PDA

View Full Version : Heal skill and some sort of added damage



Suzaku
2007-01-18, 11:07 PM
I've always wonder why there are no feats that use heal skill for preq to add some sort of damage. I mean stuff like Sneak Attack is suppose to add damage because you strike the vitals and heal skill is suppose to help you heal someone because you know where the vitals are on someone and help mend them.

Maltrich
2007-01-18, 11:09 PM
I think you're looking for something like Knowlegde: Anatomy or Profession: Surgeon. Heal is more like first aid; I wouldn't allow it to confer more than a general knowledge of internal organs.

Suzaku
2007-01-18, 11:21 PM
I think you're looking for something like Knowlegde: Anatomy or Profession: Surgeon. Heal is more like first aid; I wouldn't allow it to confer more than a general knowledge of internal organs.

Yes a skill that allows you to know how someone died like forensic(sp?) science does today, this is including knowing if someone died from suffocation, poison or spells with no visible effect doesn't give you general knowledge of internal organs.

Draz74
2007-01-18, 11:30 PM
Yeah, a lot of people seem to want to treat the Heal skill as Knowledge: Anatomy. There may be an element of anatomical knowledge in the skill, but maybe not. It has more to do with knowledge of healing herbs, and experience at setting splints or things like that. Even if it means you know, "if he's bleeding there, it's a top priority to bandage him in such-and-such a way," that doesn't mean you know, "... because there's a key vein or artery that runs underneath the skin and is relatively unprotected at that point ..."

I_Got_This_Name
2007-01-18, 11:46 PM
Well, yes, but that's what dumping more (a feat or class feature) into it means.

Mike_G
2007-01-19, 12:20 AM
Yeah, a lot of people seem to want to treat the Heal skill as Knowledge: Anatomy. There may be an element of anatomical knowledge in the skill, but maybe not. It has more to do with knowledge of healing herbs, and experience at setting splints or things like that. Even if it means you know, "if he's bleeding there, it's a top priority to bandage him in such-and-such a way," that doesn't mean you know, "... because there's a key vein or artery that runs underneath the skin and is relatively unprotected at that point ..."


I think that kinda goes hand in hand.

I'm a Paramedic, and in my experience the study of medicine inolves a lot of cause and effect.

Exactly like "there's a big artery here, so this is the pressure point to stop any bleeding below that point," and "trauma to that area of the abdomen can rupture the spleen, which bleeds like crazy, so watch out for any bruising in the upper left quadrant."

Either of these bits of knowledge could be used to screw somebody up as well as fix them.

So, I might allow a Heal check to allow more damage, or high ranks in Heal to be a prereq for some kind of precision damage ability.

Lord_Kimboat
2007-01-19, 12:25 AM
Yeah, a lot of people seem to want to treat the Heal skill as Knowledge: Anatomy. There may be an element of anatomical knowledge in the skill, but maybe not. It has more to do with knowledge of healing herbs, and experience at setting splints or things like that. Even if it means you know, "if he's bleeding there, it's a top priority to bandage him in such-and-such a way," that doesn't mean you know, "... because there's a key vein or artery that runs underneath the skin and is relatively unprotected at that point ..."

Well a lot of my DMs make us do heal checks to work out how someone was killed or how badly wounded someone is.

The_Snark
2007-01-19, 12:27 AM
I think that kinda goes hand in hand.

I'm a Paramedic, and in my experience the study of medicine inolves a lot of cause and effect.

Exactly like "there's a big artery here, so this is the pressure point to stop any bleeding below that point," and "trauma to that area of the abdomen can rupture the spleen, which bleeds like crazy, so watch out for any bruising in the upper left quadrant."

Either of these bits of knowledge could be used to screw somebody up as well as fix them.

So, I might allow a Heal check to allow more damage, or high ranks in Heal to be a prereq for some kind of precision damage ability.

This is true, but rememberr that you're coming from a modern perspective here. First aid in D&D consists of doing something because the character knows it works from experience and maybe a little intuition, not because they actually know what's going on under the surface. It's more concerned with stopping the bleeding than understanding why that particular spot bleeds that much.

