Diseases
To be fair, it’s super easy to pour fluids down a void zombie’s throat. Lots of real estate to aim at. Not that it’s particularly advisable to do so. You just know that background akata is waiting for Street Samurai to make a “treat disease” check and let her guard down.
Any dang way, if you haven’t tried out the Dead Suns adventure path over in Starfinder, they got some actually-deadly diseases to worry about. Coming over from Pathfinder 1e, my group was taken aback to discover how low-level afflictions were a bigger deal than the filth fever of yore. Rather than taking a manageable penalty to an ability score or two, PCs were suddenly progressing down something called “the Physical Disease Track”. You can follow that link down the rules rabbit hole if you like, but trust me when I say that’s not a track you want to be on.
I’ve got some sympathy for game designers here. The deadliness of afflictions is not an easy needle to thread. On the one extreme you’ve got the “oops you’re dead” style made famous by rot grubs. On the other end of the spectrum is the unimpressive inconvenience of medium spider venom. And you’d better believe that there’s plenty of design space in between.
Beyond the variability of penalties inflicted, there’s also the question of a cure. Make it too easy to down a potion of “poison doesn’t matter” and your affliction ceases to be a meaningful threat. Then again, if you restrict access to antidotes, players might have to go multiple sessions with a crippled character. That’s doubly true if you’re running a wilderness adventure without easy access to medical care.
In my own view, the most fun you can have with a disease is a half session or so of “fighting wounded.” It’s the same trope as John McClane getting in shootouts with bleeding feet or Korra trying to finish her duel before the poison kills her. There’s a ticking clock element to these sequences, and watching our heroes make it through on grit and force of will is a rewarding narrative. We’re playing games rather than watching movies though, and that means my ‘optimal scenario’ is hard to dial in with random saves and variable DCs in the mix.
All of the above is my attempt to lay out the problem space. Diseases can differ wildly in effect, ease of cure, and intended play experience. If you’re chucking dice in something like Warhammer Fantasy Roleplay rather than D&D, you’re going to have a VERY different experience at ye old doctor’s office. I’d therefore be curious to hear how the rest of Handbook-World likes to play it. Is there a system that manages to get the deadliness of diseases right? What’s the most fun you’ve ever had using afflictions as a plot device? How did that space goblin stuff its head into that helmet? For all of the above, hit us with you own disease-ridden opinions down in the comments!
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Not quite a disease, but there is the one time where the whole party was perma-blinded by a shining child encounter in one of the official APs. In the middle of a hostile megadungeon. The DM had to provide a wand of cure blindness to prevent a TPK via stumbling blindly into death.
If one PC is blind that’s the player’s problem. If the whole party is blind, that’s the DM’s problem.
Agreed, they’re mostly useful as a plot device… tropes like “do this job for me and I’ll give you the antidote”, or “go questing for rare components to cure the magically-afflicted princess”.
As a mechanical feature, they’re just not that interesting… save-or-die, or save-or-penalty… they might be wrapped up in lots of description of symptoms, but they still come down to a) you’re dead, b) you’re dying slowly, or c) you’re carrying some inconvenient penalty that’ll make it easier for something else to kill you. At best, you might get to roleplay through some hallucinations, if that’s your thing?
That said, I’m struggling to think of any occasion where I’ve encountered them as plot devices either. I’m sure we’ve done the “work for antidote” thing before… but most of those scenarios are such clichés that I can’t see myself using them…
> At best, you might get to roleplay through some hallucinations, if that’s your thing?
Make me wonder if “creative magical disease that inflicts RP conditions” is a better solution? Of course, that begins to sound pretty indistinguishable from “curses.”
