So I'm working on this game called Medical Hospital.  The core conceit is that players create their own medicine-themed story by mashing together various mini-games, each of which takes 5-10 minutes to play out and consists of a single scene.  The scene types can be mixed and matched a bit to reflect different sorts of stories.  Right now the scene types are trauma, surgery, diagnosis, romance, drama, and comedy.  I see opportunities for others.  Trauma and surgery are tactile, not roleplaying exercise at all, and currently quite awesome.  I worked up diagnosis this weekend and tried it out today.

The diagnosis game is sort of medical Mastermind.  A doctor's "opponent" plays the ill patient and creates the disease, which starts as one of 40 offered in the game.  They look like this:

Vibrio parahaemolyticus
Pathogen: Bacteria
Vector: Water, Food
Symptoms: Vomiting, Cramps, Chills
Etiology:  Patient has ties to the food service industry
Notes: Vibrio parahaemolyticus is a bacterium in the same family as those that cause cholera. It lives in brackish saltwater and causes gastrointestinal illness in humans...blah blah blah

To this general description the patient player adds three pieces of bogus information, like spurious symptoms or multiple possible vectors.  The first diagnosis scene involves the patient roleplaying the intake interview. 

In each diagnosis scene, the doctor player can either refine his understanding by either filling in a single blank (learning vector or pathogen) or confirming a symptom, or making a diagnosis.  There is a currency wager associated with each overall diagnosis, and each scene costs one.  A successful diagnosis doubles whatever currency remains, and a failed diagnosis segues straight into a trauma scene, where the patient may die.  In the initial playtest, it took an average of three guesses (and three currency) to make a definitive diagnosis, which seems about right - you'd need to bet at least 7 currency for it to show a profit at that rate.

In trying this out with three pairs of doctor and patient, I learned a few things.  First of all, clever application of bogus traits if key - one patient used obvious left-field symptoms and his doctor dismissed them and nailed a wicked case of dengue fever easily.  Second, no diagnosis is better than a bad diagnosis - another guy made a firm judgment that was totally wrong, sending his patient to the ER early in the game.  A more methodical doctor identified my Ehrlichiosis and profited.  Third, I can already see that interspersing what are really extended conflicts into the punchy, one-off shorter scenes if going to be really, really fun. 

One problem that arose was the need to consult a lengthy booklet of possible illnesses, which  had all the doctors fighting for time with the pages.  40 possible illnesses seems like a good number (I'd like to work up another for systemic internal illnesses like heart irregularities and cancer; the ones I have are all infectious diseases), but it's a dense pile of material.  One cool and interesting possibility would be to put the same material on line, so players could reference it electronically in real time. 

Sounds cool, like what I imagine med. students actually do when they role-play with actor patients.

I'm curious how these diagnosis scenes fit into the game as a whole. Do they just pop up now and then so the players can get currency to drive the other scenes? Seems to me that the romance, drama, and comedy scenes would be the meat of the game and the trauma, surgery, and diagnosis as the fluff. Is that how you're seeing it?

How are the illnesses cross referenced? Maybe an index or chart would help speed up the process of passing around the book. The online line material would be cool, especially if everyone has a laptop and wi-fi.

Seems that their is some cross over potential here also for non-gamer friends. What I've seen so far, I think, I could sell my SO on playing.

This is all pretty early, but I don't see any of it as "fluff" - just more or less roleplaying involved.  Diagnosis, trauma and surgery have very little, and the others have a bunch.  You could actually tune your game based on preference, ideally mixing it up to keep things fresh.  The same scene type cannot appear twice in a row, but right now that is the only restriction.

Right now the illnesses are just alphabetized.  I think part of the challenge will actually be an information processing task, so I don't want to lay it all out in a big if/then chart (a playtester suggested that, based on the way the actual Physician's Desk Reference apparently works).  I'm not sure how to organize the illness information to make it challenging, entertaining and accessible.

For a chart I was thinking something much more basic than an if/then chart. Something like listing Vomit and then all the illnesses that include Vomit. Or a simple x/y chart with the symptom's list across both the x/y and the intersections listing the illnesses that contain both. This would allow the players to narrow down the illnesses quicker without spelling it out completely for them.

Jason wrote:
So I'm working on this game called Medical Hospital.  The core conceit is that players create their own medicine-themed story by mashing together various mini-games, each of which takes 5-10 minutes to play out and consists of a single scene.  The scene types can be mixed and matched a bit to reflect different sorts of stories.  Right now the scene types are trauma, surgery, diagnosis, romance, drama, and comedy.  I see opportunities for others. 

Thanks, I definitely see extensibility, too, both in terms of scenes and genre, but I want to focus on making it work inside a very narrow set of parameters and then encourage people to go nuts.  One scene type I'd love to see is horror, so you could play Riget.  Swapping out a few scene types and you could play cops, or paramedics, or firefighters.  Swap out a few more and you could play Gilmore Girls, I guess. 

One thing I'm really excited about is the mix of dumb party game type activities (actually using office supplies to mess around with a two dimensional abdomen) with more straightforward roleplaying.  I think people will really like this, especially people (like me) who fiddle around at the table anyway.  If I get all jumpy from sitting too long, I can bust out a trauma scene and use my hands for a bit while advancing the game.

Jason wrote:
Thanks, I definitely see extensibility, too, both in terms of scenes and genre, but I want to focus on making it work inside a very narrow set of parameters and then encourage people to go nuts.  One scene type I'd love to see is horror, so you could play Riget.  Swapping out a few scene types and you could play cops, or paramedics, or firefighters.  Swap out a few more and you could play Gilmore Girls, I guess. 

Jason wrote: One thing I'm really excited about is the mix of dumb party game type activities (actually using office supplies to mess around with a two dimensional abdomen) with more straightforward roleplaying.  I think people will really like this, especially people (like me) who fiddle around at the table anyway.  If I get all jumpy from sitting too long, I can bust out a trauma scene and use my hands for a bit while advancing the game.

This is a cool idea.  I think we've suffered too long under the tyranny of the "core mechanic".  Why not have a rule for everything?  I've been thinking about a similar idea for Arthurian Romance, with Quest, Joust, Magic, Intrigue and Embroidery scenes.  One thing I was interested in was in having some scenes only available to some characters.  So only women (or "feminine" characters) could do magic, only masculine characters could do jousts.  You could think of something similar, where doctors can do surgery and stuff, but nurses get some other valuable type of scene.  The balabnce I was going for was that each type of character was required to make the economy of the game flow.

Yeah, that's a great idea - focused scenes available to specific roles.  My original idea was to have everyone play both a doctor and a member of the staff (nurse, orderly, administrator), but half of the fun games (trauma, surgery, diagnosis) are really only open to doctors, who can enjoy the other half as well.  So right now the focus is on playing a doctor, with other roles being picked up as needed, troupe style.  I'm open to other ideas, though. 

And as far as "core mechanic" goes, there really is one - or three.  Every scene has a card-based resolution system that is a variant off a few simple rules.  There are three different games (the color game, the sequence game, and the matching game), which all vary by scene.  Because this makes every card potentially valuable (you play the color game for surgery and trauma, but red is good in surgery and black is good in trauma), a balanced set of initial scenes is important.  When you toss out scene types, you are adding value to specific cards and combinations and de-valuing others, which is fine.