Disease in your game

[Zapp]

How do you avoid disease becoming either trivial or oppressive in your game?

If you have a Cleric or Druid, disease is trivial once play reaches level 5 since unlike poison disease acts so slowly you can simply load Remove Disease in all your top slots and you will sooner or later remove the disease.

If you don't, disease easily becomes a major bummer - especially disease that inflicts cumulative stages of Drained or other conditions that lower your Fortitude save.

Let me leave you with a couple of related notes:

* Every instance of disease in official APs is level appropriate, meaning that Remove Disease in your second highest level slot needs a success on the counteract, while Remove Disease in your highest slot even works on a failure (only critical failure fails).

* Addiction to drugs is mechanically represented as a disease, significantly defanging drugs, since your cleric can keep removing any addictions you develop.

---

I realize one answer could be "don't let the party take days off". If every day is an adventuring day, reserving your top slots for the Remove Disease spell becomes a real cost. But I don't like how Sue the party Cleric needs to pay for Bob the Fighter's mistakes.

What I guess I'm after is a middle road where disease is neither trivial nor completely dangerous. Where the presence or absence of a Cleric doesn't mean the difference between night and day. Where drugs remain dangerous even to adventuring parties.

The way Pathfinder 2 works means you can't solve it the intuitive way - if you increase the level of the disease so the DC increases, you don't just lower the chance of success gradually, you abruptly reduce the chance to rolling a 20 only.

Do you have any advice?

[Captain Morgan]

I think the biggest thing is keeping it a secret. Contracting a disease really should be a secret fortitude save because most stage 1 diseases have no discernable effect.

The next thing is that you have flexibility on when stage 2 kicks in. If it is after the casters prepare spells, the sick player will probably stay sick that day at least. Unless the cleric took Channeled Succor, in which case that is a good time for that feat choice to shine.

Without a cleric there are still other options of course. Antiplagues and the medicine skill spring to mind. And as you get to higher levels more and more classes get juggernaut which does a lot to let people beat a disease sans magic.

[Zapp]

The question about when do you feel sick (is it before or after the Cleric has prepared that day's spells?) has come up, yes.

But in many cases it really isn't a secret. And so the Cleric loads up on Remove Diseases "just in case", and the party takes a day off if they can (to humor not the disease victim but the Cleric, who after all just spent her best slots). It all ends up being a speed bump so small it is as if it wasn't there. That's a lot of rules for something that ultimately doesn't matter.

What am asking is: how do you make disease matter more than either of the below two cases:
A) With a Cleric (or Druid etc): it's only a thing if the Cleric first fails two counteract checks (probably by rolling two 1's in a row, since failure is enough to Remove a disease)... and the disease victim then fails the next disease check (since success would bring you up from stage 1 to no disease)
B) Without a Cleric: a character with weak Fortitude saves will have a real chance of failing multiple disease checks even with a small bonus from potions and elixirs. These people are exactly the ones that never get Juggernaut. Disease can ruin the entire party's morale this way ("No point in trudging on since Bob is so sick, and more likely to get sicker than to recover. Let's abandon the current quest and head back to town").

How do you accomplish the middle ground, where the presence or absence of a Cleric isn't such a massive binary: taking Disease from a potential game ruiner to a completely trivialized nuisance?

That is, a middle ground between "the disease goes *poof* unless I roll a 1" and "I'm doomed unless I roll really well, and for each failure I'm sinking deeper into something I can't get out of".

Ideally, you'd have a scenario where physically strong characters have maybe a 60% chance of making the save while feeble characters might have a 40% chance.

Not a physical character having 75% chance, and every success counts as a critical (so you only need on success for every two failures); while the frailer character might only have 25% chance.

If the party pauses their adventuring the healer might get a +10% for 24-hour treatment.

A Cleric might help by casting a spell akin to that vitality spell (name?) that accelerates rest as if a day went by, not by insta-poofing the threat.

[Deriven Firelion]

You would have to manipulate the math and rules to get the effect you want as you're doing. That's your best bet.

[cavernshark]

I think the main question here is whether the disease is, itself, a plot piece that's supposed to linger around a long time or just a general nuisance hazard. PCs are heroes and it's not exactly heroic to waste away to that, so they're generally going to be able to deal with disease, especially past the level where they can cast the spell regularly.

If you're writing an adventure where disease is the point, you're going to need to do things differently with the disease itself that makes it worthy of being front and center in the plot.

As others noted, one way to do that is to make it more powerful than the players (forcing them to manage the effects), or given some kind of special consideration like a virulence. Or simply introduce it early enough in an encounter with some time pressure where simply camping isn't possible. If you don't want to make it more powerful, you can also make a variant of a disease that speeds up the onset and frequency to every hour or two.

PFS Scenario 9-07, Salvation of the Sages:

This scenario in PF1 used disease to very good effect. Written for level 7-11 characters, well after they have the ability to handle disease, players are exposed to a different kind of disease very early that's much harder to shake and plays a roll in the dungeon / encounters themselves. Good play and management of resources can protect them from it, but it's woven throughout the adventure rather than a little one off.

Another option if you want disease to feature more prominently in your campaign is to make it more widespread than a single PC can reasonably handle (especially if people can catch the disease again). Maybe the PCs are trying to help a town or city being affected; suddenly spending resources on remove disease each day may not be worth it when those resources could be better spent adventuring to assemble ingredients for a cure, or triaging the spell for only the sickest patients each day. The cleric's resources are only really infinite if there's no competing pressure for them.

It's unfortunate that an example like that is almost too real at the moment; but it is an arc for an adventure if you really want to do it.

[Captain Morgan]

I was also thinking of this thread when I made my deadlines thread. Obviously time pressure has been mentioned, but it doesn't have to necessarily be "we have no choice but to soldier on despite this disease" or "well going back to town is obviously to heal up is obviously the prudent thing to do." If the party has several days but a firm deadline, then the disease starts to create meaningful decisions with or without the cleric.

Without, a party that needs to return to town might be sacrificing multiple days depending on the distances involved. Even with a cleric, stopping to wait for them to prep spells is a cost, so the players may very well choose to press on anyway.

