Showing posts with label Disease. Show all posts
Showing posts with label Disease. Show all posts

Monday, March 23, 2020

Stories Don't Work

"The year of our blessed Savior's incarnation, 1348, that memorable mass-death took place in the excellent City, far beyond all the rest of Italy; by which plague, that came about because of our conceit, or rather because of our enormous wickedness, by the just anger of God, was sent upon us mortals.  Some few years before, it took beginning in the Eastern parts, sweeping thence an innumerable quantity of living souls: extending itself afterward from place to place westward, until it seized on the our City, where neither humane skill or providence could aid any prevention ~ notwithstanding, it was cleansed of many annoyances, by diligent Officers who were deputized.  Besides prohibition of all sickly persons to enter, and all possible provision used daily for the conservation of those who were healthy, there was employed incessant prayers and supplications of devout people, for the assuaging of so dangerous a sickness.
"About the beginning of the year, it also began in very strange manner, as appeared by different admirable effects; yet not as it had done in the East Countries, where Lord or Lady were being affected by bleeding at the nose, the obvious sign of inevitable death to follow.  But here it began with young children, male and female, either under the armpits, or in the groin, by certain swellings ~ in some as big as an apple, in others the size of an egg.  And so, in difference greater or lesser, which (in their vulgar language) the people termed to be a blotch or a bile. In very short time after, these two infected parts grew deadly, and would disperse abroad indifferently, to all parts of the body.  Whereupon, it was the nature of the disease to show itself by black or blue spots, which would appear on the arms of many; some others, on their thighs, and every other part of the body. And in some, great and in few places, in others in many small and thick places.
"Now, as the bile (at the beginning) was an assured sign of rapid approaching death, so proved the spots as well, to those that had them.  For the curing of that sickness, it seemed the virtue of Medicines, that the physician’s counsel or any other application could not yield any remedy.  But rather, it plainly showed that either the nature of the disease would not be cured, or that the ignorance of the physicians could not understand the source of the cause.  And so, as a result, no solution was found.
"Moreover, beyond the number of those who were skilful in medicine, many more, both women and men, became physicians, without ever having had any knowledge of medicine.   So that not only were few healed, but almost all [the patients] died, within three days after the said signs were seen ~ some sooner and others later, commonly without either a fever or any other accident.  And yet, this pestilence was of far greater power or violence, for anything ~ not only healthy persons speaking to the sick, or coming to see them, or airing clothes in kindness to comfort them ~ was an occasion of ensuing death.  Even touching their garments, or any food upon which the sick person fed, or anything else used in his service, seemed to transfer the disease from the sick to the sound in very rare and miraculous manner.
"About these marvellous matters, let me tell you one thing ~ which, if had not been seen by the eyes of many (as well as mine own), I could hardly be persuaded to write about it, much less believe it, even if a man of unimpeachable honesty should report it.  I say that not only was the quality of this contagious pestilence of such efficiency, in passing and being caught from one to another, either man or woman, but it extended further, even ~ in the plain view of many witnesses ~ that touching the clothes, or anything else, worn by one that died of that disease.  And if it was laid on by an animal, being nothing like a man, they [the clothes] did not only contaminate and infect the described beast, whether it was a dog, cat, or any other ~ then it, also, died very soon after.
"One day, my own eyes (as I said before), among many others, experienced evidence of the following:  some poor ragged clothes, of linen and woollen, torn from a wretched body dead of that disease, had been hurled into the open street.  Two swine came by, and (according to their natural inclination) seeking food on every dunghill, tossed and tumbled in the clothes with their snouts, rubbing their heads likewise upon them.  And immediately, each turning twice or three times about, they both fell down dead on the said clothes, being fully infected with the contagion of them.  This accident, and others that were similar, if not far greater, started many fears and imaginations in those that saw; making them rush towards a most inhumane and uncharitable option:  namely, to fly away from the sick, and from touching anything of theirs, by which means they thought their health should be safely protected."
Giovanni Boccaccio, The Decameron, written in 1350
at the height of the Black Plague


I cannot help coming back around to this, for perspective if nothing else.  For those not familiar with the Decameron, I've simplified the language to produce a more modern description; I have no Latin professors to impress now, so I can cheat on the original language as much as I wish.  Boccaccio outlived the plague by 25 years; he was 37 when the above lines were published.  He predates the printing press, so most people would have heard a speaker read aloud from the book rather than ever hope to have a copy themselves.  The book isn't short; the Penguin Classic, which I read, has 1,072 pages.  Written with a quill pen.