Most fun with poison? Easy! My three favorite “toxic” DMing experiences:
a) The bard in a party is the only one without darkvision or a magic light source. He starts to wonder why his torch keeps going out whenever they go down a certain flight of stairs and then can’t be relit (regardless of Survival die rolls or anything) but can be easily lit above. Some quick thinking and backtracking leads the party to cast Detect Poison on the hallway and discover that the air below the landing is filled with an odorless, heavier-than-air toxin that would have killed them all in a few rounds.
b) The party has no Delay- or Neutralize Poison spells available and is away from civilization. The ranger asks if there is anything that they can do to help the afflicted teammates. I offer some skill checks for Survival, Knowledge Nature, and Craft Alchemy. With successful checks, the PC leans into the roleplaying, muttering lays of Luthien and pantomiming grinding Kingsfoil into a dose of Antitoxin for each of the unfortunate PCs who dutifully begin wheezing and making big-eyes (despite the sometimes less-than-impressive effects of centipede poison in 3.X).
c) Desperate to put something a little more flexible into our 3.X game, I introduced the rules for poison making from the DLC for D20 Modern by letting an alchemist Wizard PC find and decipher an ancient notebook from a lost civilization. This created a dilemma for the PC: sell the secrets for money and wonder what uses the world will find for this advanced chemical knowledge or keep it for themselves and leave the rest of the world in darkness.
I realized a little belatedly I should have told my best poison story. It’s not the most impressive, but it was a case of “working as intended.”
We were down on level 2 of Dragon’s Delve, and the party had just crossed a bridge over this enchanted stream. Turns out the “bridge” was actually one of these bastards playing possum:
https://www.d20pfsrd.com/bestiary/monster-listings/vermin/centipede/centipede-giant-whiptail
The battle was eventually won, but our poor cleric had been hit hard. Round after round the dude failed his save vs. 1d4 dex damage. By the time the sixth and final roll came around, he was within 1 failed saving throw of Dexterity 0. We only found out later that you’re not technically dead at that point, but you better believe we were freaking out like Sam looking at Shelob-poisoned Frodo.
Like I said though: really hard to achieve that moment when there’s so much random chance at play.
Ah, the Incident on Absalom Station…my half-elf Solarian, Arcalinte Soter, remembers all too well how absolutely miserable Void Death made him. He luckily made better saving throws later so the disease didn’t progress to the fatal stage.
He’s now on his way to Hibb, having become a hero of the Dead Suns crisis and is now investigating the mysteries of The Destruction Ark! I’m so proud of him!
All my games have been on hiatus since June. We are only THREE FREAKING SESSIONS from the end of Dead Suns, and that unfinished business is friggin’ killing me.
We were doing it via play-by-post and it STILL took us about 5 years! 😛
Does PbP usually go faster than face-to-face gaming?
It can…but it has some unique challenges, as it’s much easier for a game to just grind to a halt if a player delays in posting. Most of the ones I’ve been in come with at least an expectation of at least one post per day from everyone involved, to keep the game going. This can also make the risk of burnout worse, especially on the part of the GM.
I like it because for a long time it was the only way I could GET into a game, due to being busy with things like school and later work and not necessarily having the means to get to a physical game due to a lack of driver’s license. But I’d be lying if I said the attrition rate wasn’t demoralizing sometimes. Of the 20+ PbP games I’ve been in over the years, only 2 have ever reached completion.
Pathfinder 2nd does a lot to make diseases feel like a big threat. In one game, our Rogue caught **the** Black Plague from an enemy. It took the constant work of our party medic AND a high level cleric to keep her alive, while she basically died on the table.
Mechanically, the plague does nothing for the first stage of infection- but gets progressively more dangerous the longer the disease remains. At the point we got to, it dealt 1d6 bleed damage every 1d20 minutes- meaning we had to be ready to stop the bleeding at any time, while the cleric repeatedly tried to remove the disease with magic. It ended up taking over two hours, and most of the party’s funds, to make sure our rogue survived.
Was it just a bunch of failed d20 checks on the cleric’s part?
Yeah, we paid an npc cleric to counteract the disease but they just kept failing the DC. Unlucky, pretty much.
There’s got to be a design solution here. It’s nuts that the only time poison is fun and memorable is when you happen to lose 3+ coin flips in a row (see my reply to Jay Graham above).
Maybe it’s impossible to get that kind of intensity without the element of luck (“Hit ’em again. Live, damn you!”). But it feels like it shouldn’t be so rare to get that experience.