As for the Sue the Party Cleric example... I don't know that her paying the cost because Bob the Fighter contracted a disease is that different than using Heal spells when Bob takes a lot of damage. Goes with the territory of being a healer.

As for how I've actually used diseases... I ran Prisoners of the Dark light and had to convert the darkblight. Because it was central to the story, I made it very dangerous-- a level 15 disease to a level 14 party that acted like a higher level mummy rot. It shaved off a big chunk of HP and needed to be separately cured as both a disease and a curse.

Then I created a lot of opportunities to contract it. They needed like a week's travel and had to roll a save every 24 hours, plus other times if they failed survival tracks to safely navigate the hazardous terrain. As such, they lived in actual fear of getting it, and most of them did at some point or another. And they couldn't simply leave or take time to fight it off, because the journey itself was the hazard.

They also had a Channeled Succor cleric, though. So they were able to remove it once they realized they had it, albeit with meaningful expenditure of resources (cleric needed to roll well twice to successfully remove it, after all.) Had they lacked the cleric I probably would have had to tune down the disease. Which is probably why the published adventures uses below level diseases, as they don't know if the players will have one.

Overall it worked really well. One misstep I made was using an extreme encounter of a hoard of elite leukodaemons. The APL-4 creatures weren't themselves super threatening, but I underestimated how dangerous their Quicken Affliction action was paired with a high level disease. The disease itself probably should have been treated as a creature for the XP budget in this case. The players who had been unknowing carriers at that point watched in terror as their hit points evaporated. It reinforced the terror of the setting but required me to bail them out with a third party intervention.

[Unicore]

I have a 4th level party traveling through the thick jungle on a long exploration quest. I have used disease as consequence for not taking the time to set up careful camps and to really make those opportunities to spend the night in a secure location a luxury. The Party has had to spend one extra day camping instead of moving when someone got fairly sick and failed 2 rolls but it has been a minor inconvenience rather than a horrific set back.

So far the feedback on that game has been pretty positive and I think the players like that nature itself feels dangerous beyond just having to fight x creatures.

[Kasoh]

Also, if you have a character with access to Remove Disease, then disease's becoming trivial are a reward for picking a character with that option. In a scenario where the party is trying to get by without a cleric or whathaveyou, then if they get diseased while adventuring (away from town) then they have to deal with it, but because someone picked a character with a specific skill set, the challenge is reduced at the expense of some spell slots. The player's decisions are rewarded with consequences befitting that decision.

And if the clericless party buys scrolls or things to solve the problem then they spent resources on it and paid for the right to be trivial about it.

[OmegaZ]

In 2020 I'm just ignoring all plagues and diseases cuz...ya know...

[Squiggit]

Kasoh wrote:

The player's decisions are rewarded with consequences befitting that decision.

The problem with this mindset is it's too binary and too reliant on having the right kind of spellcaster in the party.

"Trying to get by without a cleric" shouldn't be a challenge condition, but the presence or absence of this single spell can completely change the tone of the campaign.

[CrystalSeas]

Squiggit wrote:

"Trying to get by without a cleric" shouldn't be a challenge condition.

As with every other (non-focus) spell in the CRB, "Remove Disease" is available to casters of two magical traditions: divine and primal.

So champions, druids, and some sorcerers can also cast "Remove Disease". As can various multi-classed characters.

If the party only has access to half the magical traditions, and can only cast occult and arcane spells, then you've got a problem bigger than "no cleric".

[Kasoh]

Squiggit wrote:

Kasoh wrote:

The player's decisions are rewarded with consequences befitting that decision.

The problem with this mindset is it's too binary and too reliant on having the right kind of spellcaster in the party.

"Trying to get by without a cleric" shouldn't be a challenge condition, but the presence or absence of this single spell can completely change the tone of the campaign.

But it is a challenge condition. One the party self selects for. Its like trying to play without an arcane caster, or without a Thievery character.

If its a problem, its a player problem, not a GM one. And it'll self correct by someone dying and the introduction of someone who can solve the problem or by throwing money at it.

[Squiggit]

Kasoh wrote:

But it is a challenge condition.

Only for this specific thing... and that's bad. You should never feel forced to play a specific character like that.

Quote:

If its a problem, its a player problem, not a GM one.

Neither, it's just faulty game design.

[Kasoh]

Squiggit wrote:

You should never feel forced to play a specific character like that

No one is forced to play a specific character. Aside from the wide swath of classes that offer the ability to cast Remove Disease a party that chooses not to have such a character is not doomed to failure, but they have chosen to have this obstacle be more difficult so they can (hopefully) have a larger competency elsewhere.

In my mind, it is no different than there being no high strength character. I've been in games where the collective Strength modifier was +1 and occasionally they had to lift something heavy. That's not faulty game design.

[Unicore]

Don't forget also that alchemists can be pretty good at helping characters recover from disease, without too much investment either, and with focusing on just the medicine skill you can be pretty competent at helping the party recover from disease as well. I mean a level 1 alchemical item can give you a +2 to saves vs disease. You might have to deal with the negative effects for a while, but between that and treat disease, by the time you know you have a disease you can pretty reliably get a +4 to your saves against, right at level 1. And having a cleric to treat disease isn't a factor until level 5 and even then it is just getting to make a counter act check. Great for clearing a disease that has really set in, but not much more valuable than giving the player a +4 or even a potential +7 to their save (with a level 6 anti plague and a crit success on the treat disease check).

I think that the "only the cleric" can cure challenging conditions is much more of a hold over mentality from past editions that any real in game situation. At very high levels, a party that invests nothing in having a talented healer (doctor, cleric, alchemist, or other divine or primal caster) is going to run into the occasional very rough situation, but they will probably have run into a stream of rough situations before that gave them the hint, bad things happen, even if you are careful and the game assumes you invest some party resources in being able to respond to them.

[Loreguard]

Zapp wrote:

How do you avoid disease becoming either trivial or oppressive in your game?

....

* Addiction to drugs is mechanically represented as a disease, significantly defanging drugs, since your cleric can keep removing any addictions you develop.

---

I realize one answer could be "don't let the party take days off". If every day is an adventuring day, reserving your top slots for the Remove Disease spell becomes a real cost. But I don't like how Sue the party Cleric needs to pay for Bob the Fighter's mistakes.

