D&D & Disease (in 5e)

There are a lot of topics that D&D isn’t ready-made to explore. As best as I can tell, disease (chronic or acute) is one of them.

This line of thought came up for me while talking with my sib about dangerous encounters in a weird fantasy / sci-fi / horror adventure campaign I’m running for some friends. It’s a roughly post-apocalyptic setting, based in The Hub, in which the apocalypse(s) in question took place a variable amount of time ago and in different fashions, depending on where the PCs explore. Some of the perils the PCs face include radiological disasters, and radioactive environments or threats.

My sib, naturally, asked what I’d done on the topic of cancer.

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‘Yes’ means nothing if you can’t say ‘No’

I’m fortunate. I’m lucky in the extreme, in many ways. One of those ways is the fact that I exist at all. My existence in the first place was improbable—my conception was a wildly unlikely event. And, given everything else going on at the time, there was no guarantee my mother would want to give birth to me. Yet my mom has told me many times that she feels blessed to have had me. I feel blessed in turn.

“Ah ha, Henry must be anti-abortion!” You say.

No, the opposite.

I was born because my mom wanted to keep me. I was born in a world where she had a choice, unconstrained by legality or safety, about whether or not I would be born. I was raised by a mother who was able to look at her life, at her family, and say “yes, I want to bring another child to this, and I am ready to love and provide for that child.”

I am lucky, I am blessed, because my mother was able to make that choice. In many ways, my life feels more meaningful because my mother had other options and chose me. I was never unwanted. I wasn’t a burden. I was chosen.

I want others to be chosen too.

But being chosen requires that it be a choice. That choice matters. Preserving the ability to choose matters. ‘Yes’ is an empty word when you can’t say ‘no.’

Taking away someone’s ability to say ‘no’ doesn’t mean they’ll say ‘yes.’ It means you don’t care what they think or feel. You might as well just tape their mouth shut.

And it’s dishonest to look at this issue on its own. Abortion access may be legislated separately, but the arguments about abortion and restricting access to it are deeply entwined with other political messages. They coexist with other narratives, and other goals.

The political party that would restrict abortion access also votes to cut funding for public health care. In Mississippi, anti-abortion legislation is passed even while support for future parents is not. And politicians arguing against abortions often also vote against funding programs that support poorer people, or expanding that support to prevent poverty in the first place.

Here in America, many of these arguments come back around to personal responsibility. Individuals are to blame, by the logic of personal responsibility, for all of their success or failure. And many anti-abortion politicians support measures that push this narrative. They sell the idea that they’re empowering the individual to plot their own course or stand up for themself.

Unless you’re pregnant.*

Raising a child in our society is extremely expensive. Giving birth is more dangerous here than in many other countries, on top of being pricey. Quality medical care is not reliably available to everyone, and where it is available it’s still costly.

Choosing not to raise a child under those circumstances is a responsible decision. Choosing to raise only the number of children you can afford to raise is a responsible decision. Choosing not to take the medical risk of bearing a child is a responsible decision.

I am lucky because my mother knew that she could provide for me. She knew that having me wouldn’t be the straw that broke the family’s back. She could make the choice to have me without being irresponsible.

But politicians who love personal responsibility would prevent people from making responsible choices. Because if someone is pregnant, then these politicians know best. They know the government should strip away that vaunted individual choice, they know the government should disempower pregnant people in their own personal lives.

I firmly believe that people should be allowed to not get abortions if they don’t want them, or if they feel abortions are morally unacceptable. They can choose to never have an abortion. They can make many personal choices, for themselves, as they see fit.

But they can’t make those same personal choices for others. They must not gnaw away at other people’s access to health care. It’s unacceptable to force anyone but yourself to carry a fetus to term.

There’s far more to say here: about political narratives, religion, extremism, and broken systems… but I’ll leave it at this for now.

Being chosen was a blessing. Let other people choose for themselves.

*In fact, this message of “empowering individuals” comes with far more caveats. It’s not just about being pregnant: when you look at larger patterns it also often matters whether you’re white, rich, male, straight, etc.

Consent and Horror Gaming, Quick Thoughts

We, as people playing story-games and RPGs, often assume that our fellow players are on the same page as us. We assume that other players want the same things, have the same tolerances, fears, and interests, or at least don’t differ in ways which would surprise us. These assumptions are frequently wrong, to varying degrees. Worse, unless they’re examined these assumptions interfere with players building trust and giving informed consent.

