The Scion ER

Question: From my reading, it looks like a Scion can't cure a disease until they have purchased Plague/Cure. Given that the entire purview is supposed to be centered around the healing/infliction of injury and illness, this seems like a pretty high bar to jump just to gain access to such a fundamental capability. Am I reading the RAW incorrectly? -CA

You're not reading it wrong; technically, the only way to cure a plague - that is, instantly remove it from the body of an afflicted person and/or cause it to no longer exist - is to have the Cure boon, which is all the way at the biggest and baddest level of the purview. This is a great question because it gives us an excuse to talk about healing, both with the purview and in general, and all the weird ways it works and interacts in Scion.

The problem with the interaction of Health boons and diseases is that Scion's system doesn't actually have a good mechanical framework in place to explain how they work. It has a bad mechanical framework, which you can find on page 182 of Scion: Hero where it talks about Virulence, Morbidity, Incubation and a bunch of other fiddly little issues that are meant to handle this problem, but like most of the rules in that chapter it was imported from another game, only vaguely works for low-level Heroes and becomes utter clownshoes as soon as Epic Stamina is in play. We ignore it totally because it's awful, but that leaves us looking at a game that has the potential for diseases to occur - indeed, it's almost inevitable, given their prevalence in mythology! - but no game mechanics to handle them.

Technically, right now, you cannot cure a disease with lower-level Health boons, but you can remove its effects by treating the afflicted. A disease functions in Scion by dealing a certain amount of damage to the person suffering from it over a period of time, so if you use Heal, Restore, Holy Font or any other boon that removes damage, you've just mitigated the disease's effects. It's basically the equivalent of what mortal doctors do about common flu viruses; they can't actually cure them, so instead they treat the symptoms to prevent them from doing any damage while the body figures out how to fight them off on its own.

That means that whoever has the disease is still diseased; you're just preventing the disease from killing them (or, if you're awesome at your healing job, inconveniencing or hurting them too much). So how do you get rid of the disease? Well, the same way you tried to not get it in the first place: the person with the disease needs to roll a mighty enough Stamina + Fortitude roll to shake it off, which mechanically represents their immune system rallying or the antibodies they've been building up finally taking over.

This leads on to our subsystem for medical care, which is not complicated but which is a nice thing to have around for illness situations, especially for Heroes who aren't high enough Legend yet to have straight-up healing powers. If there's a chance of a disease being caught by a character (because they're crawling through the sewers, hobnobbing with lepers, being targeted by evil Health titanspawn or whatever else), they roll Stamina + Fortitude against a difficulty decided by the Storyteller based on how dangerous and virulent a disease it is. If they succeed, they're home free, but if they don't, they're infected and begin suffering its ill effects. Every few hours thereafter (again, depending on how hoss the disease is), they'll roll again to try to shake off the disease. If they roll well, they claw their way back to wellness and are no longer sick (if they were resting during that time, they can also heal as normal). If they roll mediocrely, they don't get better and take more sickness-related damage or penalties. If they botch, they're probably entering a death spiral.

But medical care can help them, just like it can in the real world! Anyone who wants to try to provide treatment for them can attempt to do so with a basic Intelligence + Medicine roll; having designer drugs and sterile equipment will grant bonuses to this roll, while trying to perform triage with a rusty spoon in a dirty alley will probably levy penalties. The would-be medic's successes then become bonus dice that the disease sufferer can apply to their next Stamina + Fortitude roll, buttressing their hardiness with some timely medical care. There's a hard cap of no more than ten dice that can be granted this way, since this is only normal mortal medicine we're talking about, and it only applies to the next roll against the disease, but it gives beginning Scions the ability to dive in with bandages and gauze and try to make sure that the fragile among them have the best chance at life. This roll is also what mortal doctors and hospitals make when they provide medical treatment - after all, even if they can't get more than a few successes, those dice might make the difference between a Scion with a terrible disease pulling through or giving up the ghost.

We also have Scions who have sustained lethal or aggravated damage at low levels roll their Stamina + Fortitude against getting infections in their open wounds, which follows the same rules; if someone gives them first aid, they'll have a better chance of staying healthy than if they just wander around the city with stab wounds oozing down their sides.

Of course, all this becomes largely moot once Scions get to the level of having three or more Epic Stamina - coincidentally, the same point where they first have access to the Heal boon. From this point onward, unless a Scion has terrible Stamina, is massively damaged and has the smallpox virus poured into his wounds or something, he probably doesn't have to worry about rolling against normal illnesses or infections anymore. But divine and Titanic diseases are still a very real and present danger, so the same rules for triage and trying to resist a sickness apply should anyone fall prey to one of those.

But, circling back around to Health boons, they still don't cure diseases, only treat their symptoms. This is a little bit of a pickle, because on the one hand, we get where you're coming from; curing the sick is a thing that Scions and other magical people should probably be able to do! But at the same time, we don't want to move a giant showstopper like Cure any lower, because that crazy ability to just erase a sickness and cause a large number of cancer victims to suddenly get up and dance is definitely something only done by gods.

We've been compromising lately, pending a rewrite of the Health purview; if a person doesn't currently have any damage but is afflicted by a disease, we've occasionally allowed a Scion to stunt the Heal boon in an attempt to cure the illness, requiring them to overcome an appropriate difficulty to do so (usually the roll of the opposing magical illness-causer, for most Scions with this problem past Hero-level). It is an area that could definitely stand more looking at.

John and I actually had a conversation about Health the other day, talking about how it could be streamlined more so that people have access to useful effects the whole way up, and whether or not it can branch out into more interesting effects than simply "heal some health boxes". It's something we'd definitely like to give a look in the near future!