Wednesday, April 17, 2013


In my youth I had been raised a Lutheran.  I remember having a conversation with a minister, where I brought up concerns I had about heaven.  Wouldn't I miss all the people that were left on earth, I wondered; and since I had been told that in heaven "all would be made clear," I asked, what if I wasn't happy with the truth?  The minister, as all good ministers will, also explained that in heaven, this perfect knowledge of everything would also make me feel good about the truth, whatever it was, and that I would not be sad for those I left behind, because I would 'understand' the reason.

Which would mean, I suggested, that I wouldn't be 'me' anymore.  I'd be so changed, that I'd lose everything that I believed now and that would be like being brainwashed, completely and utterly.  The minister, naturally, did not understand.  He perceived it as a 'healing.'  I was not comforted.  If being healed meant having my mind wiped and a new program installed, I'd rather be sick.

And I say this, writing now, sitting in a robe and suffering from some kind of cold.  Serendipity, that I would be writing about medicine today.

What I could not explain to the minister, because I was quite young and didn't know it yet, is that I am the product of my trauma - and trauma is damage.  If something happens to me that distresses my body or my psyche, it leaves a 'scar' that does not simply evaporate.  I'm thinking of the five inch scar I have on the top of my knee, which I obtained from five years ago when I snapped my quadriceps tendon while on a diving board.  That's the tendon shown in the image.  I succeeded in breaking it completely by running along the diving board, leaping, and landing on the end of the board with the intention of getting height to do a jackknife - a dive I'd done hundreds of times.  Only on this occasion, my right foot slipped on the board, and rather than bounding off the end, my body continued in a straight-down direction, doubling up my left leg under my left hip.  The knee overextended and the tendon snapped, and I fell into the pool with my left leg effectively 'hanging' off my femur.

The next day I was in surgery, and two days later I was released.  The knee, five years later, is pretty much 100% ... or perhaps 99%.  I'm no spring chicken, and both my knees tend to ache anyway.

Am I over it?  Oh, sure.  At least in the sense that I'm willing to dive again, or run or take part in physical activity.  But am I completely untouched by the event?  No.  No, that would be impossible.  I am not immune to the psychological effects of suddenly finding myself helpless and sinking in deep water ... nor to the conception of instantaneous terrible pain.  No one is.  If you've ever been in a car accident, then you know how fast they happen.  Bang!  And its over.

Your characters, however ... being fictional and not real, are little affected by trauma.  YOU, the player, may feel a bit of trauma at having lost something that was precious to you - a character, a +3 mace falling from your hand and lost in a gorge, that sort of thing - but it isn't going to compare with a real car accident or a spontaneously required knee operation.  Hit points are lost, hit points are gained, and there's no psychological loss.  If anyone out there really wants to simulate combat - if they really want to LARP - then they should pay a massive bruiser to sit at the table whose job it is to rise, walk over to someone who's just been hit for 10 damage and clock them across the jaw, or perhaps just thump them hard in the chest.  Bruiser cracks his knuckles ... player experiences trauma.

Somehow, I don't think it would catch on.  It would, however, really cause players to reassess the nature of combat and its place in the game.

It's foolish to think that we simply 'get over' the terrible traumatic events of our lives.  What we do is adjust.  We fix our patterns of behavior to compensate for the mistakes we've made, to ensure as far as possible that we don't make those mistakes again.  Sometimes, we adjust by increasing our aggressiveness.  Sometimes, we adjust without being conscious of it, fearing a particular highway, or choice of venue ... and we can get very surly and defensive if that fear is either identified or discussed.

We'd rather not be afraid ... but we are and that's the fact of it.  It took forever for the psychological community to finally accept that post-traumatic stress disorder is a real thing, largely because so many people respond to it in ways that socially we identify as 'chosen.'  Anger, resentment, avoidance - even the so-called pussification of the male sex - are things we don't associate with illness, they are things we presume are character flaws.  More often than not, however, fury is a response, not a decision.  On that, we're still trying to educate the masses.

Staying with the characters, however ... there are a great many psychological features that don't play out in their design, simply because they don't suffer from traumatic feedback.  They can afford to be 'heroes' because at heart they are wooden, two-dimensional false fronts, like the buildings that feature in old films (particularly westerns, satirized in Blazing Saddles).

