What is an appropriate list of Medical Investigation Skills for GUMSHOE?

Question

I’m currently working on a one-shot for Gumsheos that will be very medically focused where the characters are quarantined in a medical facility and trying to identify a “super plague” of occult origins before it’s too late. To better capture the feel of medical procedurals (like House) I’m developing a set of investigation skills based on medical specialties to help differentiate the characters.

Here’s what I have so far:

• General
• Medicine
• Anatomy
• Neuroscience
• Epidemiology
• Toxicology
• Pharmacology
• Genetics
• Surgery

My questions are:

1. Is this an appropriate level of detail for you?
2. How much of a skill blurb would you need to easily utilize this skill in a game?

Answer 1

Yeah, GUMSHOE is all about the little fiddly skills - due to their mechanic, it works out better than a traditional skill-points game.

In Mutant City Blues, there are the following medically related skills.

"Medic", a general ability to actually patch people up with first aid. If anyone's going to be a nurse or EMT or whatnot you probably do want a general skill like that.

Then they have: forensic anthropology ("normal" forensics) forensic entomology (bug specialist) because mostly they're concerned with dead people, and then Chemistry as pseudo-related.

For a purpose built medical game I think extreme drilldown on medical skills is appropriate. I might do:

General:

• Medic (for EMTs and nurses)

Technical: (cut ones that aren't needed - you say "occult plague" so who knows what might come in...)

• Anatomy (the body)
• Cytology/histology (cells/tissues) - might be more relevant in a disease scenario
• Neuroscience (nervous system)
• Emergency Medicine (for keeping victims actually alive via workarounds)
• Epidemiology
• Pharmacology (drugs)
• Toxicology (drugs, bad) - may or may not be needed
• Genetics
• Surgery (operating) - there are subspecialties but don't sound like they're relevant here
• Forensic Pathology (cause of death)
• Forensic Entymology (bugs & the dead) - maybe needed
• Forensic Anthropology (the long dead) - probably not needed unless they have bones of victims of a similar plague in the 1300s or whatever
• Forensic Archaeology (grave sites) - almost certainly not needed if they're stuck there
• Forensic Dentistry (teeth) - almost certainly not needed

Academic:

• Medical History - useful if the occult part means that knowledge of past plagues, or vaguely mystical pseudo-medical mumbo jumbo about humors and whatnot is relevant

I could be more specific if I knew if ancient/historical/mythical stuff is relevant at all to the occult plague or whether it's just a new thing, and how much working on dead bodies will be relevant, and how much trying to tactically keep sick people alive is a focus. I think forcing a balance between intervention to keep people alive and "solving the root cause of the problem" would be compelling.

Answer 2

I wouldn't have a general Medicine skill that overlaps all the other ones; I think that lessens the impact of the more specific skills, particularly in the GUMSHOE system.

Looking at this list, I think Toxicology and Pharmacology are hard to distinguish. If I worked in the field I'm sure I'd know the difference, but as a novice I have no idea. My initial impression is that both are about substances you can put into a body to get effects. One's beneficial substances, and one is not, but wouldn't they overlap a lot?

For a game, I would like to see concrete examples for each skill. E.g.:

Anatomy: this skill covers blah, blah, and blah. If you were trying to figure out what caused someone's appendix to migrate from their torso into their left leg, Anatomy would be an appropriate skill.

Answer 3

I am not sure what you mean by Genetic Surgery? Or did you mean Genetics and Surgery as separate skills? If the latter, I would not consider surgery an investigation skill...

I would consider adding physiology to the skill list. I see you have epidemology, but in my opinion they are very different.

As for the blurb level of detail, it really depends on your players. For me just the names are enough, but you might want to add a sentence or two explaining what the skill is used for... Perhaps with a couple of examples.

e.g. Epidemology is used to study how a disease spreads in a population... Determine where a disease originated from, the likely vectors it is using to spread, and predict how much it will spread.

Answer 4

Skills like Surgery or Emergency Medicine are better as General Abilities, since they involve doing things more than getting information. The writeups for similar General Abilities explain how they might be used as Investigative ones: for example, Surgery would show evidence of a recent operation.

Include a separate Diagnosis ability (Academic, for live patients) as well as Forensic Pathology (Technical, for dead ones). The latter would cover Toxicology and Forensic Entomology. You could leave Pharmacology for man-made chemicals and drugs, although I would certainly give a lot of information about toxic substances to someone with Pharmacology.

If you are envisioning something like House, where many of the PCs will be doctors or otherwise in the medical field, you probably won't need an ability like Cop Talk for doctors (not sure what to call it). But such a skill becomes important when you have PCs from other fields who have to interact with doctors or develop medical personnel as contacts). I would include Bedside Manner as an Interpersonal Ability, for getting information from patients (functions like Trail of Cthulhu's Oral History).