I'm not sure how historically accurate this is, but it seems reasonable from a medieval standpoint.

That said, a feat requiring ranks in Heal that does something similar to sneak attack seems reasonable, indicating that the character has put effort into studying weak points on people.

Draz74
2007-01-19, 01:12 AM
This is true, but rememberr that you're coming from a modern perspective here. First aid in D&D consists of doing something because the character knows it works from experience and maybe a little intuition, not because they actually know what's going on under the surface. It's more concerned with stopping the bleeding than understanding why that particular spot bleeds that much.

I'm not sure how historically accurate this is, but it seems reasonable from a medieval standpoint.

That said, a feat requiring ranks in Heal that does something similar to sneak attack seems reasonable, indicating that the character has put effort into studying weak points on people.

This is exactly what I would have wanted to say, if it hadn't already been written before I got to it ...
Or, as I guess they say on forums, "QFT."

Although I really dislike when houserules require you to be an expert Healer in order to be a competent Assassin, or anything like that. A few ranks in Heal giving you a boost to sneak-attack-like abilities is a fine homebrew idea. But it can definitely be taken too far. It's messed up when the killers are way better healers than the healers.

SpiderBrigade
2007-01-19, 10:08 AM
I think part of the reason this idea crops up so often is that the Heal skill is kind of weak, and people are looking for a reason to invest in it. At low levels, even with maxed ranks your chances to stablize someone are not super-great, and at higher levels (say, level 12 or so, when you can auto-succeed at first aid) healing SPELLS are going to be waaaay better. Same thing for the poison or disease treatment. So, when people have a character concept who is a "Great Healer" (but not a divine caster) they're eager for something to make that skill investment more worthwhile.

clarkvalentine
2007-01-19, 10:15 AM
Even coming from a modern perspective, medical school does not turn people into invincible ninja assassins, and I wouldn't go to a grizzled veteran paratrooper to get my gall bladder removed.

Just knowing where the things are doesn't mean knowing what to do with it.

squishycube
2007-01-19, 10:29 AM
Even though Clark's post is hilarious, I think Mike_G has a good point. Like a true dutchman I will say: The truth is probably somewhere in the middle. (Look up "Polder Model" on wiki :thog: )
I think making underused skills more interesting is a good idea and this seems to be a nice way to do it. Let us know when you come up with a balanced mechanic.

Suzaku
2007-01-19, 10:30 AM
Even coming from a modern perspective, medical school does not turn people into invincible ninja assassins, and I wouldn't go to a grizzled veteran paratrooper to get my gall bladder removed.

Just knowing where the things are doesn't mean knowing what to do with it.
That's what a feat is for

Jayabalard
2007-01-19, 10:31 AM
I always figured that it's kind of assumed that most all characters are studying where vital organs are to a certain extent; it's just a part of your weapon's training. That would also explain why you can learn to be a healer as easily as you can practice any other skill.

NullAshton
2007-01-19, 10:34 AM
Okay... I think of sneak attack as not knowing exactly where to hit, but having the skills to hit it during combat. Anyone can stab someone in a major artery or something, that's not too hard to do, and that's basically what coup de grace is. But sneak attacking is the capability to do that while in combat, while a person is moving.

Matthew
2007-01-19, 11:19 AM
I think part of the reason this idea crops up so often is that the Heal skill is kind of weak, and people are looking for a reason to invest in it. At low levels, even with maxed ranks your chances to stablize someone are not super-great, and at higher levels (say, level 12 or so, when you can auto-succeed at first aid) healing SPELLS are going to be waaaay better. Same thing for the poison or disease treatment. So, when people have a character concept who is a "Great Healer" (but not a divine caster) they're eager for something to make that skill investment more worthwhile.

Hang on, you can just 'take 10' with Heal, can't you? The DC is 15 to Stabalise, so maxed out at Level 1 + Wisdom 12 = Automatic Success. That's my understanding of the Heal Skill, anyway.

Golthur
2007-01-19, 11:22 AM
Hang on, you can just 'take 10' with Heal, can't you? The DC is 15 to Stabalise, so maxed out at Level 1 + Wisdom 12 = Automatic Success. That's my understanding of the Heal Skill, anyway.
Sure, but I wouldn't let someone get away with that in the middle of combat :smallsmile: No taking 10s in combat - that qualifies as "under duress" to me.