Consider, if the gentle reader can, the effects of a stranger in a dungeon stepping up, catching your fighter by surprise with a military pick and breaking your shoulder blade.  In D&D, naturally, you respond by making a few ticks on your page, snatching up your 20-sided and swinging back.  In life, you may yet do that - but psychologically you're never going to forget that moment.  You will be traumatized ... and you'll never be able to walk down a dungeon hall in the same way.  You would resist suggestions to go down some corridors; you may even act irrationally and violently against other party-members suggesting that a dungeon adventure may be a good idea.  It doesn't matter that you're healed ... the after effect remains despite your present condition.  That is the very definition of PTSD.

Imagine, then, the effects of some spells!  If a military pick is a frightening object to be struck with, what would it be like to find yourself suddenly immolated by a fireball?  Only to then look around you and see three or four of your friends or associates dead and gently smoldering?  Fear?  Potentially ... but potentially also a rabid, insensate hatred of magic in every conceivable form.  Look at the effects of the hatred that arose surrounding drunk drivers ... and the social stigma attached to same.  How would it be with magic users?  Would you be able to even tolerate the magic user in your own party?  Knowing, always, every day, what he or she might do at any given second.  Talk about bouts of anxiety, distrust or aggression.  How long would it be before the fighter was being held down by the cleric and the monk, as he screamed, "I'm going to kill it, I'm going to kill the mage before he kills us all!"

Someone, I'm sure, will suggest that a cure light wounds spell would cure the spirit as well as the body ... and to that I say, we are back to the heaven example at the outset of this post.  Curing the spirit is a convenient gaming explanation for enabling a hardcore adventuring crew to go on fighting without any lasting emotional effects - but it is a terrible, awful form of brainwashing.  Perhaps, just for the sake of deepening the characters in the game, it might be better to consider that 'depth' of character begins with comprehension of what these characters have gone through.  Not just as stick figures, but as breathing, living beings.  Beings that understand that for some things, medicines don't really exist ... and that their lack defines us as who we are.  Not sticks.  Not heroes.  But flesh-and-blood beings possessed of doubt.

I don't expect anyone to embrace that.  Still, give it some thought.  And please accept my apologies for not writing the expected, long dissertation of the practice of applying herbalistic techniques in a D&D campaign.  Strictly speaking, that didn't sound very interesting.  Because, technologically speaking, the development of medicine in human history has almost wholly been about healing us physically; there still lacks any desirable means of healing us emotionally ... except, perhaps, the tremendous healing quality of sitting around on a fine evening playing a game with friends.  Preferably without the trauma ... er, drama.


Butch said...

Hm... if a spell takes away the emotional trauma of losing hit points, should you still be entitled to experience points? Isn't pain nature's way of telling you not to do something? Isn't pain -- whether from an accident or getting dumped -- how we learn?

To quote James T. Kirk:

"Damn it, Bones, you're a doctor. You know that pain and guilt can't be taken away with a wave of a magic wand! They're the things we carry with us, the things that make us who we are. If we lose them, we lose ourselves. I don't want my pain taken away! I need my pain!"

Strix Nebulosa said...

Interestingly enough, this is the topic of the TED talk today.

Ozymandias said...

Combine this with your post on ennui and I think you have a system for measuring when psychological trauma takes its toll on a character. And with the means to measure trauma comes the means to assign the effects of trauma.

Liliet said...

Thanks. You`ve just given me an idea of adding a small detail to my character. She`s been almost killed by Inflict Light Wounds, and I think it SHOULD change her personality a bit. She`s in no danger of fearing magic in general, since she is a magic user herself, but her attitude to necromancy will shift a lot.

See, I`ve come to D&D from freeform play-by-post roleplaying, and there all effects of passing events on your character are those you personally describe. And most people prefer not giving their precious alter-ego some physical injury, but rather emotional scar. It gives so much to describe in the post, it makes your character much more interesting and special than the power to regenerate missing limgs and kill with touch, which is there, due to lack of combat rules, rather cheap and uninteresting - if it doesn`t come with deep psychological consequences.
It would really be nice to bring this attitude over to D&D. Not easy - D&D is too full of potentially traumatic events - but very interesting.