What I guess I'm after is a middle road where disease is neither trivial nor completely dangerous. Where the presence or absence of a Cleric doesn't mean the difference between night and day. Where drugs remain dangerous even to adventuring parties.

The way Pathfinder 2 works means you can't solve it the intuitive way - if you increase the level of the disease so the DC increases, you don't just lower the chance of success gradually, you abruptly reduce the chance to rolling a 20 only.

Do you have any advice?

Since an enormous portion of an addiction is a persons own struggle to keep from partaking of the substance, if you feel like simple addictions are too simple to mitigate with a basic remove disease spell, you could have someone who willingly partakes of the same substance again, have the addiction's level bet bumped up to that of the person taking it. If you don't want this to happen always, you can limit it to ones where they critically failed at least one addiction check in the past. Subsequent exposures to the addictions could advance the level track up 1 level each time, with a max determined by the type of addiction, ranging from User's level, to User's Level plus 4.

Other options making addictions more challenging could be making Cure disease not cure additions, just provide one tier of recovery and allow for an additional recovery check.

It might be worth noting that players combatting an addiction may be something that might impact some players enjoyment of the game. Not just their own character, but seeing other characters doing it, and seeing how hard, or easy it appears to be in the game mechanics. As a GM it might be important to make a note of that potential. Individuals whom have themselves, or seen family members struggle with it may take offense to the process seeming to be too easy, or potentially too hard, in their fantasy setting.

I will mention that there was a game where it became an issue in the past, where due to a paladin's immunity of disease, that it made their use of addictive substances that boosted abilities a free-be for them. The situation caused quite an uproar between a player and GM, who obviously felt differently about how it should have been reflected in the game rules.

As far a plain diseases go, and how you could make them more challenging depending on the role they should play in the adventure, you could also, allow for diseases which you caught, and defeated either provide a temporary immunity for some cooldown period from the disease in question. Or the disease could provide a situation where the 'level' of the disease would be increased by one if you contract it again, during the specified duration if it didn't provide an immunity. And you could have instances where if you use remove disease to cancel/cure the disease, it would also cancel any natural immunity you would have acquired from it. (And might or might not cancel any increase in level from future exposure during timeframe in question) This might make it more advisable if you know you will keep becoming exposed to it, better to try to naturally defeat the disease and get a temporary immunity than to keep repeatedly attempting to magically cure it. Leaving that to when things have taken a turn for the worse and it doesn't seem like you're going to quash it naturally.

This might even be a reason why in game clerics might be inclined to not be overly generous in dispensing cure diseases, if in some cases it can lead to worse cases, if not part of a larger plan.

Honestly, there is also a certain degree to which I would think it could make sense for Diseases and Curses to potentially require a certain material component to cure them. Ones that sometimes are relatively simple to find, but in other cases could be uncommon or rare.

With that in mind, if you only preform the generic casting of the spell without the correct component it might only for instance reduce the level of the affliction by one instead of completely counteracting it. Making it much harder to 'cure' without the required component.

Those are some options I could think of for advice.

[Ascalaphus]

I do think that it highlights a difference between spontaneous and prepared divine casters. For a divine sorcerer/oracle it's painful to take Remove Disease because to make it strong, you need to cast it at high level. But that means sacrificing a high-level spells known option, or a signature spell option, all for a spell you don't use very often. Meanwhile the cleric/druid/witch just prepares it in a top slot only when needing it/expecting to need it.

[Zapp]

Deriven Firelion wrote:

You would have to manipulate the math and rules to get the effect you want as you're doing. That's your best bet.

That's a different way of saying "houserules exists".

I'm not asking if I can modify rules I don't like.

I'm instead asking how and why YOU are content with the existing rules, if that is indeed the case.

I'm bringing up a couple of points and would like your advice - how are you thinking when (if?) you rationalize the existing rules as good enough for you?

[Zapp]

cavernshark wrote:

I think the main question here is whether the disease is, itself, a plot piece that's supposed to linger around a long time or just a general nuisance hazard.

I'm asking what is the point of creating a rule that is either

a) so trivial to fix as to beg the question: why go through all that trouble for so little effect?

b) so dangerously debilitating that you have no other option than head back to town to try to sweat it out, or switch characters?

I'm asking why wasn't disease created to be playable first and foremost?

Where my definition of "playable" is a state where the die rolls have an impact (so not A) while remaining fair (so not B)?

Any insight into how the devs or playtesters must have thought would be most appreciated.

Cheers

[Zapp]

Kasoh wrote:

Also, if you have a character with access to Remove Disease, then disease's becoming trivial are a reward for picking a character with that option.

Well, that might sound logical at first blush, but really isn't.

First and perhaps foremost, we're not talking about some obscure build that gets its moment to shine.

EVERY cleric and druid (and more) gets Remove Disease. It's not as if you need to keep it prepared. You simply load a few slots with Remove on the day where the disease gets too annoying and *poof* it's gone.

Secondly, since disease has a major impact (if left untreated) it wouldn't be right if it indeed was a fringe benefit. If you want something to be an reward for picking just the right build it better be something rare or circumstantial - so all the other characters (that can't do whatever this special character can) aren't completely shut down by their lacking ability.

[Zapp]

Kasoh wrote:

And if the clericless party buys scrolls or things to solve the problem then they spent resources on it and paid for the right to be trivial about it.

The only thing the can buy is antiplague that gives a very small bonus.

(If there's a character that can read the scroll, that character can simply prepare the spell. You purchase spells to get more slots, not spells*)

*) the divine sorcerer would be the exception, but that most definitely is an exception

[Zapp]

Unicore wrote:

I have a 4th level party traveling through the thick jungle on a long exploration quest. I have used disease as consequence for not taking the time to set up careful camps and to really make those opportunities to spend the night in a secure location a luxury. The Party has had to spend one extra day camping instead of moving when someone got fairly sick and failed 2 rolls but it has been a minor inconvenience rather than a horrific set back.

So far the feedback on that game has been pretty positive and I think the players like that nature itself feels dangerous beyond just having to fight x creatures.

Prepare for all this excitement and challenge to fall completely by the wayside once your cleric or druid levels up.

