“Do Less Harm” – Surgery rolls and rules
Over on the GURPS Discord, there was a question about removing a barbed dagger without taking 50% more injury while doing so. This was in response to a backstabbing to the vitals that apparently delivered in the neighborhood of 40 HP of injury. So removing it risked 20 more.
Seemed to me to be a good case for Surgery, and off the cuff I suggested “roll 1d or 2d damage, and let the Surgery roll’s margin of success mitigate that damage, with a minimum of 1 or 2 points.”
That minimum represents that you probably have to widen the wound to get in there and get the dagger barbs out. But a skilled physician can possibly do the least amount of harm there.
I sort of joked that the difference between me doing an appendectomy and a skilled surgeon is that the surgeon LOWERS the damage done, and guards against side-effects (such as bleeding, infection, death, or cooties). Some of the gear modifiers make sense: clamps mitigate bleeding, so increase skill (and thus reduce damage taken).
I need to look at this more. Surgery is typically invasive, it does controlled damage in order to prevent even worse outcomes. Ye Oldyn Tymes surgery even more so lacking magic.
But I like the feel of it. And even if the injury were as much as 2d (maybe even ×3 for vitals), that has the net effect that on the average, Joe Clutz will be doing an average of 21 points carving that dagger out of the victim…just like removing it would do. A proper surgery roll mitigates this.
I could even see
The GM secretly rolls the damage the surgery would cause
A player rolls Diagnosis. Success tells the value of the roll.
Then the Surgery roll could be aborted or not.
So there’s a dagger in the vitals; the GM secretly rolls 2d and gets (gulp) a 10. Any damage NOT mitigated suffers the ×3 multiplier.
A good surgeon might say “yeah, I got this. With skills, magic, and equipment, I will certainly lower that number from 10 down to maybe only a few points.” A mediocre or poor one might say “I can’t operate on this; I’d kill him trying. We need to find a better healer.”
I feel like there might be some fun dialog and options opened up here.
Yes. Love that. Would have made for a fun denouement after the battle.
I think the idea needs work and fleshing out, but I love the concept that – as anyone who has HAD surgery can tell you – by and large it’s controlled destruction.
On my own part, after I blew myself up in 2015, my heel was shattered into six pieces. Had it been left alone, I’d have been lamed or crippled. Certainly pain and limp for the rest of my life.
What was the fix? They opened me up, took out a piece they couldn’t fixate, and with five steel screws that look on the X-ray like someone spilled out a small bag of deck screws, bolted me back together. I couldn’t walk on it for two months, at all. Could only limp for a few more. And the total lack of muscle tone in my left leg meant I had to re-learn to walk.
But now I run, do martial arts, and since the accident did my best-ever squat and deadlift. So I took targeted damage in order to avoid being crippled for life. That doesn’t exist in GURPS right now. Perhaps it shouldn’t. But I think it would be fun if it did.
I have a sudden hair-brained idea that one might combine Mr. Fix-It (Pyr #3/37) and Life is a Battlefield (Pyr #3/120) to model a more detailed surgery scenario.
Design the wounded parts using Mr. Fix-It, then treat the possible damage surgery going wrong as the durability of the “enemy” and then spread it around among affected parts.
Hmm.
Excellent idea!
I would love to see a GURPS Medical Ops book covering the medical skills and covering different TL, equipment, and magic. Ideally including Powers based stuff too, A physician with Microscopic and Penetrating Vision? TK for sterile surgery, etc.