[Stat! TV Medical Drama] Design Goals

[Daniel Solis]

While putting aside the other game ideas that are simmering in the back of my brain for the time being, I started thinking of Tales of Human Drama!

A few months ago, during the discussion of a legal drama RPG, I proposed a trilogy of games based on common primetime drama premises. The games would be "Stat!" (medical), "Objection!" (legal), and "Freeze!" (police). The games wouldn't necessarily have similar systems, but they would have the same theme of "Yahoo Drama." The games wouldn't be accurate simulations of their subject matter, any more than their television counterparts are accurate representations of their subject matter. Instead, the average game session would be under an hour and packed wall-to-wall with white-knuckle life-or-death decisions, careening past one ridiculous plot twist after another.

I've written up a sketch of what I'd like the system to do.

You're part of a highly stressed medical team at a major hospital. Every day, you get the cases that other hospitals see maybe once a month if they're unlucky.

Stat! is not meant to accurately represent medical practice. It's inspired by and meant to emulate fast-paced emergency room prime time dramas.

System
Every patient has a Crisis. This is a randomly generated number representing the severity of disease or injury the patient has sustained. When the number is reduced to zero, the crisis has been resolved. Crisis is initially kept secret from the players.

You have a limited amount of Time in which to resolve the crisis. "Time" is a number representing how many actions you may take. If you do not resolve Crisis within the number of actions allowed by Time, the patient dies. Time is initially kept a secret from the players. When an action is attempted, Time is reduced by one increment, no matter the outcome.

Three outcomes might happen as a result of an attempted action:

Success - The intent of your action is accomplished. The nature of success depends on the ability being used, described below.

Stress - Crisis is unaffected, but you gain an increment of Stress. Every increment of Stress you accrue represents an extra increment of time that is lost whenever you attempt an action. Stress can only be reduced by being Consoled by another player.

Complication - Something happens during the procedure that increases Crisis by one increment. The complication is introduced by the player who made the attempted action. It can pertain to the medical procedure itself, but may also be something external like the patient's distraught family member barging into the emergency room.

The following are the abilities your character may use. Several players may attempt their actions simultaneously and have only one time increment used, but only one action can be attempted by one player. Any acting character's Stress still affects the loss of time as described earlier.

Treat - Success reduces crisis by one increment.
Diagnosis - Success reveals the Crisis number or the Time number.
Stabilize - Success negates any change to Crisis for one time increment.
Console - Success reduces another character's stress by one increment.
Stat! - Success increases Time by two increments. (In effect, negating the time lost by attempting the action and adding one extra increment.)

You can also take a Risk, which increases the chance of stress or complication. The successful effects of each ability are the following:

Treat - Reduce crisis by two increments.
Diagnosis - Randomly generate a new Crisis number or Time number. If the new number is less beneficial than the one already being used, it may be disregarded.
Stabilize - Negate only unbeneficial changes to Crisis for one time increment.
Console - Completely remove all stress from another character.
Stat! - Increase Time by three increments.

It's very rough and the wording could be clearer, especially with the risk stuff, but this is the direction the game seems to be headed. At first, I thought a "yahoo drama" game would be more narrativist, but I think this gamist race against time works well.

You'll notice that at no point have I mentioned how a character mechanically attempts to perform an action. That's because I'm unsure what would be the best way to do it. I'd like some suggestions from the Forge-ites on what would be a simple resolution system to accomodate these intents. The only idea I have right now would be to use a "d6 dice pool, take the highest result" mechanic.

1-2: Complication (+1 Crisis)
3-4: Stress (+1 Stress)
5-6: Success

If you choose to take a risk, the new outcome spread would be something like this:

1-3: Complication (+1 Crisis)
5-4: Stress (+1 Stress)
6: Success

If I go with that, I could redesign Stress so that it forces you to take the next lowest die in your die rolls instead of having it mess with Time. That stress/time interaction is rather clunky at the moment.

And I ought to encourage complications more, since they're what make an ER-type drama so interesting. The audience doesn't entirely understand the medical procedure going on, but they do understand the stress of having to do something very important only to be interrupted by something else. Maybe dealing with a complication can reduce stress? That's not necessarily accurate, but I'm not really concerned with accuracy. If dealing with complications reduces stress, it could be an annoyance to the character but a welcome diversion for the player. Hm.

Well, anyway... How can I encourage interaction with the complication? How can I encourage introducing really crazy complications? What would be the best mechanic to meet the stated intents of the system? A lot of it seems fairly random too, should there be some sort of resource system? ...I bow to the wisdom of the Forge.

[Daniel Solis]

After thinking about it a bit, I will go ahead and keep the d6 dice pool resolution, along with the outcome spread.

I'll change Stress so that it forces you to use next highest die result.

Also, I'll get rid of the second outcome spread for risk. Instead, Risk forces you to use the next highest die result, just like stress, but if you do succeed, you get benefits proportional to the riskiness of the act. So, if you perform an action with Risk 2, you're forced to disregard your two highest die results. Risk 5, you have to disregard your five highest die results. The new successful outomes for risk are:

Treat - Reduce crisis by risk.
Diagnosis - (I don't really like this randomly generating thing. I'll keep thinking of something good to put here.)
Stabilize - For an amount of time equal to risk, disregard only negative changes to crisis.
Console - Remove a number of stress points from another character equal to risk.
Stat! - Increase time by risk.

Should complications and stress also be proportional to the risk or is the reduced chance of success do that enough?

[MoonHunter]

You might want to include some additional abilities, as Stat! will often overflow to outside the ER.  They can be very general and abstract, like Athletic (for ALL physical activities), Tech (for all machines except medical ones), Charm, Resistance (for all damages, throwing off illnesses, etc).

You should also include some form of rank, for medical students, residents, fellows, attendings, sr attendings, department head, and so on.  Some players might want to start as attendings, while others want to start as medical students.  Since both should start the game with the same starting level/ points, eventually the Medical Student should become an uber doctor... but will have to do what the Attending says.  

A stat/ skill in dealing with hospital organization might also be important. It will give you another avenue of game conflict in addition to being a way to resolve patient needs.  

To help round out characters I would suggest gifts and flaws of some sorts, to better define characters.  Certain characters will have knacks that will give them advantages. Maverick (gives you pluses to perform certain actions, but gives you negatives in other social situations) for example.  Alcoholic, prone to violence, and a variety of other things.  

Lastly, players should be albe to take on interpersonal issues in play.  By taking on such a complication (romance in the workplace, issues with the boss, possible hep c infection), it might give them bonuses to resolving medical issues (as a game mechanic balance).  So the more dramatic, complicated your life becomes, the better you are at helping patients.... until they either self destruct or find a way to decompress.