Matthew
2007-01-19, 11:27 AM
Oh sure, I wouldn't let it fly during combat, but most applications of Heal should be taking place outside of those conditions, at least I would have thought so...

Golthur
2007-01-19, 11:31 AM
Well, in my games, I've found that a Heal check to stabilize is almost always used in combat, not after. Although Cure Minor Wounds is a close second - it depends on who's "available" at the moment someone goes down.

But, even with a roll, it's around 50/50, so it's not like it's really hard to do or anything.

Matthew
2007-01-19, 11:34 AM
Interesting, most Heal Checks I have known take place after Combat, unless the situation is particularly dire (-9). Healing Spells in combat tend to depend on the situation, but are usually used before they reach 0 Hit Point.

If a Character was dragged away from combat, I would probably allow taking 10.

Golthur
2007-01-19, 11:37 AM
I have fighters who won't withdraw and use healing potions, and I also have clerics who won't stand behind them and cure them every once in a while in my games, so that probably explains the difference. :wink:

If a Character was dragged away from combat, I would probably allow taking 10.
I'd probably only allow that if they were far enough away or behind cover sufficient so that they weren't at risk from any missile weapons. Otherwise, they'd still have to watch their back.

Matthew
2007-01-19, 11:57 AM
Oh yeah, they'd have to be relatively unthreatened.

I have to admit, I have never really figured out what can be done in three to six seconds for a guy who is going to bleed to death in under a minute... hmmn, what was that feline sounding scream?

Golthur
2007-01-19, 12:09 PM
Oh yeah, they'd have to be relatively unthreatened.

I have to admit, I have never really figured out what can be done in three to six seconds for a guy who is going to bleed to death in under a minute... hmmn, what was that feline sounding scream?
Shove a rag in/on it?

Yeah, I'm running out of room in my backyard to bury all the catgirl bodies at this point.

Jayabalard
2007-01-19, 11:05 PM
apply pressure, preferably with a clean cloth but with your bare hand if nothing else is available.

BCOVertigo
2007-01-19, 11:46 PM
apply pressure, preferably with a clean cloth but with your bare hand if nothing else is available.

....keep this up for 3-6 seconds then resume combat as usual. Making certain to drop your dagger as a free action first.

Fizban
2007-01-20, 01:46 AM
Anatomical Precision
You can apply your knowledge of anatomy and physiology to combat.
Prerequisites: BAB +1, Heal 4 ranks, Wis 13
Benefit: Whenever you successfully hit a creature, you may make a heal check. If you do, you add the result divided by 10 to your damage roll as an insight bonus, i.e., on a result of 20, you would add one point of damage. This damage bonus does not apply to creatures without a discernible anatomy.

Improved Anatomical Precision
You are even more skilled at making anatomical attacks.
Prerequisites: BAB +5, Heal 8 ranks, Wis 15+
Benefit: When making an anatomical strike, you divide the result of your Heal check by 5, rather than 10, to determine the extra damage dealt.

Epic Anatomical Precision [Epic]
You are a surgeon of death.
Prerequisites: Heal 25 ranks, Wis 20+
Benefit: When making an anatomical strike, you do not divide the result of your Heal check at all to determine the extra damage dealt.Source (http://www.giantitp.com/forums/showthread.php?t=11032&highlight=feats), by The Demented One.

Closet_Skeleton
2007-01-20, 04:32 AM
My version would be something like;

Anatomical Knowledge [General]
Prerequisite: Sneak attack or Sudden Strike ability, Heal 6 ranks
Benifit: Your Sudden Strike or Sneak Attack bonus dice increase in size by one die type.

Anatomical Knowledge Death Attack [General]
Prerequisites: Anatomical Knowledge, Death Attack Class Feature, Sneak attack or Sudden Strike ability, Heal 5 ranks
Benifit: For every 5 ranks you have in the heal skill, you gain a +1 bonus to the DC of your Death Attack.

