Surgery

Though grisly to outsiders, and oft regarded with a mix of fear and distaste, surgery is the indispensable study of healing and transforming living bodies – or in maiming or weakening them. Skilled surgeons can graft or implant body parts, alter the functions of people’s bodies, cure or inflict diseases, or produce intricate tattoos. Surgery can also play a part in conjunctional magics, preparing bodies for animation as simulacrums or resurrection as undead.

Surgery Skills

The general skill of Surgeon allows the character to diagnose illness or injury and treat some wounds in the field; with a surgeon’s bed, they can heal more serious injuries or produce simple tattoos.

Surgeon is the prerequisite for the following archetype skills:

• Anatomist: An anatomist can perform the most basic grafts and transplants, strictly between mortal bodies.
• Physician: A physician can cure the most common diseases, by draining fluids, cleaning the body and rebalancing the humours.
• Tattooist A tattooist can perform more complex tattoos, including the larger tattoos required for investment as talismans.

Surgeons can also learn the special skills Improved Surgery and Improved Sanctuary, which enhance their medical prowess in the field.

Surgical Diagnosis

Any surgeon can, after a few seconds’ examination, diagnose a living creature’s ailments, including any injuries and diseases, per the spell Diagnosis. This consumes one fluid to clean the patient’s skin to aid examination.

With about two minutes’ investigation on their surgeon's bed, they can determine a dead creature’s ailments at the time of death, including what likely killed them, although if there are several possible causes (e.g. the victim was mortally wounded, poisoned and under the effects of a lethal spell at the time they died) it may be hard to determined which specifically led to their death.

They can also identify any surgical alteration or tattoo they know how to perform, including any materials and work units required and specific mechanical effects. When examining an alteration they don’t know how to perform, they can identify approximately what was done, but not the effects.

Example

Dafydd ap Gwedon is examining a creature who staggered into camp, firing off spells uncontrollably before dying. Opening the creature up, he can see their liver had at some point been surgically altered, enlarging one of the lobes and shrinking the other two. He infers it’s connected to how the creature behaved before dying, but would need further research to be sure.

Surgeon's Beds

Any use of surgery skills that expends work units or study units, including procedures or research, requires the use of a suitably equipped surgeon’s bed. As with all equipment, a standard quality bed has no in-character cost; all that’s needed is a physical representation. Higher-quality beds must be bought or made in play and provided with item cards. Research specifically requires a superior or higher quality bed.

Although consisting of several parts, a surgeon’s bed is treated as a single item in game; a higher quality bed receives a single item card to track its existence, which must be attached to the bed itself.

Representing a Bed

At minimum, a phys rep of a surgeon’s bed must consist of a surface large enough to accommodate a patient (a table or bed, a stretcher, or even a roll-up mat or blanket) and at least three appropriate tools or fixtures, including scalpels, saws, awls, hooks, tweezers, retractors and forceps and cauteries, and lamps to see by or straps to hold the patient still.

Tools do not necessarily have to be constructed to the same standards as LARP weapons, but should be safe and suitable for use in play, e.g. no sharp scalpels, saws or needles or delicate glass vessels.

Note: The intent is to promote an engaging and immersive experience, not to present an insurmountable barrier! As with all phys reps, any sincere effort will be accommodated, and other players and staff may be able to lend props or give advice on how to source them.

Transporting a Bed

Transporting a bed (e.g. to steal it) does not require any special skills or numbers of people; as long as the players carrying the bed can physically move it, they can move it in character. This requires transporting the bed itself and at least three tools or fixtures, although it is permissible to pack it up or carry it in parts.

Bed Quality

Like all equipment, beds vary in quality. Like a crafter's workshop, a higher-quality bed can be configured by its owner, granting the owner bonuses. Other characters can still use the bed (i.e. can make use of the phys rep), but gain no benefits from it.

Making a Surgeon’s Bed

Beds are made via the Artisan skill, at a cost in materials and work units. See Making a Workshop.

