A Pirate's Life IV: Ship's Surgeon

In the last part of this series we explored a mini-game for a player to manage crew morale on a ship during a naval battle. Today I’d like to shine the light on what happens to a crew not mentally but physically during combat, and a player role for managing this. We’ll go over the role of a ship’s Surgeon, how many crew get injured or killed, and how the Surgeon goes about reducing this number. After quite a bit of thought, and discarding a few working theories of how things might play out I eventually settled on a system informed by enemy damage dice.

Here the relevant ability score is Wisdom, since healing depends on it everywhere else in D&D. Perhaps we center this around the Medicine check? It gets no love in 5e since every healing item, class ability, or spell is about bypassing this skill. It’s also the only skill that fits for d20 rolls having to do with healing, but I think I’m getting off topic. What is the Surgeon’s goal and the choices he has to make it happen? Abstractly, the goal is to help injured/dying crew and either get them stabilized or back into the fight. All healing in D&D is a matter of hit points, so by starting there we have to consider what is the average crewmember’s hit points? I’m heading to the back of the Monster Manual to look at the NPC appendix. The bandit, guard, acolyte, and cultist all have around 10 hp. Their CRs are either ¼ or ?. The commoner has 4 hp and a CR 0. NPCs with CR ½ to 2 have a hp ranges of 16 to 32, with the exception of the Bandit Captain and Berserker (CR 2 with about 65 hp). This also gives me the idea of different levels of crew, but then I’d be getting off topic again (maybe another post).

If we were to assume all crew is a little tougher than commoners and in the CR range of ? to ¼, we can assume they have 10 hp each. I also want to abide by the rules for Dropping to 0 Hit Points (PHB 197). Though making death saves and keeping track of individual crew hp would be an exercise in frustration. Keeping with the rules, it is safe to assume any 10hp crew member dealt 20hp suffers Instant Death, any less damage and they are unconscious. Going about things like this will mean thinking about how damage done by cannon fire can affect a crew. Naturally I went to the cannon entry in the DMG (255). It wasn’t much help. Next I went to the Improvising Damage table (DMG 249). Reading the table gives gives a good idea of what kinds of trauma translate into D&D dice. I feel like exploding wood shrapnel from cannon balls tearing through the ship, in addition to falling masts and other falling debris could be the equivalent of being in a collapsing tunnel. It’s kind of funny that getting hit by lightning is less dangerous than falling rubble, but let’s move on.

We want to keep an eye towards verisimilitude, but also a simple ruleset. After carefully considering the Adjudicating Areas of Effect table on the same page, it got me thinking. What if we treated the damage from a cannon as an area effect? More importantly, when the ship gets damaged so does the crew. Figuring out where the crew are on the ship when it gets hit and how much damage gets allocated to each of them is a fool’s errand, when it can be done much more simply.

Each time an enemy ship hits the player’s ship, the number of injured crew will accumulate each round. Hopefully, this will give a little verisimilitude to the increasing number of wounded during a battle. Enemy damage also determines how many are killed outright. An average crew member has 10 hp, so what if each damage die determined the fate of an average crew member? A roll of 10 on the die kills 1 crew, but a 10% chance of death from pervasive carnage sounds a little low. Let’s say 9-10. On the flip side we can say damage rolls of 1-2 mean a crew member got a little hurt but he’s still ok to fight and man the ship. It’s simple so far, and only one player needs to keep track of this - the Surgeon. Every round the number of wounded will pile up, making his job a matter of managing numbers. So how does he do this?

The Naval Combat round is 1 minute long, meaning whatever the Surgeon’s action is it has to be accomplished in that timeframe. Consider a Sailing ship firing a broadside of 10 cannons most likely with disadvantage, with an average accuracy of 25% cannons hitting and causing 33 damage per hit. This means an average of 15 dice are rolled (6 dice per hit and 2.5 hits per 10 attacks) this means 15 crew members have the potential to become injured. Taking this further, 20% of the dice will roll 1-2 (the crew shrugs off the damage) while 20% of the dice will roll 9-10 (dead crew). This leaves the Surgeon with an average of 9 crew to treat per broadside. Now we know what we’re dealing with.