Improved Crippling Strike [General]
Prerequisite: Sneak Attack +5d6, Crippling Strike Class Feature, Heal 12 ranks, Spot 6 ranks
Benifit: When using Sneak Attack, instead of dealing 2 points of strength damage you may choose the ability you deal damage to.

Dark
2007-01-20, 05:57 AM
Benefit: When using Sneak Attack, instead of dealing 2 points of strength damage you may choose the ability you deal damage to.
"Aieee! He's cut me in the charisma! It bleeds!" :smalltongue:

Mike_G
2007-01-20, 02:56 PM
Oh yeah, they'd have to be relatively unthreatened.

I have to admit, I have never really figured out what can be done in three to six seconds for a guy who is going to bleed to death in under a minute... hmmn, what was that feline sounding scream?


Tourniquet.

Or pack the holy bejeezus out of it if it's not an extremity injury. Or opening the airway if your buddy is choking on his own blood or has a crushed trachea.

Binding a wound is a quick thing. Because it needs to be.

I've, kinda done that a few times.

The Heal skill isn't giving back HP, or actually fixing anything, it's preventing you from dying which can be done really quickly. It works well enough to represent reality, but in a world of cure spells, it's quite underpowered.

Matthew
2007-01-20, 03:03 PM
In three seconds? Well, I'll defer to your experience.

Viscount Einstrauss
2007-01-20, 03:06 PM
The point is to prevent further blood loss ASAP, as the body requires a certain minimum to keep the brain/heart/lungs/various extremely vital organs from stopping. If you can stop the blood flow in three seconds, then I believe it would work in three seconds. But I can't imagine any kind of medieval medical practice that can do that.

Draz74
2007-01-20, 03:10 PM
I think part of the reason this idea crops up so often is that the Heal skill is kind of weak, and people are looking for a reason to invest in it. At low levels, even with maxed ranks your chances to stablize someone are not super-great, and at higher levels (say, level 12 or so, when you can auto-succeed at first aid) healing SPELLS are going to be waaaay better. Same thing for the poison or disease treatment. So, when people have a character concept who is a "Great Healer" (but not a divine caster) they're eager for something to make that skill investment more worthwhile.

Actually, I find it annoying to waste prepared cleric spell slots on "Neutralize Poison" and anti-disease spells. I think those are the main uses of the Heal skill -- no need to pack those spells if your Ranger has managed to donate one skill point per level to his Heal skill.

Of course, the standard Cleric and Paladin are already hurting for skill points, so they probably won't be able to get Heal very high. And if you have a Paladin, then you're already wasting class features on a magical Cure Disease ability anyway. So I guess Heal is still only useful to parties with a Ranger or maybe a Druid in them, and if you have a paladin, it's still only half-useful.

Mike_G
2007-01-20, 04:14 PM
In three seconds? Well, I'll defer to your experience.

In three "D&D seconds," definitely, given the multitude of things that are move actions. In a world where a high level fighter can shoot four arrows in six seconds, three to pack a wound isn't outlandinsh.

In an emergency, on a co-operative patient, probably. Definitley within 6 seconds.

I treated a guy who sliced his ulnar artery lengthwise on a piece of broken glass pushing down trash in a barrel once. It was painting the ceiling of the ambulance until I tourniqueted it. I used a blood pressure cuff, but I doubt whipping a band around the arm and tying it, then twisting a stick in it would take more than a few seconds. From finding him on the street to wheeling him into the ER a mile away was 3 minutes, during whih time I also did a set of vitals and a lot of supprtive stuff that you wouldn't need to do in D&D "stabilization."

Simple first aid, the kind to stop bleeding or clear a blocked airway is very quick.


The point is to prevent further blood loss ASAP, as the body requires a certain minimum to keep the brain/heart/lungs/various extremely vital organs from stopping. If you can stop the blood flow in three seconds, then I believe it would work in three seconds. But I can't imagine any kind of medieval medical practice that can do that.

It's a good thing D&D isn't limited to medieval skills then. Or long term car for diseases would be how well you bled your patient.

Trauma care, however, is pretty simple, and was grasped far earlier than treatment of most diseases.