Maybe progression advancement?
The way a lot of games do it, you roll to end the effect. What if you roll to advance the effect through the stages of the disease, and failing means you’re stuck in the current stage longer, and suffering for it?
End result is, once sick, you’re going to suffer the effects. It’s only a question of getting through them rapidly and hopefully avoiding the worst ones (or avoiding progressing to a worse version).
D&D 5e Example: The Flu.
-Save DC 12.
-Save interval 1 day.
-On a successful save, move on to the next stage. On a natural 20, advance to stage 3 stage. On a natural 1, the user acquires Pneumonia, which has a higher save DC and more dire effects, and during the worst stages, can lead into possible death territory.
–Stage 1: Congestion. Disadvantage to Athletics, Acrobatics, Stealth. Those who remain in close proximity for more than 1 hour must make a save to avoid contracting it.
–Stage 2: Fever and Exhaustion. Disadvantage on physical skill and ability checks and saves. Subject is no longer contagious.
–Stage 3: Recovery. Disadvantage to Athletics, Acrobatics, Stealth.
–Stage 4: Immune. Effects end, and Flu cannot be contracted for one month.
I think the biggest design problem is *Cure Disease*. You’re always one cleric away from it all going away. With the above setup, I would suggest an alternative spell that lets you roll two saves per interval to advance quicker, instead of “poof, you’re cured, now go back to smiting goblins or whatever.”
It all kinda rolls into how well or poorly the game handles day to day survival. Goodberry removes any danger of bad food. Neutralize Poison means a poorly chosen poison ivy salad is just as good as any other. Me and my group basically had to ban a bunch of spells to make any sort of survival challenge.
Well done MrBright! I think you’re spot-on with the issue of “oops-you’re cured.” The idea of progressing more quickly through stages seems like a stronger version of “magical help getting over a sickness” to me. Nice bit of design work there. 🙂
Of course, much of this feels closer to the Starfinder “disease track style,” but I am a fan of distinct stages on the path to recuperation.
Ah, akatas. My most successful campaign (the Ancient Aliens one) started off with their first appearance back in Pathfinder proper in a modification of the Second Darkness AP’s “Children of the Void.” Because I combined it with the first book of the Iron Gods AP, the functional scenario was that an alien mining ship had been overrun by akatas in the asteroid belt before crashing onto Golarion thousands of years later. As various locals hunted for the “meteor”, they started getting picked off by akatas, and once the PCs got through all of that, they found a whole akata hive inside the buried spaceship!
As for diseases and the like, I have found in my Pathfinder 1e experience that temporary ability damage (from various sources) can actually be a fairly fun mechanic. You get back one point a day from resting and can heal a further 1d4 with a casting of the 2nd-level spell Lesser Restoration, so it doesn’t affect you for THAT long in-game, but it can cause interesting situations. (My players have had a lot of fun roleplaying when they get reduced to like 3 Wisdom, for example.) I really don’t like “permanent” effects like permanent blindness or ability drain, however, as those seem to call for annoying detours to fix them rather than being temporary inconveniences that you can power through.
The biggest time when I intentionally brought up ability damage (for most of Ancient Aliens it was an unintentional side-effect of the various monsters I was using combined with some TERRIBLE rolls) was when the party was in the tomb demiplane of an ancient pharaoh. The sphinx guardian who kept sending the PCs into traps then claiming they were “tests” had a spot that created free food and water for visitors. The water had a poison that caused mental stat damage, and the food had a poison that caused immense thirst to encourage exposure to the first poison, but both had long enough onset times that it wasn’t immediately obvious that that was where the effects were coming from. I’d just have characters roll random saves while they were doing something else in the tomb, as they noticed the effect or not.
I love that akatas are just straight up aliens from Alien. XD
I think I said it elsewhere, but curses seem to be where all the fun RP effects live. “Makes you thirsty” isn’t really a standard “take 1d2 dex damage” sort of effect, so you get to play that up as a player in a way that you don’t with more mechanical penalties.