[Zapp]

Squiggit wrote:

Kasoh wrote:

The player's decisions are rewarded with consequences befitting that decision.

The problem with this mindset is it's too binary and too reliant on having the right kind of spellcaster in the party.

"Trying to get by without a cleric" shouldn't be a challenge condition, but the presence or absence of this single spell can completely change the tone of the campaign.

Thank you for seeing the problem.

[Zapp]

Loreguard wrote:

...

Thank you for your advice.

[Zapp]

Ascalaphus wrote:

I do think that it highlights a difference between spontaneous and prepared divine casters. For a divine sorcerer/oracle it's painful to take Remove Disease because to make it strong, you need to cast it at high level. But that means sacrificing a high-level spells known option, or a signature spell option, all for a spell you don't use very often. Meanwhile the cleric/druid/witch just prepares it in a top slot only when needing it/expecting to need it.

You really need to play in a campaign with default access to purchasing/crafting scrolls or wands. Otherwise yes, very painful.

[Alchemic_Genius]

Now, I'm gonna assume by this thread, you're only referring to the application of disease as a direct threat to the pcs, and not as a plot device.

The base rules, imo, make diseases a fairly minimal threat unless they are virulent, but only if there's no real time pressure. That said, you could say the same about a lot of parts of the game; hp damage, for example, is pretty trivial if the group has the ability to just stop and treat wounds as often as they want.

To avoid diseases from being a minimal threat, just like HP damage, I usually make my games have some sort of deadline or time restriction, and to increase tension, I make it known to the players. Like, if the group has to stop the evil cultists from their full moon human sacrifice ritual in three days, and it takes a day and a half to travel there, it forces a choice on the party; the group can take a day off and cure the disease, and still have all their spells, but have next to no time for treating wounds and refocusing on the night of the ritual, and thus making the last day very difficult, the cleric just accepts they will go in without as many/any top level spells and cure the disease, but have more time between the encounters on the last day, or just suck up the disease penalty and have the cleric go in and prep their top level spells.

Instead of seeing the problem as trivial because a top level spell can hand waive it, understand that the problem was so non trivial that the cleric straight up chose to use their biggest, most powerful slot to remove the problem because it actually was a threat.

[Unicore]

Zapp wrote:

Kasoh wrote:

Also, if you have a character with access to Remove Disease, then disease's becoming trivial are a reward for picking a character with that option.

Well, that might sound logical at first blush, but really isn't.

First and perhaps foremost, we're not talking about some obscure build that gets its moment to shine.

EVERY cleric and druid (and more) gets Remove Disease. It's not as if you need to keep it prepared. You simply load a few slots with Remove on the day where the disease gets too annoying and *poof* it's gone.

Secondly, since disease has a major impact (if left untreated) it wouldn't be right if it indeed was a fringe benefit. If you want something to be an reward for picking just the right build it better be something rare or circumstantial - so all the other characters (that can't do whatever this special character can) aren't completely shut down by their lacking ability.

Remove disease is a counteract check, not disease be gone and buying scrolls to take care of it means having to upgrade every couple levels or else be faced with situations you can't handle. Being prepared to shut down diseases everyday for a high level party traveling in dangerous environs can mean wanting 4 of these spells ready to go. As a GM, you can either ask for fort saves regularly (based upon the onset conditions) and then the caster is in a situation where they start memorizing them when the players start rolling low on fort saves in which nothing appears to happen (and probably assuming it will take a high level spell to counter act) or else they will research and learn about the potential threat, in which case, they are taking it seriously enough that you should reward them by having the conditions of the disease be trivial. Most diseases I see in adventures are going to be ongoing threats that will consume party resources one way or another to mitigate and provide a little push not to spend endless days in a hostile environment. Having 1 character have to dedicate upto 4 of their high level spell slots every day with one specific spell can't really be considered a trivial situation.

Also, It is still possible to challenge PCs with diseases that they really don't want to deal with at many different levels of the game, especially if it is a disease that becomes contagious. Walking around and only treating the disease when the conditions become serious is a great way to cary it to a community that might not be as capable of handing it themselves. Ok, the party cleric can manage having one or two cases at 5th level, if they are willing to sacrifice all of their high level spells to do so, but if the disease/curse) gets out, that is a big deal (see the slithering).

My party does not have a druid or a cleric, but they do have a MC alchemist and have just caught on to the antiplague idea. Even if they did, at level 5 they would be happy to finally have the spell, but it would also mean having to have it memorized almost every other day (the party has neglected fort saves). They are on their way to Kibwe and will be running the slithering so having some sense of the reality that diseases in the jungle are dangerous will make the threat feel more real to them. I think that pretty squarely falls as neither trivial nor overwhelming, with multiple ways to approach.

This is a little different from the specific situation of addiction that you talk about in your OP, but trying to create hard core rules around addiction is a bad idea for a game system any way. If your players really lean into drug use for performance enhancing, you probably need to decide if it is better for your table to let the DCs be trivial and basically hand wave the role of addiction with performance enhancing drugs or else take it seriously enough to consider house ruling it like Loregaurd suggests above. It is a touchy enough subject not to be a real great focus point to build all the rules of diseases around.

[Kasoh]

Zapp wrote:

Well, that might sound logical at first blush, but really isn't.

First and perhaps foremost, we're not talking about some obscure build that gets its moment to shine.

EVERY cleric and druid (and more) gets Remove Disease. It's not as if you need to keep it prepared. You simply load a few slots with Remove on the day where the disease gets too annoying and *poof* it's gone.

Secondly, since disease has a major impact (if left untreated) it wouldn't be right if it indeed was a fringe benefit. If you want something to be an reward for picking just the right build it better be something rare or circumstantial - so all the other characters (that can't do whatever this special character can) aren't completely shut down by their lacking ability.

I am unsympathetic to players who build PCs with no concession to the fact that they will be performing adventuring activity. That means covering their bases with regards to traps, status removal, healing, flight, etc. If they went out on adventure without a core competency, then that's a problem they created for themselves and they can solve it themselves.