Tools

By default, a surgeon’s tools don’t receive separate item cards from their bed; in game terms, the tools are part of the bed. That said, some of a surgeon’s actions can be performed away from their bed, e.g. healing injuries with a surgeon’s bandage; this requires some phys reps of suitable tools, which need not be carded.

A surgeon may make an individual high-quality tool, if wished (e.g. so that the tool can be enchanted). By default, this has no mechanical effect when using a bed.

Butchery and Bloodletting

If a character wants to collect a trophy from a slain foe for roleplaying purposes – e.g. to hang up in their tent or add to their kit – they can just go ahead and do it; this has no game effect beyond bragging rights. But in order to yield a carded raw material, the following rules apply.

The body must be butchered immediately, and in sight of a Referee who witnessed the creature’s death, and who will confirm whether the body will yield any useful materials - in the same way that not all trees can be cut down for timber and not all plants yield herbs, not all bodies can be harvested!

How much the character can harvest depends on their skills:

• Unskilled: An unskilled character can collect one body part and drain one unit of blood.
• Ranger: A ranger can collect three body parts or one hide, and can drain three units of blood.
• Surgeon: A surgeon can collect a total of three body parts and internal organs, and can drain three units of blood.

Note: These are mutually exclusive; once, for example, an unskilled character has hacked off a limb, the body is too badly mangled for a ranger to cleanly butcher.

Harvesting requires a phys rep of suitable tools and a reasonable period of roleplay, e.g. cutting off a limb requires only a few seconds with a hatchet, while extracting a kidney demands at least a minute with surgeon’s tools.

The attending referee will then issue a temporary harvesting card, describing what has been harvested and giving the time and date. Harvested items need to be preserved within one hour, which will exchange the harvesting card for a suitable item card; any item not yet preserved by that time is spoiled.

Harvesting Living Creatures

Anyone can collect one unit of blood from a living creature, inflicting one physical hit to the location the blood is collected from, which can be healed normally.

Someone with the relevant skills can cut one body part or organ from a living creature, reducing the location to zero physical hits in the process. The location can be healed, closing the skin and restoring the hits, but this does not restore the lost part. If a character’s heart is removed, they are instantly killed, with no death count.

It is never permitted to dismember a player character without their express out of character permission (e.g. because the character wishes to sacrifice a body part to a god).

Performing Surgical Procedures

A Surgeon may perform any of the standard procedures known to them per their skills, or any unique surgeries they have learned through research or training.

Every procedure has a cost in work units and resources.

Materials for Surgery

Surgeons use a mix of different materials, including crafting materials (especially cloth for bandages and charcoal for cauterising) and alchemy ingredients (especially blood and humours, and fluid for diagnosis).

They can also make use of body parts, to graft them from one creature to another, and are unique in being able to extract internal organs, which they can transplant. Most procedures consume some bandages, at least at the end!

Roleplaying and Logging Work

To perform surgery on any particular day, the player must engage in at least 30 minutes’ suitable roleplay at their surgeon's bed, either all at once or spread out over several tasks through the day. Roleplay includes using their phys reps to mime cutting, cleaning, stitching and cauterising etc. as appropriate.

One patient need not stay on the bed the whole time, unless all the Surgeon’s work units for the day are being spent on them! Time can be assigned to each patient proportionate to the work being done on them, e.g. if a Surgeon is performing the same procedure three times, each patient should lie in the bed for around 10 minutes.

Unlike crafters and alchemists, Surgeons cannot perform any procedure over more than one day to spread the cost, since the patient must be sewn up and allowed to go about their day. To complete larger projects, they must split them into multiple smaller procedures, work with a surgery team, or both.

Having completed the roleplay, the surgeon must then log their work with a referee, who will confirm that the character knows how to perform the procedure (checking the procedure card, if relevant), confirm any benefit they get from using a configured surgeon’s bed, collect the resources consumed, note how many work units the surgeon has used.