This is sounding a lot like triage: prioritizing where medical attention is most likely to affect a positive outcome, while giving a low priority to those who are already likely to live or die regardless of what care they receive. I think we may have our first action for the Surgeon. The Triage action: make a Wisdom (medicine) skill check to prioritize the wounded. Maybe we’ll give advantage or some other benefit for further actions taken that turn to help the wounded. At the moment I’m just spitballing.

As always, the most important thing to determine here are what choices the Surgeon has. Let's be real. Whoever is taking on the role of ship Surgeon is likely to have some healing spells. This can be their first choice to make: use the medicine skill or magical healing. The different consequences are not only used up spell slots but the effect on the crew. With this approach crew healed by non-magical means are out for the count. The medicine skill can only stabilize the wounded because injuries need time to heal. Magical healing repairs injuries instantly and gets the crew back into the fight, let’s say for every 10 hp of healing cast 1 crew member is no longer injured and gets back into the fight. Any leftover healing stabilizes 1 of the injured/dying crew.

As to the specifics, page 197 of the PHB says, “You can use your action to administer first aid to an unconscious creature and attempt to stabilize it, which requires a successful DC 10 Wisdom (Medicine) check. The Naval Combat round is a minute long, meaning 10 actions of stabilizing. This totally ruins verisimilitude for me though. It takes time going to each of the injured. Applying first aid in an emergency situation does require swift efficiency, but neither doctors nor first responders are machines. They’re no conveyor belt of wounded with the PC applying a tourniquet in to each one every 6 seconds. A die roll is called for to sort this out.

The Surgeon can make a Wisdom (medicine) check each round. The DC is 10, and for every 3 the DC is exceeded by the Surgeon stabilizes an additional crew. At first I was going with 2, but a 20 result means he stabilizes 6 people in a minute. Sounds like too much. If we went by 5 it may be more realistic but remember: verisimilitude. Exceeding the result by 3 satisfies me in terms of striking a balance between being just short of keeping up with the growing pile of wounded while getting decent mileage out of that skill check.

One last thing about NPC crew damage is the larger the crew the more concentrated they are on deck. More crew means more injured. Let’s go to one of my handy-dandy charts:

Total Crew	Crew Damaged Per Die
0 to 100	1
Above 100 to 200	2
Above 200	3

NPC crew damage has been determined; on to PC crew damage. Here’s another choice: the Surgeon needs to decide how to allocate his healing spells between the crew and the players. Not addressing this will break suspension of disbelief. I think the players will notice when crew are dying all around them and they’re immune to the damage from enemy cannonfire. It would be akin to watching a TV show and knowing they can’t kill off the main character.

The past few posts have come a ways in terms of filling out a complete game structure for naval combat, but we’re getting too close to making this an overly complicated system. However PC damage gets determined it has to be without adding any new die rolls. I’d like to say when the player’s ship takes a critical hit from cannonfire, a random player will take a d10 of damage instead of the NPC crew. At first it seem a little flat when the group isn’t near first level. A 5% chance to take a single d10? The threat of danger needs to be felt by the players, and I think it will. When 10 cannons are fired at their ship every round those chances go up plenty.

In summary, whenever the ship takes damage, after damage is calculated for the ship the Surgeon looks at the dice and determines how many crew are severely injured. As play goes on the Surgeon’s job is to keep track of the Able-Bodied Crew Count, which is simple the number of uninjured crew able to fight. When crew are injured that number will go down, and the Casualty Count - the growing number of the injured/dying - will increase. As he stabilizes crew via skills or items he’ll keep track of those separately, too, and when the crew is magically healed the number healed is subtracted from the Casualty Count and added to the Crew Count (able-bodied crew count is a mouthful).

It seem straightforward. I’d like to add is that the Surgeon role doesn’t have to be filled by only one player. There’s no reason other player’s can’t lend the ship’s surgeon an extra pair of hands. Multiple player’s can see to the crew for greater effect. Also, note the Casualty Count will affect Morale. When the Crew Count drops below half its starting number Morale will drop 1 step automatically. Let’s leave both the Surgeon and the Boatswain something to think about by adding the following addendum to morale: if at the end of a turn, the Crew Count is half the number or less than it was at the start of the turn Morale drops 1 step. Life at sea is tough. Until next time!