And if the group has properly prepared, then diseases are only a problem for a day or so (which might include encounters where the PC is under the malus of the disease, in which case the disease has served its entire function in the game) the Status Remove spell gets prepared and it ceases to be an issue until the next time they fail a save. And if the caster kept it prepared, then more's the better for them. and if they spend the gold to keep on level scrolls handy, that's the kind of preparation I like to see. It means I as the GM no longer have to track the disease information and I can get on with more interesting rules minutia.

To be fair, I am not interested in examining the long term consequences of disease at my game table. Prep the spell, remove the disease, carry on. Same thing with death. Prep the spell, remove the condition, carry on. That's what the magic is there for. It absolutely highlights the utter privilege of Player Characters over the common rabble. The problems of physical bodies cease to actually be problems.

[Deriven Firelion]

Zapp wrote:

Deriven Firelion wrote:

You would have to manipulate the math and rules to get the effect you want as you're doing. That's your best bet.

That's a different way of saying "houserules exists".

I'm not asking if I can modify rules I don't like.

I'm instead asking how and why YOU are content with the existing rules, if that is indeed the case.

I'm bringing up a couple of points and would like your advice - how are you thinking when (if?) you rationalize the existing rules as good enough for you?

Oh ok. I can only tell you how I do things in my games.

If I want a disease to matter (or really anything), I will write up the disease myself using the rules framework given. I will take an inventory of the saving throws of the party as I want to make sure that I don't make the save hard for a Greater Juggernaut barbarian as that would be impossible for an expert at best fortitude save caster with an often lower Constitution.

Note: If you want another class to feel the pain of a disease, you can make it a Will save disease or even a Reflex save if you so feel like it.

Then I will decide how much of a factor I want it to play. If I want the disease to act like a time pressure, then I will have them make the roll with stage advancement on a time table that pressures them to move. If I want it to be some kind of continuous environmental issue that is a real threat, then I would have them save maybe twice a day depending on where I set the saving throws.

I would probably increase or map out the stages according to what I wanted the party to feel using the conditions I feel best represent the negative impact of the disease.

If I really want them to feel it, I would make it extra virulent and resistant to removal. Maybe incorporate that a rival god of disease was resisting the power of the cleric's god to remove it or just make the save occur so often as the cleric or druid would have an insufficient number of remove diseases to keep it at bay daily.

In my personal games I am a big on tailoring encounters and challenges to fit my party narratively and mathematically. I view RPGs as a creative framework for storytelling. I manipulate the math to get the effect I want the party to feel and then ensure it fits in with a compelling narrative reason.

I can't really give you much generic advice as I don't personally work that way in my games. I have always taken TTRPGs and manipulated them as needed to tell the story I want to tell. That's how my entire group works for the most part DMing. It's the best I can offer you, Zapp. Hopefully it helps some.

[Ravingdork]

Kasoh wrote:

I am unsympathetic to players who build PCs with no concession to the fact that they will be performing adventuring activity. That means covering their bases with regards to traps, status removal, healing, flight, etc. If they went out on adventure without a core competency, then that's a problem they created for themselves and they can solve it themselves.

As am I. I've been roleplaying for over 25 years, and I still see my longtime roleplaying buddies doing stupid s~$% from time to time, like not purchasing ranged weapons. Gets so frustrating!

I'm like "what are you going to do against snipers or flyers, die?" I don't know why it never seems to stick with some people.

I guess some people think it's not cool, or not in line with their character concept, or something.

[Squiggit]

Unicore wrote:

Having 1 character have to dedicate upto 4 of their high level spell slots every day with one specific spell can't really be considered a trivial situation.

It doesn't need to be every day, though. You can do it purely reactively. Take a day off and prepare some Remove Diseases.

Or don't. Even a single casting of Remove Disease in a day provides dramatically higher chances of curing the disease than anything else, especially if the disease has progressed at all.

It's a problem of proportionality. Remove Disease is just so much vastly better than any alternative option in its ability to simply brute force diseases away.

Kasoh wrote:

In my mind, it is no different than there being no high strength character. I've been in games where the collective Strength modifier was +1 and occasionally they had to lift something heavy. That's not faulty game design.

Not a great example. For one, literally any class could choose to have a good strength score, while only a couple have access to prepared divine/primal casting (and therefore able to do what the OP mentioned).

For another, environmental challenges usually aren't as binary as the situation being described here. You might not be able to lift the rock, but maybe you can break it, or go around it, or do something else entirely. There's no option outside of Remove Disease that really compares to Remove Disease.

I mean I guess if you made it so there was no way to advance the plot without lifting the rock and you started killing off party members if they failed the rolls, it'd be comparable. But at that point you might as well skip the formalities and just say rocks fall everyone dies.

Ravingdork wrote:

As am I. I've been roleplaying for over 25 years, and I still see my longtime roleplaying buddies doing stupid s*$+ from time to time, like not purchasing ranged weapons.

Again, not a particularly apt example, because buying any kind of ranged weapon (or taking some feat or somethin to provide an alternative) is a much smaller imposition on a character concept than having to play one of a small handful of specific character options.

[shroudb]

I mean, it really depends on the narrative of the disease (or its lack therefor).

If it's just a random disease just because encounter X had it in its attacks, then by having the encounter "waste" a full day of adventuring for the party already fulfilled its purpose:

Imagine a hard encounter that your casters have to blow through all their high level slots to bruteforce it and then they ask for a break to rest for the next day.

It's basically that but you had to do it not for a hard encounter but for just a regular one just because some of the frontline contacted diseases.

Now, you may say that wasting days is trivial, but then again I assume that "5 minute adventuring day" (aka 1 encounter per day) is NOT something that any regular narrative of an adventure supports.

So, that 1 lost day does matter exactly as much as a hard encounter.

And then you have the other kind of diseases, those that instead of being random abilities are narrative ones, plagues and such, those usually work on a different scale than a simple random encounter one, and probably you lack the slots to have a single person keep it under control for everyone around and you need to search for alternative solutions.

[Zapp]

Alchemic_Genius wrote:

Now, I'm gonna assume by this thread, you're only referring to the application of disease as a direct threat to the pcs, and not as a plot device.

The base rules, imo, make diseases a fairly minimal threat unless they are virulent, but only if there's no real time pressure. That said, you could say the same about a lot of parts of the game; hp damage, for example, is pretty trivial if the group has the ability to just stop and treat wounds as often as they want.