The above is merely an introduction; in his story, 10 persons flee from the plague to an isolated farmhouse in the hills.  There, still expecting to die of the plague, they agree to tell one story each, one time per day, for ten days.  The book, then, records the 100 total stories told by the characters.  Each day, one of the refugees is charged as the King or Queen for that day; and each day the stories follow a particular theme: love stories that end tragically, tricks people play on one another, examples of virtue and so on.

The stories are fair.  Now, years later, I cannot recall a single one, though I did read them all.  I'm sure I'd remember many of them if I started the book again.  It is very like the medieval period; dumb characters are extraordinarily dumb, along Chaucer levels, while those in love are ludicrously, blind and besotted by love.  None are particularly believable.  And no story in the collection makes any attempt whatsoever to address the plague, though they comment a great deal on social culture, families, the power of money, cruelty and troubled morality.

My personal analysis is that while Boccaccio intended to speak upon the unchanging nature of humans through the stories they tell, inadvertantly he highlights how ineffectual these stories are in the face of ongoing tragedy ... or enduring happiness, for that matter.  Look at the first lines of the above, giving the story that supposedly explains the horror of it all.  But stories are not real; they are the thing we tell ourselves to push back the real, to escape the real ~ and we naturally think of this as a virtue, because the power of certain stories to change who and what we are as people is indisputably magnificent.

But in a moment like this, with the virus descending on the populace and kicking the fragile anthill of our society to pieces in not very much time, it's easier to see little power story-telling really has.  For that is what we're doing with ourselves now, to get through this ... telling ourselves stories.  Telling ourselves that this won't last more than a month or two, or that facemasks will keep us safe, or that the government will get this under control.  We tell ourselves that by doing these things, we'll make ourselves safe; and we tell ourselves that watching the news makes us informed and therefore better prepared.  We rush out and horde tons of critical material so that it can sit unused in our basements, resulting in greater suffering for those without the means to horde, and we tell ourselves that we'd be stupid not to do this.  We tell ourselves all kinds of stories about what we're doing and how we're ready and what's smart and what's stupid.

These stories are designed to push back the fear ... very like our pre-historic ancestors invented gods and spiritual ancestors to manage the storms and the sea, along with the moon, the sun, the turn of the seasons, the inevitability of death, famine and, yes, pestilence.  Not because these stories really did anything, but because it felt better to tell ourselves that these stories did things.  Because looking into the hard, cold, brutal face of reality is scary as hell.  And we are all discovering that right now, as despite our efforts we're also able to recognize that, a lot of the time, the stories don't work.

For most of us, it's a d100 roll to see if we die.  The result isn't actually random; it has a lot to do with whether we smoke or if we've had a really bad lung infection at some point in our lives, how old we are, our genetics, what our condition happens to be when we get the disease and how much care we can potentially obtain when the disease comes.  But a d100 roll will do to get the point across.  The odds are quite good.  Personally, I don't know many D&D players who would choose to risk their hard-fought-for 10th level ranger on a d100 roll if it meant a 1% chance of permanent death; but if the risk is forced on them, they'll feel pretty good about their odds of survival.  And so should we.  So should we.

But some of us, sorry, are going to lose that roll.  Some of us, your author right now included, will be quite realistically be dead inside of three months ... whereupon none of the stories are going to cut it.

Which is why I want to take this moment of helpless lucidity on the part of the reader, where none of the stories are going to curtain off the reality, to make a few points.  Much of where we are just now comes from having told ourselves a few too many stories.  Stories about how safe we are, and how great the country is, and how we don't really need everyone to have a good health care system, or why austerity measures seems like a better way to pay back the debt than raising taxes.  These are all stories.  And stories, for all the virtue we tend to heap upon them, are, most of the time, just how we bullshit ourselves.

When the stories gain too much of a foothold, and we allow the odor of mendacity to reach a point where our eyes become utterly blind to reality, this present circumstance is what happens.  It is this present circumstance, this pestilence, that motivated communities a century ago to pay more attention to public health and the general welfare.  The threat was stark and unimaginably terrifying, what with the dead bodies of relatives and strangers alike, and it made people think, "Perhaps it would be a good idea if everyone was healthy, and not just me, and my family, and the people in my county and, hell, the people everywhere on the planet."  And so we took steps to build systems that would fight back such things, and passed measures that would more realistically ensure our safety ~ not by telling ourselves stories, but by having doctors and people with medical experience direct reality in exactly the way reality manifests.  Because a really good story won't keep you alive, even if you want to tell yourself that stuff that happens in some other part of the world doesn't really have anything to do with you.