Case in point: https://www.handbookofheroes.com/archives/comic/curses
Oddly enough it was a canonical poison that had the thirst effect. (It also does STR damage, triggers dehydration rules and blocks potion use.)
https://www.aonprd.com/PoisonDisplay.aspx?ItemName=Draughtcap%20fungus
I think your core point is sold, though – poisons should have more weird roleplay effects! (My players do generally have fun roleplaying mental stat damage.)
Good on your players. 🙂
Looking at that fungus gives me anxiety, lol. There must be rules for dehydration that I have to google now!
I think part of the reason that the pendant that makes you immune to disease (in 5e) is only uncommon rarity is that disease is unlikely to come up, compared to its poison immunity equivalent (rare). Also, the reason they can give warforged and autognomes disease immunity, that and the concept of a golem soldier with the sniffles is a bit absurd.
Huh. Kind of makes me want to ask our own Warforged for an opinion:
https://www.handbookofheroes.com/archives/comic/killing-machine?utm_source=rss&utm_medium=rss&utm_campaign=killing-machine
“Is there a system that manages to get the deadliness of diseases right?”
Yes, GURPS. Like all things, it’s just better.
“What’s the most fun you’ve ever had using afflictions as a plot device?”
Plot device? Why would I make them a plot device? The feature as regularly as the genre would imply. In Dungeon Fantasy? Usually as a monster hazard, some times an environmental or trap hazard (hello Swamp Fever and Tetanus). In a survival settings, like Post-Apoc or Zombies themes? //Very// frequent.
“How did that space goblin stuff its head into that helmet?”
Space gerblins are like stress balls, so when they squeezed their head in their hands and feet got bigger.
I do quite like the concept of “zombies as disease.” Especially if you can find a way to relay that info to the players as they’re slowly turning themselves.
I think that has more to do with “corruption tracks” than diseases as such though: https://www.d20pfsrd.com/gamemastering/other-rules/corruption/ghoul/
I do like me some Corruption Tracks when I’m running horror. Sanity Meters as well…
Well, it looks like a lot more people are going to be playing GURPS going foreward what with Hasbro driving D&D into the wall
Either that or Kobold Core.
https://koboldpress.com/raising-our-flag/
I once had one of my players catch the Sight Rot (Your eyes starts rotting) disease, while the party where stranded in a yuan-ti infested jungle. It made the whole thing pretty terrifying as her sight slowly rotted away while they were navigating dangerous terrain. It also eventually caused her to get captured, as the party where forced to leave her behind during an escape.
Favorite part through, where when the Ranger discovered he had, had Lesser Restoration all this time, and that one of its abilities is curing disease. We still rib him for it, every now and then, years later.
Through my favorite use of disease where during a Warhammer Fantasy Roleplaying Game (I think second edition) I was in as a player. Where the DM used various diseases as a way to spread horror (A battle with a bunch of normally low-danger thugs becomes much scarier when you think they got the plague). Also used it for karma for the one player that kept doing absolutely insane stuff, and kept getting away with it, by giving him an STD (It was all in good fun. The guy just kept doing incredibly reckless stuff, that somehow always led to him walking away mostly intact while the same could not be said for the rest of us. Or our wallets. He got said STD during an incident in which he tried to use the party fund to pay for overpriced prostitutes. After having kept the rest of the party up the entire night with the noises). Getting an ointment for it did lead to a small quest in and off itself.
Oof. That mess can be tough to live down: https://www.handbookofheroes.com/archives/comic/un-prepared-casting
I’ve played Dead Suns, and yeah, the disease tracks can be pretty brutal.
I like it that way.
Better a brutal struggle with every sickness your adventurer comes across than the disappointment of a non-issue.
True that. Nothing worse than feeling like your fiction has transformed into a baldly mechanical status effect rather than a real threat.
The funniest one I saw was when our Ranger, shamelessly named ‘Danger Rangerette’, after some rather silly shenanigans some time before (yes it was that kind of group) failed her ‘save vs morning sickness’ just as the party was attacked.