By the Napoleonic period, most modern trauma techniques were at least understood, and much of modern emergency medicine developed from techniques learned on battlefield injuries then. Many terms for fractures are names after french battlefield surgeons who documented their treatment of them.

D&D is not really medieval recreation. However, in the Middle East there were some pretty advanced meidcal techniques.

Viscount Einstrauss
2007-01-20, 04:45 PM
The Middle East was just in general more advanced then Europe during the Crusader era. They managed to get the best technologies from Europe and Asia combined, then invented several of their own. The typical European/American views of the Crusades as knights in shining armor against an inferior force of scimitar-wielding cloth-clad Muslims is a purely skewed perspective. The Muslim forces proved their extremely advanced military tactics, equipment, and prowess several times during the Crusades, especially in the case of the battlefield genius Saladin.

And now you know.

Matthew
2007-01-20, 04:55 PM
In three "D&D seconds," definitely, given the multitude of things that are move actions. In a world where a high level fighter can shoot four arrows in six seconds, three to pack a wound isn't outlandinsh.

Well, that is a good point. I'm not sure if I'm convinced, but it is useful to hear the other side of the argument. I suppose a lot of this depends on relating game mechanics to the real world. 0 = Unconscious, -1 to -9 = dying in less than a minute.

With regard to Medieval Arabic and Western medicine / technology, there is a lot of overlap. It's easy to generalise and characterise, but the truth is often considerably more complicated. Byzantium springs rather readily to mind as a counter example.

Mike_G
2007-01-20, 05:10 PM
Well, that is a good point. I'm not sure if I'm convinced, but it is useful to hear the other side of the argument. I suppose a lot of this depends on relating game mechanics to the real world. 0 = Unconscious, -1 to -9 = dying in less than a minute.

With regard to Medieval Arabic and Western medicine / technology, there is a lot of overlap. It's easy to generalise and characterise, but the truth is often considerably more complicated. Byzantium springs rather readily to mind as a counter example.

I think the timing on skills is largley game balance. I don't think you generally pick a lock in six seconds, or diable a trap, or search a door either.

But, if you pointed at my comrade bleeding out between 10 and 30' away, I thin k I could run to him and get the bleeding controled, certainly within 10-15 seconds, unless I fumbled the dressing, which would count as a failed roll.

On the practical exams for Paramedic licensure, you need to control the bleeding in a fake patient in under a minute, and they usually make you run through three or four methods before they annouce that you succeed. I usually goes pressure bandage, second bandage, elevation, pressure point, ice pakc, tourniquet. They gemerally, unless you have a jerk for a tester, let you get to pressure point and say the bleeding is controled. This just to show that you can simulate four or five methods in well under a minute. I've stopped life threatneing bleeding in a few seconds, or at least reduced to to a trickle in the field. Assessing vitals, staring IVs and treating for shock adds time, but that's beyond stablization.

Now, going from fighting to sheathing my sword, slinging my shield, digging out a dressing, moving and applying it, all in a round, yeah too much, but this is D&D.

Matthew
2007-01-20, 05:18 PM
Well, what I always recall is that this rule was first invented during the days of the one minute round, which then became the twelve to fifteen second Round before finally becoming the six second round.

In the interests of suspending disbelief I run things differently in my House Ruled game and just try to ignore the implications in default D&D.

Interesting to hear some comparative discussion, though.

Golthur
2007-01-20, 05:29 PM
I think the timing on skills is largley game balance. I don't think you generally pick a lock in six seconds, or diable a trap, or search a door either.
Well, I can say from personal experience that picking a lock with lockpicks is not that fast, but then again, that was a modern pin tumbler lock. Perhaps picking a medieval-style warded lock is faster.

Mike_G
2007-01-20, 05:55 PM
Well, what I always recall is that this rule was first invented during the days of the one minute round, which then became the twelve to fifteen second Round before finally becoming the six second round.

In the interests of suspending disbelief I run things differently in my House Ruled game and just try to ignore the implications in default D&D.

Interesting to hear some comparative discussion, though.

Twelve to fiftenn seconds would seem more resonable, but I don't think there are any "two round actions" in D&D, so I have no issue with one round. It should maybe be a full round action, though.