In fact, it does.  It really does.  And even as we tell ourselves silly stories to assuage the panic, I think for at least a few weeks we're all getting acquainted with this.

So when it is over ... and it will be, once we survive the economic crash that follows this nightmare, we should all be asking ourselves whether or not we want to dive back into those stories again.  Because this could have easily been a lot worse.  We could have easily drawn a pestilence card that killed on a 1 in 20, or a 1 in 12, or a 1 in 6.  A card that is, I promise you, still in the deck.  Just waiting.  If the d100 roll is getting to you ... just consider what a d6 roll would mean.  Not only for you, but your family and all the people you know.  And for the sheer number of cold, dead bodies that would mean, scattered all over the world.

Frankly, I think it's a bad time for stories.

Monday, March 28, 2016

Where You Eat Matters

Five years ago I wrote a post about compelling players to observe some kind of nutrition rules for campaigns.  It was a mental exercise and no more: just an example of the sort of thing that can be reviewed and considered but which is impractical for actual gaming and accounting.

That idea has sat on the shelf since I proposed it.

And now, today, I had an idea.  Have a look at this table, that I've only just designed:


Sorry about the size of the text; I recommend opening it in another window.

Undoubtedly, some are not familiar regarding my very basic rules about the consumption of food.  I am now very seriously considering augmenting those rules by implementing the above table where it comes to where the characters eat and how much effort they make towards that goal.

Basically, the characters make up their mind what sort of food they want to eat and how they wish to prepare it.  The next day, after they've slept, they make a saving throw on the top third of the table; for the most part, the saving throw is going to have no effect on most of the characters.  If it does have an effect, it is likely to be on less than 1/3rd of the party, even if the sorest rations are consumed without any cooking.  However, it makes a significant difference if the party wants to take the time to get themselves a proper wagon, or eat from a kitchen in a house they build, or eat at the local tavern when they get the chance.  The above could seriously punish characters who insist on eating food out of their pockets rather than spend a little for the boar at the local tavern.

Note that the actual food eaten does have some influence.  If the characters do not buy leafy vegetables for their campfire or chuckwagon, they don't get the chuckwagon's effect, no matter how nice the cooking is.  The same is true if the characters insist on drinking beer and not wine or coffee - at least, with regards to amateurs.  I see I will have to make a note that the kitchen has to obey the rule of food choices, but the tavern and up the scale from there does not - because with vegetable stock, cooking with wine and so on, the fortified benefit is cooked right into the meal.

The chance of disease eating field rations is 1 in 20; but I see that the chance is only 1 in 400 with campfire food and 1 in 8000 with wagon food.  I think that's fair.  Characters need to know what they're doing in making their food choices.

Incidentally, the cellar food option comes from a game, Patrician III:


This is the sort of meal that the players can only get if they know people (or they've joined a guild or some such in a given area).  The lord's kitchen, obviously, requires knowing someone in nobility or royalty circles.

There is an ultimate solution for the proposed rule: Heroes' Feast.  A cleric can obtain the spell at 11th level.

Monday, July 6, 2015

Buggies

At the moment, I have no rules for players catching a disease from out of the blue; i.e., the player trips and falls face first into a mud puddle after leaving a tavern, wipes himself off, leaves a bit of residue from the dwarf that peed there an hour ago, feels bad the next morning, finds the disease in full swing by afternoon.  No rules.  My players don't mind.

If I were going to create rules, I'd probably start with some ballpark estimates for medieval death rates.  Here are some English numbers from John Hatcher's Mortality in the Fifteenth Century: Some New Evidence:


Those are quite unhealthy.  Apparently, it was hard to be a Cleric; harder, we suppose, to be the common population, but then characters aren't common.  For the record, tenants-in-chief refers to whomever happens to hold the land for a fief - typically a captal or a baron.  The monks at the priory of Christ Church were Benedictine monks, the classic cloistered monks who set the standard for a cloistered existence.

So the columns above describe two groups of relatively active but home-bound persons, at the top of the food chain . . . and still we're talking between 165 and 224 deaths per thousand per year for a fellow my age.  That's better than 1 in 6 that I'll be dead by next summer.

For comparison, the death rate for Canada in 2013 was 7.  The death rate for Afghanistan that same year was 8.  The highest death rate for anywhere in the world was Sierra Leone, with 17.  If any country in the world right now had a death rate as high as the above table, the world press would be freaking out in ways that would make Rwanda look like a passive affair.

