesn't make practical sense.  How about opening up one shift of stress in a filled consequence slot?  After medical treatment, each treated consequence slot can soak up a single point of stress, but not more.  If a person fills that one shift, it's as if the consequence were brand new.  This means a free tag for whomever caused you to fill it, a new recovery process initiation, and a reset of the time needed to recover.  In other words, you popped your stitches, or misaligned your set bone . . . go back to the doctor.