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Say a player asks "Do I feel like I've been poisoned?" Or "Do I feel like I have a disease?" Or "Do I feel like my leg is broken?"

I've considered a few options and have nothing that makes me think "Yes. That'll do."

Straight up Medicine doesn't seem exactly right: A character may be able to medically examine themselves for signs of a disease, break, etc. but if they're asking in the moment, having been hit with a piercing or slashing implement, or landed wrong after a big drop, they aren't making an examination so much a intuitive, self-awareness judgement call "can I put weight on my leg?" or "does something feel off with me since I ate?" type of decision.

Medicine-Charisma feels like a strong option if only because of a PHB description of charisma implying a level of self-awareness, but in context that seems more a reference to knowing ones own mind than ones body. Might work for a "Do I feel like my memory has been altered?" or similar but doesn't seem right for a quick personal assessment of physicality.

To clarify, I'm not asking what might give an advantage. Many things could (experience with medicine, poisons, etc.). And I'd likely allow such an attempt if applicable. So I'm not looking for a hard rule so much as a soft default...

Yes "NOTHING" is a valid answer. How badly am I hurt is often a trivial question to answer. And I'm not inclined to insist on rolling for everything, so won't argue that "Don't request a roll." isn't good advice here and in many cases, but there may be situations as listed in my question where one person with a greater self-awareness would be able to tell that they had been poisoned where another might not, or even to what degree of recognition AND there is likely to be an element of chance to that. Hence wanting to decide what the determining factor (or appropriate roll) might be.

I'm not suggesting I'd hide a sensation from a player. Example scenario: 2 characters enter a room. Each sits at a table and takes a sip from a different vial. They are told that one of the vials was poisoned. They aren't told the type of poison or its effects but let's say they're told one of them has only hours to live. The first thing each does is examine the vials. They give each a look and a sniff. No dice. Next thing they do is look at each other. One looks worried but neither seems certain. Next thing they do is consciously attempt to discern whether they feel at all unusual. This is something that, in my opinion, is not always a given. So this first guy; non too bright, low mental resilience, prone to fear, anxiety and not all that self aware (rolls 5-3 Medicine, Wisdom), so he ends up convinced that the itch on his knee is a symptom and panics. The other guy; cool as a cucumber, an expert herbalist and poisoner, and generally pretty in touch with his physicality (rolls Medicine, Wisdom with advantage - 19+4 and double proficiency), sits there and focuses on his respiration, notices that his heart rate is up, that the pinky on his left hand is a little numb and "oh s***. Yep. That's the old M5 playing up. Tasteless and odorless? Nothing local. Unless..." guy downs the rest of the vial. It induces vomiting. He stands covered in puke with a smile on his face. I'm happy this makes sense now. Medicine was obvious for a diagnosis. Just wondered if something else would have made more sense for the initial self-analysis.

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    \$\begingroup\$ If you are looking for advice how to handle a greater self-awareness I would get rid of the "Do I feel like my leg is broken?" example, you don't need a lot of awareness at all to feel your leg hurting and noticing its odd angle. The other 2 examples can be made more clear too, to help exemplify you are looking for skills that help with subtle effects that aren't just automatically noticed by everyone. \$\endgroup\$
    – Pepijn
    Jul 4 at 9:29
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    \$\begingroup\$ How do you even break a leg in D&D? With an abstract hp system, the only way I know of to functionally impair limbs is via optional rules in the DMG. \$\endgroup\$ Jul 4 at 11:54
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    \$\begingroup\$ @GroodytheHobgoblin Bards of the College of Eloquence have been known to break legs with alarming regularity. \$\endgroup\$ Jul 4 at 12:02
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    \$\begingroup\$ @GroodytheHobgoblin Yeah, you got it. \$\endgroup\$ Jul 4 at 12:14
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    \$\begingroup\$ Relevant meta: Don't signal your edits in text. Instead, you should edit your question to read as if it were always the best version of itself. Anyone interested in older versions can always view the revision history. \$\endgroup\$
    – V2Blast
    Jul 5 at 21:31

6 Answers 6

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Not everything requires a roll, but....

I agree with the other answers here, that not everything requires a roll.

Perhaps your examples aren't really suitable, since if someone breaks a leg they are going to know about it. Or at least, they will know something is hurting a lot and that leg is unusable, and whether its a fracture, a really bad sprain or a break is not going to make any practical difference for the purposes of the game (unless you are using home-brew rules about injuries and healing).

I'm not sure why you appear to want this to have a roll. It's the sort of thing that only slows a game down and, if you insist on rolling for obvious things, your players will eventually get annoyed.

However....

If you really want to roll, then a Wisdom (Medicine) check would be the one to go for, which would equate to a straight Wisdom check for someone not proficient. Wisdom is the stat for self-knowledge. The PHB does allow for using different attribute + skill combinations however, and that could fit the players concept of what they are trying to determine.

For example, Intelligence (plus their Medicine modifier if they are proficient) could be used for: Can the character logically "connect the dots" between that drink they had earlier and the fact they are feeling a bit woozy now.