Still, we must assume the death rates for the artisan and peasant classes were higher.  Not that everyone died of disease.  Executions for crime, accidents, deaths from war and pillage, all these things were higher.  There was a much greater chance of being killed in the street because of a riot in those days.  So we have to restrain ourselves from arguing that a 20-year-old fighter has a 6-10% chance of catching a disease this year.

However, if we consider mortality rates from disease as a guideline, we see that Canada's morality rate from all diseases in 2009 was 2.2 per 1,000 (220 per 100,000).   That's 2/7th of our total death rate . . . in a world where most of the horror-show common diseases from the Middle Ages have been successfully conquered.  We're still losing 31% of our people to disease.

So, arguably, we could double that ratio to 4.4 over 7, then multiply that against death rates for the youngest tenant-in-chiefs for the latest period in the table above.  That gives us a ballpark figure of 64 persons per 1000 population dying of disease each year (6.4%).  That's about 1 chance in 569 per day.

Whereas I could simply make a table in excel that would roll up that chance at the push of a button, I haven't felt the necessary desire.  Players are not enamoured with dying from disease.  They're cool with catching a disease from giant rats and other things, that's all part of the combat world.  But catching a disease from a mud puddle?  "No fair, man!"

It is a very hard thing to argue against, however, from a player's perspective.  We can't argue that disease didn't exist; we can't argue that spending weeks in dank dungeons, slogging through storms to and from town, camping outdoors and spending most days covered with welts, cuts and occasional deep gashes isn't a breeding ground for little buggies.  But . . . if the paladin in the party is just going to heal these regularly as they come up, is there really a point in keeping track?

Well, the paladin could get overwhelmed.  A cleric with a cure disease spell, too.  And the problem gets bigger as the parties do.  I just had a thief in my party hit 10th level and pick up 19 henchmen.  That's a LOT more chances for one of them to catch a disease and die while the paladin is off gallivanting in a nearby dungeon.  Shame to lose a 4th level follower that way.

For the present, however, I only plan to tweak the old DMG's disease formula - which I find isn't bad, if lacking a little on the details.  I'll be working on this for the wiki between humping my ass around trying to find a cooking job.

UPDATE:

I wrote this post more or less on the spur of the moment, inspired by the table I stumbled across above.  In it, I've realized now that an hour has passed that I spent no time whatsoever considering the contraction of disease that does not kill, but continues in a more or less chronic matter.  Nor had I given any thought to mild cases of illness that, although they wouldn't kill the infected, would seriously affect the infected's ability to participate in most adventures.

As such, clearly, this entire post needs a rethink.




Tuesday, February 26, 2013

Downing the Disease Difficulty

So, let's do some simple design, just to get a handle on some new rules for disease.  Disease is one of those things in the game that everyone hates, players and DMs alike, because it is so random, so out of the blue and in turn so deadly, it seems grossly unfair to arrest a player in his or her tracks just because the percentile dice comes up '01.'

Looking at the vegetation map I posted for Dalmatian Lands yesterday (the second map down the page, mostly green and yellow), the gentle reader can see numbers that are black on white.  These are degrees of civilization, or what I was calling 'infrastructure' nine days ago.

(See?  There is method to my madness.  First, I introduce the math, then the data, and finally the purpose)

Let's take a wide variety of places.  We can pluck them all from southern Italy.  Hopefully, the reader can find Naples ... its in the middle of a bright yellow area in the lower left quadrant of the map.

Naples has an infrastructure (IS) of '3478' ... which is the highest number I could find anywhere that I've actually calculated.  Paris might be higher, but I haven't actually calculated it.  The number is based on the relative density, and in the middle ages, the density around Naples was HIGH.  It was, at that time, one of the most urban places on earth.

Above and to the right is a hex with Benevento, with an IS of '456.'  Two hexes to the upper right, the reader can see Lucera, with an IS of '88.'  One hex down and to the right of Lucera is an empty, dark green hex with an IS of '30.'  And up and to the right of Lucera is a empty, light green hex with an IS of '5.'

Let me blow up the relevant area so it's convenient.  The places I've described are makred with blue arrows.


Now, it can be seen that there is another small number in the right corner of every hex, in black.  In Naples, that number is 0.  In Benevento, it is 275.  In Lucera, it is 610.  Finally, in the dark green hex it is 2814 and in the light yellow hex (near San Severo) is 2109.  These are elevations, in feet.  On the original map, the reader can see that these elevations (and the low IS numbers accompanying them) follow the Apennine Mountains down the spine of Italy.

