Medical procedures not detailed in the D20M sourcebook

[Felon]

A character who's a medic wants to do doctory stuff that's not covered in the D20M sourcbeook. As the DM, I have to arbitrate what skill checks are involved. I don't want to do it half-assed, either, because it's important (to me at least) that characters see a definite value in having invested their skill points in the right skillset.

The first task at hand is attempting to diagnose a health problem (such as a disease). This I make a Knowledge (Earth & Life Sciences) check, since this area of knowledge inorporates medicine. Some folks would object and try to make all medically-related tasks a Treat Injury check. I think Treat Injury checks might be useful interms of performing diagnosis procedures that be useful or even necessary in order to make a diagnosis (i.e drawing fluids, exploratory surgery, etc.), but you need the KS to make an actual assessment. How does that sound?

The next task at hand is similar, but is a little more tricky: performing an autopsy. Now, I think this requires a Treat Injury check, with a -4 penalty for those without the Surgery feat. Of course, disassembling a corpse probably isn't as hard as repairing a living body, so the difficulty of the check would be less, like 15. Now, the tricky part here is that an autopsy is basically looking for clues inside a person. Looking for clues is supposed to involve Search and Investigate. Should these skills come into play? Should the Treat Injury check act as the Search check? Should the Investigate check supplant the KS check to determine a cause of death (a synergy bonus from the KS is an option)?

Some considered opinions (hopefully backed with some kind of rationale) would be welcome.

 

[Roudi]

Some folks would object and try to make all medically-related tasks a Treat Injury check. I think Treat Injury checks might be useful interms of performing diagnosis procedures that be useful or even necessary in order to make a diagnosis (i.e drawing fluids, exploratory surgery, etc.), but you need the KS to make an actual assessment. How does that sound?

I think that sounds pretty accurate. I like it.

Now, the tricky part here is that an autopsy is basically looking for clues inside a person. Looking for clues is supposed to involve Search and Investigate. Should these skills come into play? Should the Treat Injury check act as the Search check? Should the Investigate check supplant the KS check to determine a cause of death (a synergy bonus from the KS is an option)?

A Treat Injury check to successfuly perform the autopsy should be first (DC 10 or easier). Roll it secretly. Now, at this point, I think Search, Investigate, and Knowledge (Earth & Life Sciences) checks all have their place. Investigate could be used to generally determine what the cause of death might be (trauma, biological/chemical, etc). If the cause of death was a disease, old age, or some other biological or chemical cause, the Knowledge check would be needed to discover it. A Search check could represent trying to find something specific (such as a bullet somewhere in the corpse's body), but is really only useful if you know what to look for. Failing the initial DC 10 Treat Injury check should impose a -4 penalty on any of these checks; basically, if you botch the autopsy, it will impair your ability to properly investigate the corpse.

Of course, you COULD just haidwaive all this with the single Treat Injury check. It all depends how many rolls (and how much roleplaying) you want to involve in a single autopsy.

 

[Felon]

Thanks for the input. Since initial posting, a few thoughts have occurred to me. The most significant is that autopsies actually happen all the time, not just in the course of criminal forensics. If I were to drop dead at my keyboard right now, there would probably be an autopsy. Not every coroner will have Investigate and all of the CSI skills it entails. So, I think I'll keep the autopsy to a Treat Injury check (to do the actual carving) and a KS (E&LS) to determine the probable cause and time of death.

As you say, a Search check might be required to find a less clue that wouldn't be manifestly obvious after opening the body. Investigate would be used as a follow-up, to get the kind of highly specific data that would require a forensics lab.

 

[Mustrum_Ridcully]

Thanks for the input. Since initial posting, a few thoughts have occurred to me. The most significant is that autopsies actually happen all the time, not just in the course of criminal forensics. If I were to drop dead at my keyboard right now, there would probably be an autopsy. Not every coroner will have Investigate and all of the CSI skills it entails. So, I think I'll keep the autopsy to a Treat Injury check (to do the actual carving) and a KS (E&LS) to determine the probable cause and time of death.

As you say, a Search check might be required to find a less clue that wouldn't be manifestly obvious after opening the body. Investigate would be used as a follow-up, to get the kind of highly specific data that would require a forensics lab.

There are cases of Death in real life that are not accurately identified by coroners, and are actually the result of a crime. I remember reading about cases of medical attendants poisoning their aged clients (for money, lazyness and rarely humanitarian reasons).

Though I don't know if that's just because the Treat Injury DC would be to high or the coroners lacked the Investigate skill, speaking of in-game terms

 

[Peterson]

Hmm.

Autopsies. Here's how I do them in my game.

I'd say Treat Injury (DC 10, -4 without the Surgery feat) for basic autopsies. You know, the kind where either the cops don't care how the hobo died, or they already know who did it.

For an "non-basic" autopsies, I'd call for a Treat Injury (DC 15, -4 without the Surgery feat).

For the CSI type autopsies, I'd call for a Treat Injury (DC 20-30, -4 without the Surgery feat).

Of course, anyone who successfully succeeds at a Knowledge (Earth and Life Sciences) check (DC 10) can add a +2 to the Treat Injury check.

Anyone with 5 ranks in either Search or Investigate gains a +2 synergy bonus to Treat Injury checks for the purposes of Autopsies only. However, you are allowed only a single (+2) synergy bonus, regardless if you have 5 ranks in BOTH Search or Investigate.

