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For a GUMSHOE game I want to build up the suspense through the more subtle, but very effective, buildup of a sense of desperation. This is a medical drama and the characters will be in quarantine. I’m looking for both story and mechanics based ideas.
Things will start with needing to save patients lives. Then the need to find out what is happening in the outside world and save their own lives, as well as hopefully some patients.
Being in quarantine means scarcity, but to emphasise desperation it has to be brought home by giving the players hard choices:
Make (almost) every decision between two unpleasant outcomes. They don't have to be equally unpleasant, but when your players start deciding, the results will be their choice, for good or bad.
If they are ill, or they are caring for patients, quarantine means scarcity. The clotting drugs they need to keep the failing splenectomy in Trauma-A alive are not available and he's crashing. The last cylinder of O2 is about to run out for the old lady with ARDS.
Scarcity can also come in the form of information - nobody on the outside is telling them what's going on, they don't have the data they need, etc. This also breeds uncertainty and finally desperation.
If they are infected, that's a whole countdown timer itself. Patients start to manifest symptoms - are they the disease or unrelated? Tell them they are sweating and clammy - is it just nerves, or the air handler, or is it the Marburg virus?
Regardless, I would definitely give them urgent business to attend to outside the quarantine, and people they care about that need their advice, assistance, and comforting. Nothing will make them more desperate than situations entirely outside their control. Make them really want to leave and tempt them to break the quarantine, of course. perhaps this, coupled with hints that it is all an unnecessary sham, would really amp up the desperation.
The story ideas are good, but I think you might want one or two stacks of tokens to really make it clear to the players that their characters are running out of stuff, perhaps health tokens or medicine tokens.
As long as they have all 20 health tokens they're fine, but when they get down to 15, they show the first symptoms, etc. You could even take away health tokens faster for doing certain kinds of actions. This should really force some hard choices. "Are we too sick to follow this lead? Even if it means the solution to the mystery?"
I'm not really sure what medicine tokens would be. Maybe they would be the lives of the NPCs who are sick. For every medicine token you take away from them, one of the NPCs buys the farm. They're running out of medicine. These people won't last much longer.
If you're using Jmstar's idea of stuff going on outside, without the PCs, you might also want to give that a stack of tokens, to remind the players that they aren't part of that, or you might want to keep it a secret how far along that's progressed, and let them use their imagination, which would be more realistic, but the players might forget to imagine what they're missing out on.
Start killing NPC's one at a time with the deaths becoming progressively more unpleasant.
Make the difficulty of keeping patients alive progressively more difficult the longer it takes to come up with a cure. For each unit of time increase difficulty by 5% - 10%
Give hints that the people outside of the quarantine don't have much hope for the situation. (piles of body bags being brought in, asking if their next of kin information and will's are up to date)