To avoid diseases from being a minimal threat, just like HP damage, I usually make my games have some sort of deadline or time restriction, and to increase tension, I make it known to the players. Like, if the group has to stop the evil cultists from their full moon human sacrifice ritual in three days, and it takes a day and a half to travel there, it forces a choice on the party; the group can take a day off and cure the disease, and still have all their spells, but have next to no time for treating wounds and refocusing on the night of the ritual, and thus making the last day very difficult, the cleric just accepts they will go in without as many/any top level spells and cure the disease, but have more time between the encounters on the last day, or just suck up the disease penalty and have the cleric go in and prep their top level spells.

Instead of seeing the problem as trivial because a top level spell can hand waive it, understand that the problem was so non trivial that the cleric straight up chose to use their biggest, most powerful slot to remove the problem because it actually was a threat.

Well, I see your line of reasoning, but no.

I compare diseases (drugs, and curses) to traps and poison.

Traps and poison work because of the built-in time pressure. You need to win before you run out of hit points.

The cost of neutralizing poison is much higher than the cost of curing a disease, since the cost of spending two actions is much higher in combat than out of it. And the cost of spending a high level slot is much higher in combat than out of it.

Disease completely fails to measure up to poison. It uses the exact same rules framework despite the vastly lower cost. (You pay the exact same price: two actions and a slot, but the cost of paying this price is vastly lower)

Disease deserved ANOTHER rules framework.

Compare to conditions like Drained or Fatigued. There's no way until very high level spells to accelerate the healing here, you simply *must* wait until tomorrow.

This remains the same with or without a Cleric.

In my mind, this makes Drained a much more interesting threat than Disease.

I hope you see what I mean.

[Zapp]

Unicore wrote:

Remove disease is a counteract check, not disease be gone and buying scrolls to take care of it means having to upgrade every couple levels or else be faced with situations you can't handle. Being prepared to shut down diseases everyday for a high level party traveling in dangerous environs can mean wanting 4 of these spells ready to go. As a GM, you can either ask for fort saves regularly (based upon the onset conditions) and then the caster is in a situation where they start memorizing them when the players start rolling low on fort saves in which nothing appears to happen (and probably assuming it will take a high level spell to counter act) or else they will research and learn about the potential threat, in which case, they are taking it seriously enough that you should reward them by having the conditions of the disease be trivial.

You mainly just read the the rules back to me and then you assume I'm okay with spending so much play time on something that much simpler and faster can be summarized by "okay so we'll just skip diseases from this point on".

Few to no diseases have stages faster than the "1 day" which allows the Cleric to (easily) keep pace.

Which is exactly my point.

If disease just means "two or three days later it's all taken care of and you can pick up the story where you left it" that's not worth my time and attention.

I mean, if the rule literally said "two or three days later it's all taken care of and you can pick up the story where you left it" then it would be okay I guess. But it's a load of rules - in fact exactly the same amount as for poison, despite the vastly lower challenge and interest level.

Why wasn't disease implemented in a similar way to drained et al, is my question.

Why choose the same framework as poison, a framework that only becomes interesting under the assumption you need to deal with it during a combat (or in the minute directly thereafter)?

[Zapp]

Kasoh wrote:

I am unsympathetic to players who build PCs with no concession to the fact that they will be performing adventuring activity. That means covering their bases with regards to traps, status removal, healing, flight, etc. If they went out on adventure without a core competency, then that's a problem they created for themselves and they can solve it themselves.

And if the group has properly prepared, then diseases are only a problem for a day or so (which might include encounters where the PC is under the malus of the disease, in which case the disease has served its entire function in the game) the Status Remove spell gets prepared and it ceases to be an issue until the next time they fail a save. And if the caster kept it prepared, then more's the better for them. and if they spend the gold to keep on level scrolls handy, that's the kind of preparation I like to see. It means I as the GM no longer have to track the disease information and I can get on with more interesting rules minutia.

To be fair, I am not interested in examining the long term consequences of disease at my game table. Prep the spell, remove the disease, carry on. Same thing with death. Prep the spell, remove the condition, carry on. That's what the magic is there...

You're answer boils down to "I'm fine with disease being a non-issue" and that's okay.

It's not helpful or relevant, but I thank you for the time you took.

Myself, I'm bugged by the way the rules use the exact same rules for disease as for poison despite that framework really only working for developments that take place within a single day.

[Zapp]

Deriven Firelion wrote:

Zapp wrote:

Deriven Firelion wrote:

You would have to manipulate the math and rules to get the effect you want as you're doing. That's your best bet.

That's a different way of saying "houserules exists".

I'm not asking if I can modify rules I don't like.

I'm instead asking how and why YOU are content with the existing rules, if that is indeed the case.

I'm bringing up a couple of points and would like your advice - how are you thinking when (if?) you rationalize the existing rules as good enough for you?

Oh ok. I can only tell you how I do things in my games.

If I want a disease to matter (or really anything), I will write up the disease myself using the rules framework given. I will take an inventory of the saving throws of the party as I want to make sure that I don't make the save hard for a Greater Juggernaut barbarian as that would be impossible for an expert at best fortitude save caster with an often lower Constitution.

Note: If you want another class to feel the pain of a disease, you can make it a Will save disease or even a Reflex save if you so feel like it.

Then I will decide how much of a factor I want it to play. If I want the disease to act like a time pressure, then I will have them make the roll with stage advancement on a time table that pressures them to move. If I want it to be some kind of continuous environmental issue that is a real threat, then I would have them save maybe twice a day depending on where I set the saving throws.

I would probably increase or map out the stages according to what I wanted the party to feel using the conditions I feel best represent the negative impact of the disease.

If I really want them to feel it, I would make it extra virulent and resistant to removal. Maybe incorporate that a rival god of disease was resisting the power of the cleric's god to remove it or just make the save occur so often as the cleric or druid would have an insufficient number of remove diseases to keep it at bay daily.

In my...

Thank you.

You don't really answer or even address the way all your efforts, ideas and tips will be completely negated by the presence of a character capable of casting Remove Disease in her highest spell slots, but I guess I can't ask for more.