Not sure how this works for you all, but its effective enough for my games.

Peterson

 

[Henry]

I'd say Treat Injury (DC 10, -4 without the Surgery feat) for basic autopsies....
For an "non-basic" autopsies, I'd call for a Treat Injury (DC 15, -4 without the Surgery feat).
For the CSI type autopsies, I'd call for a Treat Injury (DC 20-30, -4 without the Surgery feat).
Of course, anyone who successfully succeeds at a Knowledge (Earth and Life Sciences) check (DC 10) can add a +2 to the Treat Injury check.
Anyone with 5 ranks in either Search or Investigate gains a +2 synergy bonus to Treat Injury checks for the purposes of Autopsies only.

I would handle it in this way, myself - it gives benefit to the related abilities, while still keeping it firmly in the province of one skill.

 

[HeapThaumaturgist]

Having been a long-term Alternity fan, I'm a big proponent of "complex skill checks".

I think you can find them in a side-bar in your friendly local DMG. Dunno if they're anywhere in d20M.

I think the DC 10 Treat Injury (-4 with no Surgery feat) works well. Synergy with K(ELS) and Investigate.

But then I'd say that you turn it into a Complex Check, one check every 15 minutes, with the GM layering information throughout.

1 Success: Bob died of blood loss from obvious lacerations to the chest and abdomen.

2 Successes: Bob seems to have been assaulted by a wild animal, there are bite marks included with the lacerations.

3 Successes: The jagged nature of the wounds indicate dull claws like those of a bear, but the bites are not consistent with predator teeth or jaw structures.

4 Successes: Teeth marks found on the ribs are human

Etc etc.

--fje

 

[The Shaman]

...I'm a big proponent of "complex skill checks".

Me, too.

I treat autopsies like Gather Information checks - different information at different DCs. Making a determination of death is DC 10 - identifying mechanism or cause of death can range from DC 15 for 'simple' trauma to DC 30 for poisoning. Each check takes as long as a Surgery check. A character with no ranks in Investigate takes a -4 on the Treat Injury check to perform an autopsy. Five ranks in Investigate and Craft (pharmaceutical) provide a skill synergy bonus to the Treat Injury check - an evidence kit and a pharmacist kit are also required along with the surgery kit in order to gain the bonuses provided by the skill synergies.

Other use of Treat Injury in my games include an assessment check, a skill check to identify a person's current health (DC 15 for current hit points +/- 10% or the presence of adverse conditions such as fatigue or exhaustion, DC 20 for ability damage such as the loss of CON or INT points) and "meatball surgery," which allows a character to heal 1d3 hit points per character level of the patient in 10-60 minutes instead of the usual 1d4 hours - there is no reduction in the amount of time required for recovery from meatball surgery for a high skill check (i.e., a character is fatigued for a full 24 hours regardless of the skill check roll).

 

[Committed Hero]

Autopsies

My gut(!) says use Investigate, since it is one of the most narrowly defined skills in the game - this gives it another application. Also, as the skill is unique to forensic-type people, you won't have the odd character with good Search or Treat Injury cutting into cadavers at the drop of a hat. I would cetainly consider synergy with Treat Injury, K(life sciences) and even C(chem/pharm), but I might not disclose those to the player if you want to keep the cause of a death mysterious.

Maybe a feat which activates the use of the skill would help, like Survival & tracking.

Why not Treat Injury? For starters, the coroner is not as concerned with preserving the body (to paraphrase Dennis Miller, "what's the coroner's idea of a bad day? He gained one on the table?"). Also, consider that the cause of death/reason for autopsy may not involve an actual injury. And finally, Treat Injury is not trained only.

 

[Felon]

Hmm. Autopsies. Here's how I do them in my game. I'd say Treat Injury (DC 10, -4 without the Surgery feat) for basic autopsies. You know, the kind where either the cops don't care how the hobo died, or they already know who did it. For an "non-basic" autopsies, I'd call for a Treat Injury (DC 15, -4 without the Surgery feat). For the CSI type autopsies, I'd call for a Treat Injury (DC 20-30, -4 without the Surgery feat).

That's true, some autopsies are more invasive than others. Cutting opening someone's lungs and seeing loads of black humors and tumors isn't the same thing as pulling the lungs, heart, brain, and other major organs out of the body and dissecting them individually.

I would handle it in this way, myself - it gives benefit to the related abilities, while still keeping it firmly in the province of one skill.

Well, it only gives benefit to having 5 ranks in the related abilities. And worse, it's denying a knowledge skill it's primary function (assessing things) in favor of a skill that has numerous applications. The way I see it, if you have a player who's dedicated to a medical profession, then this is one of his times to shine. Keeping it simple is selling him short.

It doesn't get tedious if the GM is descriptive and has the check work progressively towards a final revelation. Following the Treat Injury check, I'd reveal immediately obvious stuff--the player might draw his own conclusions just from visual evidence (not all causes of death are big mysteries). Following up with a successful KS check ascertains specifc facts (again, not all types of death entail a great deal of facts; "yep, he was shot in the head at point blank range"). Now, the player adds those facts up, and he decides and decides if the cause of death requires further investigation. He then uses Investigate to perform specific tests, some which will go beyond the medical realm (ballistics tests, for instance).