Let's take advantage of these numbers being based on density and lets say that the number itself, divided by 10,000, gives the % chance for becoming diseased if you spend a night in that hex.

WHOA!  A 35% chance for disease if you sleep in Naples?  Ridiculous! The population would all be dead!

Yes, that is probably correct, except for a few points I'd like to make.

First, I said becoming diseased, not catching a disease.  I'm arguing that you will contract something that first night ... but not that there is then again a 35% chance of catching something completely different the next night.  What I'm saying is that if you lie down in a gutter for three nights in Naples, then yes, by the end of the third night, you will probably be sick with something.

Second, I must rush to point out that in all probability, most persons in the medieval world probably were diseased ... with things we hardly think about: a wide variety of skin maladies, fungus, moderate pneumonia or tuberculosis, not to mention tape worms and other internal beasties, scabies, mild forms of disentary, scurvy and a host of vitamin deficiencies, etc.  All that and chronic malaria, for another thing, which was rife in 16th century southern Italy, particularly among the coastal urban population.

Finally, this is D&D ... so the reader should expect modifiers.  34.78% is just a base figure.

Note, however, that as one gets further and further from the city, climbing up into the mountains, the character actually becomes safer.  Don't want to die of disease?  Don't go to town.

Paladins, naturally, are immune from disease anyway, and they could keep the diseases of a small party fairly at bay.  But a lot of time spent in Naples could make cure disease as useful as cure light wounds.

Features that would prove useful combatants against disease would include public baths, the prevalence of falconers and rat catchers, wells for fresh water (if it was fresh - wells helped kill people of cholera in 19th century London), hospitals, apothecaries and gong pits (which would presume a steady effort to clean up).  Dug sewers, too, would be a feature which I hadn't mentioned before.

This is Naples, however, with a population exceeding half a million and surrounded by a million more in the surrounding cities and duchies.  So it can't be a question of whether or not Naples has sewers, gong farmers, a hospital and so on.  Obviously, it would have many hospitals, and lots of everything else besides.

What matters isn't the presence of these things, but the degree of presence.  And here we get to pull away from the flat numbers.  Has the town kept up the sewers?  Are the hospitals intelligently run, or are they warehouses for the dying?  Are there enough apothecaries, gong farmers and rat catchers?  Is the water in the wells very fresh or awfully tainted?  What standards apply to the baths, and are they in the best of maintenance?

Suppose we make a supposition that each feature (seven in total, baths, ratters, wells, hospitals, apothecaries, farmers and sewers) has the potential for reducing disease in that area by 18%.  Thus, the potential could be to eliminate disease in Naples.  More to the point, however, 3d6 are rolled for each feature to see what is effective, and how much.  The average says disease will be lowered, in toto, 73.5% ... but a couple of bad rolls could make Naples into a disastrous vacation choice.

The same rolls are applied to every hex ... that is, that has a town (please note that the danger of disease applies to staying anywhere in the given hex, not just the town itself - though you could double the number for the city and halve it for the country, if you like).  Benevento and Lucera are a lot smaller, so they have less of everything ... but they also have less disease to combat (Benevento a base of under 5% and Lucera with a base of under 1%).  All in all, both could be quite decently safe.

The hills, of course, could not have sewers or baths ... but 'hospital' is a fairly wide term and in any case, there could be a local physician, along with a local herbalist and rat catcher.  Overall, there would be slightly less reduction ... but there's also a lot less disease to reduce.

Now, once the party is informed of the principle, they would know what chances they were taking ... by actually assessing the local towns.  They'd be asking after hospitals.  They'd be tasting the water upon arrival.  "Is there any evidence of sewers?"  "Have I even seen a rat catcher today, or someone with a falcon?"  And so on.  Bang.  A town now is more than just a collection of houses.  The players care what the infrastructure is.

More to the point, it would be REALLY HARD to raise Naples' sewer system from your ... call it a 'mitigation' roll ... of 7% reduction to an 8% reduction.  That's a lot of time, labor and money, where it comes to rebuilding parts of disease-infested Naples.  But improving Lucera by 5% might be something a mid-level party could manage - now that there is some logic to what needs to be done and how it is to be done.  The town has one crappy hospital - build another.  The town's baths are basically three natural ponds.  Let's shore them up and make the townspeople appreciate us.  "Let's spend our money on something concrete, as opposed to just more armor!"  And let's have some adventures grow out of the struggle to overcome the miserable process of living ... when there are people out there to oppose or help our efforts.

You want an adventure?  There's an adventure.