[Zapp]

Ravingdork wrote:

Kasoh wrote:

I am unsympathetic to players who build PCs with no concession to the fact that they will be performing adventuring activity. That means covering their bases with regards to traps, status removal, healing, flight, etc. If they went out on adventure without a core competency, then that's a problem they created for themselves and they can solve it themselves.

As am I. I've been roleplaying for over 25 years, and I still see my longtime roleplaying buddies doing stupid s*+* from time to time, like not purchasing ranged weapons. Gets so frustrating!

I'm like "what are you going to do against snipers or flyers, die?" I don't know why it never seems to stick with some people.

I guess some people think it's not cool, or not in line with their character concept, or something.

Actually I would say diseases play out in a grimly satisfactory way in campaigns where the PCs have no access to Remove Disease.

It's just that I would have wished for a middle road between disease potentially killing the heroes and a Cleric (not exactly a rare addition to PF2 parties) completely reducing disease to nothing.

[Zapp]

Squiggit wrote:

It's a problem of proportionality. Remove Disease is just so much vastly better than any alternative option in its ability to simply brute force diseases away.

Yes. Thank you.

Honestly, this is so completely obvious I struggle to understand why we're even debating this.

[Kasoh]

Zapp wrote:

Honestly, this is so completely obvious I struggle to understand why we're even debating this.

I mean, you asked a question on the internet.

[Ravingdork]

In a recent game I was running, the PCs all TPK'd shortly after fighting a band of ghouls and a ghast. At the time of their deaths, two PCs had ghoul fever, and one had ghast fever. None of the players knew they had contracted the disease until the new party arrived to the dungeon a week later to try and find out what had become of their missing friends.

They ended up encountering their undead counterparts and were forced to destroy them. It was a chillingly surreal encounter for several of my players. During the battle, one of the PCs again contracted ghoul fever. They continued adventuring in the dungeon for a day before returning to a nearby town for rest. I described the PC waking up the next day feeling drained of energy, down 2d6 hit points, and paler than usual. The others were concerned, and so made several Recall Knowledge checks to determine that he had contracted ghoul fever.

They made a Medicine check to Treat Disease and prepared the appropriate spells the following morning. By then, he had grown even paler, had lost even more hit points, was immune to healing, and had a growing, gnawing hunger that normal food did not seem to satisfy.

Then, with the help of his friends, he got well again and they left to complete the rest of the dungeon. In the end, the whole thing was resolved within 5 minutes of table time and the heroes lost a day.

I imagine that's the way it will be for many diseases. But you know what? It had a pretty big narrative impact on that PC. It was a gaming experience that, that player is not likely to forget about any time soon, about how he nearly died and became a ghoul after he died and became a ghoul.

[Captain Morgan]

Has anyone ever seen a PC die from a disease? Because I haven't, and most of my parties don't have a cleric. If the party has access to decent settlements they can usually just buy a scroll or hire a local caster to remove it. Most diseases take a long time to kill you and require a lot of failed saves,and I've found usually people either fail to contract the disease at all or save it away in a few day.

Having a cleric makes it trivial, but condition removal is the big thing the spell list has going for it. It isn't much different than an arcane caster trivializing groups of enemies with bad reflex saves or a thievery specced character making traps much less dangerous.

The divine spell list has healing and not much else. I feel like it is ok for it be the best at that by a large degree.

[Fumarole]

Ravingdork wrote:

At the time of their deaths, two PCs had ghoul fever, and one had ghast fever. None of the players knew they had contracted the disease until the new party arrived to the dungeon a week later to try and find out what had become of their missing friends.

The players didn't know even though they created new characters? I'm having a hard time imagining a player being cool with having to create a new character not knowing what happened to their previous one. You must have the most laid-back players ever.

[Alchemic_Genius]

Zapp wrote:

I compare diseases (drugs, and curses) to traps and poison.

Therein lies the problem, disease shouldn't be considered the same as poison or traps. Diseases are typically longer term threats, while traps and poisons are more immediate/short term ones.

If you're going to use traps as an example, there's only a time pressure if the story makes one. A lot of simple hazards just deal damage and are done. That in of itself has no time pressure to just sit down and ise Treat Wounds. The same can be argued of poison, honestly, though the potential for taking more damage in increase your dying level I suppose can make them scarier.

Diseases should really be treated more like mundane curses, where they provide a nerf over a period of time until you cure them. Certainly diseases are typically easier to cure/remove than a curse, but whether that's a bug or a feature depends on how important the threat of each is to your game world.

Unless your party cleric stocks a max level remove disease or whatevs each daily prep, functionally it'll stick around for at least a day anyways before the power of faith wishes it away.

You asked for people's experiences, I don't understand why you're calling people experiences "wrong" if they don't agree with you

[Ravingdork]

Fumarole wrote:

Ravingdork wrote:

At the time of their deaths, two PCs had ghoul fever, and one had ghast fever. None of the players knew they had contracted the disease until the new party arrived to the dungeon a week later to try and find out what had become of their missing friends.

The players didn't know even though they created new characters? I'm having a hard time imagining a player being cool with having to create a new character not knowing what happened to their previous one. You must have the most laid-back players ever.

They know what happened. They were massacred by a cultists and his demons. The just didn't know they had contracted diseases from the earlier fights against the undead. At least. Not until their new characters encountered the undead versions of their old characters.

[Unicore]

Jim Henson didn't die of Pneumonia because it was an illness that was untreatable at the time of his death, he died because he didn't take it serious, assumed he could take care of it by other means and that it wouldn't really be that bad, and tried to keep overworking himself by trying to produce a weekly show in both New York and Toronto at the same time.

If your PCs are never as busy as Jim Henson, then their adventuring schedule is probably too light. Especially with a cleric in the party (or other divine healer) most of the time past level 5 diseases should not be a terrifying condition to face, but it should be a complication that starts to affect how the party approaches encounters and the overall mission that they have to accomplish. Refusing to do anything for a day, because a party member came down with disease, should have real, in game consequences or else, yes, you might as well not introduce disease as a game element and just keep it narrative. It is ok to do that with many things that are sometimes game elements, but only when it matters.