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  • \$\begingroup\$ I think you misread. I explicitly said that I wasn't requiring a roll for everything ("I'm not inclined to insist on rolling for everything"). I don't ask for rolls where an action would be trivial. I disagree that the examples aren't suitable. Some may not seems intuatively so. Others I'd argue are very much instances of things where you may not know the extent of a detrimental effect. It may be easier to just tell a player everything but I'm anticipating/inventing situations where a PC may e.g. deduce the exact mechanics of an effect, that something is wrong absent detail, or nothing at all. \$\endgroup\$ Jul 4 at 10:56
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    \$\begingroup\$ However... I'll concider the merits of Wisdom (Medicine). Feels right for most things. And I like the idea of using intelligence to try determine the source of a lingering effect that wasn't immediately obvious, in the same way someone might try to deduce when exactly their pocket got lighter and who the rat-bag that took their gold was. \$\endgroup\$ Jul 4 at 11:00
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    \$\begingroup\$ @BrentHackers Apologies - I misread a previous comment of yours! \$\endgroup\$
    – PJRZ
    Jul 4 at 11:12
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    \$\begingroup\$ This answer definitely reflects how I’ve always run situations like the ones outlined in the question. If you aren’t going to use Medicine for stuff like this, the only thing it’s there for is stabilizing an unconscious creature, which anyone can do with a reasonable likelihood of success at DC 10 (and the occasional field autopsy). \$\endgroup\$ Jul 4 at 11:26
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    \$\begingroup\$ I could easily see a situation where a person might distantly register something as a bit off, but not think much of it until it gets to be an un-ignorable problem. That happens pretty much every time I get sick for whatever reason. It doesn't seem super-weird to simulate this effect on a PC with perception checks. \$\endgroup\$
    – T.E.D.
    Jul 7 at 15:26
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"I know what's wrong, but not why it's wrong!"

Everyone can agree that the best person to tell you how your body feels is you. Knowing what hurts, how much it hurts, if you're feeling poisoned or sick, this kind of thing should be obvious to a character. I'd argue it's part of describing the scene itself. Either way, in any normal situation where a character is aware of its own body, there shouldn't be a reason to hold such an information behind a roll. Of course, unique situations where a character is on the verge of fainting or is under a pain suppressing effect might call for a roll.

However, knowing the symptoms doesn't mean you know the reason for those symptoms. This holds especially true for poisons, diseases, parasites or anything of the sort. Of course, you'll notice that your head is spinning, or that your arm feels numb and hot, but if you're not well versed in the topic, it can be hard to understand exactly what's affecting you. Of course, if your character has been affected by a specific poison or disease in the past, it'll be easier for them to link the dots, which could translate in advantage when rolling.

In terms of what to roll, Medicine would make sense most of the time. Once again, special situations might make other rolls more relevant. One example that comes to mind is if you've been poisoned by a plant you ate or touched, in which case a Nature check might make more sense. Or maybe you've been afflicted by an old, famous disease, and a History check to recall its properties would be better.

Do note that (usually) the characters you play are adventurers. Even rookies should know the basics, like distinguishing broken bones from a mere sprain. Similarly, when fighting a poisonous creature, it should be obvious what kind of venom you're currently afflicted with.

To put it in a few words : no roll should be necessary for the symptoms, but a roll might make sense to determine the precise nature of an affliction (in which case, a Medicine roll would fit most situations).

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    \$\begingroup\$ Everyone can know "my shoulder hurts", but a good medicine check can get you to "I've probably got a grade 2 sprain of my acromioclavicular ligament". \$\endgroup\$ Jul 4 at 12:05
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    \$\begingroup\$ That's an excellent way to put it. I'd argue that anyone could separate a broken bone from a sprain, but it would definitely take quite some medical knowledge (read : a good medicine check) to know exactly what you fractured or sprained. \$\endgroup\$
    – Matthieu
    Jul 4 at 12:05
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    \$\begingroup\$ And if you've got some decent working knowledge of anatomy, you can get creative and assign some "success by degrees" to the magnitude of the medicine check. "you just know your shoulder hurts" - "There's something wrong with your glenohumeral joint" - "you've torn your labrum". \$\endgroup\$ Jul 4 at 12:12
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Don't roll, role-play

Not everything needs a roll. It is more up to the DM to narrate situations like these.

The player is asking a question like this, they must suspect something is up. So tell them the truth.

A three-year-old can sense their tummy hurts because they ate something bad. Why do you think an adventuring adult has a chance to misdiagnose pain, aches, bleeding, etc?