Players’ trust, consent, and buy-in is important regardless of the game, but it’s critical in games dealing with uncomfortable material… like horror games. There’s a much larger conversation to be had around gaming and consent, but this piece will focus on consent in horror RPGs.

Quick note: when I say “players,” I include the storyteller. As the storyteller, you’re not only doing a bunch of work, you’re also participating in this story world that you’re creating with and for your fellow players—if people are pulling the game into territory you’re uncomfortable with or which you really don’t want to cover, that’s important too! Don’t sacrifice yourself for the sake of other players, or at least not any more than you want to.

Trust is a simple word and a complex subject. Too complex for me to cover in depth in one post. You can’t build consent without a modicum of trust between people involved; for consent to be meaningful, there must be trust that other people will respect the boundaries set and will act promptly and responsibly on feedback they receive. The depth of that trust governs how readily groups can achieve consent, and influences how willing people may be to experiment with their boundaries. One person may have varying levels of trust for different people or topics, and the only way to learn those levels is to ask and observe. So pay attention to those around you, ask for and give feedback freely and without judgement, validate reported discomfort, and resolve that discomfort to the preferences of the uncomfortable person.

Informed consent is another large subject, but at its simplest I’d call it agreement without coercion or surprises. I mention buy-in earlier because I think enthusiastic participation and shared investment is the obvious next step following informed consent; it’s important to have players’ consent, but you really want their buy-in as well. But without laying the groundwork with your players, you’ll only achieve consent and buy-in by luck; ideally, we want to get there by design.

What might that groundwork look like?

The first step is for someone (usually the storyteller) to offer or request a specific kind of game—for our purposes, we’ll assume that people want a horror game. There may be some back and forth here, until there’s a sufficient body of excited players to support a game.

The second step is when a storyteller should warn their players about what underlying kinds of discomfort are likely in the course of the story: a narrative version of “side effects may include,” where you might mention character death, fallible perceptions of reality, gaslighting, decaying sanity, things that go bump in the night, etc. Whatever is particular to your game. You (the storyteller) can also take suggestions from your players here! There’s an art to crafting that warning, given that many horror games revolve around the unknown: I strongly suggest that you touch on broad themes more than specific perils. The specific perils can come up in the next step.

Once you’ve warned folk about what underlying themes you may play with (and asked what themes they might like to add), ask what specific things they’d like to see in the game and what specific things they don’t want. Here the terminology of lines and veils is useful: lines are hard vetos against specific content showing up in a game, while veils are a request to fade-to-black around that content without excluding it entirely. There’s an excellent explanation of lines, veils, and some other safety mechanics here.

Double check to make sure that you’ve heard people’s requests, and that they’ve heard your underlying content warnings.

In the course of play, take breaks! Check in with people, preferably one on one, about how things are going for them and whether there’s anything that they’d like to update in terms of lines, veils, or other requests for the game. I suggest checking in one on one because it’s easy for people to unconsciously pressure others (or themselves) into not speaking up about discomfort. To quote from the link above, a good interaction might look like:

“Ouch!”

“Oops, sorry. Let’s fix that.”

You can also use those check-ins as a means of getting useful feedback on your storytelling, or on the character you’re playing. These are good opportunities to discuss bleed, or any other things that have come up for people through the course of the game. It’s also worthwhile asking the group as a whole to check-in, so long as you’re addressing people’s needs and concerns individually as well.

And remember that trust, consent, and buy-in are all things which can change! None of those established preferences are set in stone, and people’s needs may change. Use safety mechanics (some linked here) to make sure that people don’t feel that their consent has been abused, or their trust diminished. Stoplight check-in vocabulary (green = more of this please, yellow = this is on the edge don’t push further, red = NOPE) is valuable for making this process easier, and having something on the table that people can use during scenes without interrupting game is very helpful. That on-table tool could be an X-card, or several differently colored circles.

Just because you’re playing a horror game doesn’t mean that you should run roughshod over your fellow players. The experience of horror should be in the game and in response to the game, not because your friends were assholes to you in real life.

p.s. the earliest mention of Lines and Veils I could find while writing this today was here, in this thread from 2004.