Most parties should be ecstatic to have 2 or three days to craft/buy new equipment/sell loot/develop story arcs with their downtime. Walking around with a high level disease, suffering obvious symptoms should be a red flag for people in world. @Zapp, maybe the issue is how you are running down time generally as a nearly endless commodity?

[Fumarole]

Ravingdork wrote:

Fumarole wrote:

Ravingdork wrote:

At the time of their deaths, two PCs had ghoul fever, and one had ghast fever. None of the players knew they had contracted the disease until the new party arrived to the dungeon a week later to try and find out what had become of their missing friends.

The players didn't know even though they created new characters? I'm having a hard time imagining a player being cool with having to create a new character not knowing what happened to their previous one. You must have the most laid-back players ever.

They know what happened. They were massacred by a cultists and his demons. The just didn't know they had contracted diseases from the earlier fights against the undead. At least. Not until their new characters encountered the undead versions of their old characters.

I see. By RAW I don't think the disease can advance to the final stage unless the characters are alive, but I can see doing what you did for story reasons.

[Ravingdork]

Fumarole wrote:

Ravingdork wrote:

Fumarole wrote:

Ravingdork wrote:

At the time of their deaths, two PCs had ghoul fever, and one had ghast fever. None of the players knew they had contracted the disease until the new party arrived to the dungeon a week later to try and find out what had become of their missing friends.

The players didn't know even though they created new characters? I'm having a hard time imagining a player being cool with having to create a new character not knowing what happened to their previous one. You must have the most laid-back players ever.

They know what happened. They were massacred by a cultists and his demons. The just didn't know they had contracted diseases from the earlier fights against the undead. At least. Not until their new characters encountered the undead versions of their old characters.

I see. By RAW I don't think the disease can advance to the final stage unless the characters are alive, but I can see doing what you did for story reasons.

I had considered that it might not technically work, but then I thought of all the zombie shows and movies my friends enjoy, about how undead diseases are often supernatural in nature and don't generally operate like normal diseases, and about how there was just enough wiggle room there for my interpretation to work out for the betterment of everyone's enjoyment.

[Deriven Firelion]

Zapp wrote:

Deriven Firelion wrote:

Zapp wrote:

Deriven Firelion wrote:

You would have to manipulate the math and rules to get the effect you want as you're doing. That's your best bet.

That's a different way of saying "houserules exists".

I'm not asking if I can modify rules I don't like.

I'm instead asking how and why YOU are content with the existing rules, if that is indeed the case.

I'm bringing up a couple of points and would like your advice - how are you thinking when (if?) you rationalize the existing rules as good enough for you?

Oh ok. I can only tell you how I do things in my games.

If I want a disease to matter (or really anything), I will write up the disease myself using the rules framework given. I will take an inventory of the saving throws of the party as I want to make sure that I don't make the save hard for a Greater Juggernaut barbarian as that would be impossible for an expert at best fortitude save caster with an often lower Constitution.

Note: If you want another class to feel the pain of a disease, you can make it a Will save disease or even a Reflex save if you so feel like it.

Then I will decide how much of a factor I want it to play. If I want the disease to act like a time pressure, then I will have them make the roll with stage advancement on a time table that pressures them to move. If I want it to be some kind of continuous environmental issue that is a real threat, then I would have them save maybe twice a day depending on where I set the saving throws.

I would probably increase or map out the stages according to what I wanted the party to feel using the conditions I feel best represent the negative impact of the disease.

If I really want them to feel it, I would make it extra virulent and resistant to removal. Maybe incorporate that a rival god of disease was resisting the power of the cleric's god to remove it or just make the save occur so often as the cleric or druid would have an insufficient number of remove diseases

...

I did address that, but I'll be specific since it is lost in the muck and you want a specific piece of information.

1. I would make the frequency of saves high enough to make using spell slots in this fashion untenable barring extremely lucky rolls.

2. I would make the disease highly resistant to removal by say making the disease so powerful that is requires a counteract level high enough to require at least a success or critical success. Such as you see with the clay golem's anti-healing fists.

This would require I determine how many high level slots said cleric or druid had say 3 or 4. Then I would make the frequency or counteract check high enough that using all those slots would achieve maybe a 50% or lower success rate depending on what I want to portray. If they get lucky rolls, I don't want to circumvent that. I do want them to have to roll a serious roll to show how powerful or virulent the disease or addiction is.

I would come up with a narrative reason why this was whether a curse upon the land by some god of disease or a disease so powerful it had become resistant to magic. Something interesting that makes the players go, "Oooh, dangerous."

I haven't played any game that handles disease or poison very well or realistically. So it's up to me the DM to make the poison or disease do what I want it to do in the narrative within the rules framework. PF2 does a much better job of making disease or poison relevant compared to PF1, 3rd edition, or 5E. But maybe not as a well as the way old editions where a failed save means you're dead.

In my opinion disease or anything should do in the game what you the DM want it to do within the narrative. Given that your group is going to have a unique set of abilities to overcome challenges, you should tailor any challenges you want them to feel accordingly.

[Deriven Firelion]

Captain Morgan wrote:

Has anyone ever seen a PC die from a disease? Because I haven't, and most of my parties don't have a cleric. If the party has access to decent settlements they can usually just buy a scroll or hire a local caster to remove it. Most diseases take a long time to kill you and require a lot of failed saves,and I've found usually people either fail to contract the disease at all or save it away in a few day.

Having a cleric makes it trivial, but condition removal is the big thing the spell list has going for it. It isn't much different than an arcane caster trivializing groups of enemies with bad reflex saves or a thievery specced character making traps much less dangerous.

The divine spell list has healing and not much else. I feel like it is ok for it be the best at that by a large degree.

Only way back in ancient D&D to something magical and terrible like mummy rot or rot grubs.

[Squiggit]

Unicore wrote:

@Zapp, maybe the issue is how you are running down time generally as a nearly endless commodity?

That only helps a little bit, because while time makes spell slots more valuable, it also makes the alternatives to Remove Disease that much worse by comparison, since they all require pretty sizable time investments in order to matter. Remember, Treat Disease requires a full 8 hours of dedicated care to do anything (and can only be once once per day). So any time crunch that makes saving spell slots important pretty much removes that treatment option from the equation entirely.