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  • \$\begingroup\$ I'm not inclined to insist on rolling for everything, so wont argue that this is often good advice, but there may be situations as listed in my question where one person with a greater self-awareness would be able to tell that they had been poisoned where another might not AND there is likely to be an element of chance to that. Hence wanting to decide what the determining factor (or appropriate role) might be. \$\endgroup\$ Jul 4 at 9:23
  • \$\begingroup\$ Sorry for the repititions in comments but these answers all flew in at the same time. I'd argue that while yes, 'a three year old can sense that their tummy hurts', that does not apply to all detrimental effects. Many may or may not go unnoticed for long periods of time, or even until it's too late. Poisons, toxic inhilation, etc. and the awareness of such things will vary person to person. Just think about people out on the drink? How many of them can accurately gauge how drunk they are? Some can. Most cant. with varying levels in between. \$\endgroup\$ Jul 4 at 9:31
  • \$\begingroup\$ @BrentHackers, but now you're getting into WebMD territory. My wrist hurts.. is a sprain? bruised? fractured? Is it the bone or the muscle? Is it cancer? Same with poisons. First, different poisons work differently. They also are administered differently. Was the sword poisoned or was it something I ate? Of breathed in? Or I can in contact with? Am I woozy because of poison or because I need rest? Diseases can be even more complex and might not have any symptoms at all. \$\endgroup\$
    – MivaScott
    Jul 5 at 22:43
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You say 'yes', or 'no' depending on which is true

In real life I have no medical proficiency, but I have been poisoned, diseased and broken in various ways, and I always noticed.

The player character is the only thing in the game world that your players control. You should let them know what is happening to them.

No roll required.

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  • \$\begingroup\$ I'm not inclined to insist on rolling for everything, so wont argue that this is often good advice, but there may be situations as listed in my question where one person with a greater self-awareness would be able to tell that they had been poisoned where another might not AND there is likely to be an element of chance to that. Hence wanting to decide what the determining factor (or appropriate role) might be. \$\endgroup\$ Jul 4 at 9:22
  • \$\begingroup\$ Also, WHY have you been poisoned, diseased and broken in various ways?! \$\endgroup\$ Jul 4 at 11:06
  • \$\begingroup\$ @BrentHackers Life is hard. And then you die. \$\endgroup\$
    – Kirt
    Jul 4 at 15:01
  • \$\begingroup\$ @BrentHackers not in serious manners, but food poisoning, flu (etc) and a broken finger :p \$\endgroup\$
    – SeriousBri
    Jul 4 at 15:04
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    \$\begingroup\$ I've also been poisoned, diseased and broken in various way and haven't always noticed it. Maybe you didn't always notice it too. (I mean, how would you know?) As a doctor once told me, if people tell you "you look like you're literally dying" consider going to the hospital because they might be right. \$\endgroup\$ Jul 6 at 16:37
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Unless there is a reason the character wouldn't be able to immediately tell, there is no roll required.

People are pretty good at determining whether or not something is physically wrong in their body, things start to hurt. I would only ever call for a roll if there is some sort of challenge to determining what is wrong. Perhaps the immediate effects of a poison are very subtle and only get worse when its already too late, in that case a Medicine check becomes appropriate.

But what you described, in the moment self awareness of ones body, is not really something that normally requires a particular skill. Not everything has to be behind a roll.

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    \$\begingroup\$ I'm not inclined to insist on rolling for everything, so wont argue that this is often good advice, but there may be situations as listed in my question where one person with a greater self-awareness would be able to tell that they had been poisoned where another might not AND there is likely to be an element of chance to that. Hence wanting to decide what the determining factor (or appropriate role) might be. \$\endgroup\$ Jul 4 at 9:23
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    \$\begingroup\$ I'd also argue that people arent necesarily 'good at determining whether or not something is physically wrong in their body' when it comes to a lot of things. Many detrimental effects may or may not go unnoticed for long periods of time, even until it's too late. Poisons, toxic inhilation, etc. and the awareness of such things will vary person to person. Just think about people out on the drink? How many of them can accurately gauge how drunk they are? Some can. Most cant. with varying levels in between. \$\endgroup\$ Jul 4 at 9:28
  • \$\begingroup\$ @BrentHackers Then you need to include better examples in your question for the situations you are thinking of. There's not much subtlety in breaking your leg. \$\endgroup\$
    – Pepijn
    Jul 4 at 9:30
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    \$\begingroup\$ There very much can be. It's not easy for most to decide when they've landed wrong from a fall whether a) That smarts, b) that's sprained, or c) yeah that's broken \$\endgroup\$ Jul 4 at 10:11
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Locking basic sensations behind dice rolls will irretrievably harm your game.

If people need to roll perception to see the mug of ale in front of them, or athletics to climb a flight of stairs, not only will your game slow to a crawl but it will be filled with inexplicable failures and pratfalls.

Nausea, pain, loss of function, loss of feeling, heat, cold, coughing etc are all things that should never require a roll to notice.

Correctly identifying that you have a radial fracture of the tibia and how it needs to be twisted to put the bone back into alignment is a Medicine check, either wis or int based.

Correctly identifying whether you have food poisoning, regular poisoning, or appendicitis is likewise a Medicine check.

Noticing obvious things about your own body (or others, in the case of wounds) does not and should never require a check (of any kind), unless there is some sort of magical effect involved, or the individual is incredibly impaired (such as by extreme intoxication or heavy concussion).

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