Note: If a patient is mortally wounded through any procedure (i.e. because it requires opening up their head or chest), and the procedure isn’t explicitly to provide healing, the patient will need to be kept alive via the spell Sanctuary or the equivalent surgical ability, which the surgeon themselves cannot do; they will need an assistant to keep the patient alive.

Completing the Procedure

Much of the time, surgery heals or cures the patient, restoring them to their usual state, but some surgical procedures have enduring mechanical effects, e.g. to grant them a special ability or defence. Like items and rites, this requires some sort of record.

If the procedure gives a charged or one-shot effect, such as a resistance or a chargeable tattoo, the referee will grant them a tearable card, with the details of the alteration recorded on it, including the name of the patient; if the procedure grants an enduring trait, they will arrange for a special character card.

Field Surgery

Surgeons do their best work at a surgeon’s bed, given time and resources, but there isn’t always time to drag a wounded person to them for help – sometimes the surgeon has to come to them.

Using a phys rep of suitable tools, any surgeon can consume surgeon’s bandages to perform field surgery as follows:

• Healing: A surgeon can heal one incapacitated location to one physical hit only (regardless of how many hits the patient normally has) in 30 seconds, at a cost of one bandage.
• Cleaning: A surgeon can cauterise and clean a poisoned or infected wound, per the spell Cleanse Wound, in 30 seconds, at a cost of one bandage and one charcoal to heat the cautery.
• Sanctuary: A surgeon can keep a mortally wounded character alive, per the spell Sanctuary, at a cost of one bandage. The surgeon may speak normally, but may not take any other action while maintaining the effect. This effect does not apply to characters who are on their death count for reasons other than mortal wounds (e.g. from drinking Beggars Poison).

The skills Improved Surgery and Improved Sanctuary enhance a surgeon’s ability to perform healing or sanctuary.

Surgery Team

A Surgeon can lead a team of skilled Surgeons, including an apprentice and an assistant. Both must at least have the surgeon skill, but do not need to know the procedure for the project. The apprentice and assistant do not need their own surgeon’s bed.

• The apprentice directly aids the Surgeon in their work, in the same manner as a crafter’s apprentice. For every two work units contributed by the apprentice, one work unit is added to the surgeon’s total for completing the procedure. The apprentice cannot contribute more work units (after halving) than the surgeon.
• The assistant provides them both with support, chiefly keeping the patient alive (per the Sanctuary spell) while the surgeon and apprentice work (this does not consume bandages, as they are working on a surgeon’s bed and not in the field). For every three work units contributed by the assistant, one work unit is added to the surgeon’s total. The assistant cannot contribute more work units (after dividing by three) than the apprentice.

A surgeon cannot belong to more than one surgery team on any day, although that team can work on multiple procedures in that day.

Example

Emilia Forêtière is performing an exhaustive procedure on a patient, altering his heart, kidneys and liver, so she has drafted the aid of her apprentice Markus von Schmeck and an assistant, Tenniel Kalivian. Emilia has the skill Anatomist, and Markus and Tenniel both have the skill Surgeon. They are working on Emilia’s surgeon’s bed.

Emilia spends 25 work units on the procedure. Markus spends 14 work units, which adds 7 work units to Emilia’s total, and Tenniel spends 15 work units, which adds 5, for a final total of 37 work units.

Disability and Surgery

Surgery in the Renewal campaign is able to make lasting changes to living creatures’ bodies, including inflicting or repairing disabilities such as amputation, with the exception that changes can only replace like with like, e.g. a surgeon can replace one of a creature’s arms with another arm, but cannot add a third arm. This extends to any native part of a creature’s body: if a creature was born with one arm, that arm can be replaced, but they cannot be granted a second arm.

By default, any real-world disability is assumed (at the player’s discretion) to have existed since birth and to be an inherent part of the creature’s pattern, that cannot be corrected or altered by surgery. This takes away the emotional and mental burden of the player having to account in character for why their real-life disability cannot be “healed” with an imaginary procedure.