Monday, July 11, 2016

Background: Medicine

The Confederate States of America has a cure for cancer. So does Deseret, Peachtree, the USA, Tejas and the 500 Nations. In a world where magic works and where divine spellcasters can literally work miracles, there's a certain number of people that could cure one or two cases of terminal cancer a day. The real issue here isn't "cancer can be cured"; if AIDS existed in 1899 world it could also be cured. At a high enough level, any cleric could restore a single person to perfect health with a touch and a prayer. The real issue is the way that the Faith (or any of the other religions) determine who those one or two people a day are going to be.

As can be expected, the rich and powerful will be able to make use of the clerics' services before the poor and destitute (there's a few cathedrals in Alabama, Mississippi and Florida that exist because the Faith traded cancer cures for enough money to build monuments to the Seven). And there are occasional moments of mercy where a high-level septon decides that someone who can't necessarily do anything for the Faith still deserves a second lease on life. When following the dictates of one's soul, one doesn't always do the expected thing. Also, it's important to note that the lower-level "Cure Light / Medium / Serious Wounds" spells only heal injuries. They don't restore severed limbs, appendages or eyes. A cavalry officer who got his leg blown off and healed by a cleric who only restored his hit points is now a one-legged man. The use of spells like "Restoration (Lesser, Normal or Greater)" can address those issues but the plain healing spells do not.

While divine spellcasters are able to heal wounds, it's amost always on an individual level and the spellcaster must be present to perform this duty (barring the use of healing potions and the like). Hospitals and battlefields are both places where divine spellcasters face the ultimate tests of their abilities, and regardless of how many healing spells they can cast (up to a dozen and a half for higher-level clerics) it is inevitable that more people will be injured and need help than they can treat. Surgery in the Divided States of America is slightly more advanced in 1899 than it was in the real world (there's nothing like a fourteen-year-long war full of traumatic amputations to change the learning curve for surgeons and bring about new techniques). Antiseptics have gone past the "spray every surface with carbolic acid and hope for the best" level and surgeons commonly accept that the time to wash one's hands with alcohol is before they get bloody as well as after. Ether became used as an anaesthetic in the 1860s as well, with some doctors learning to specialize in its use and monitor the patients to keep them in the twilight zone between agony and death while being treated.

As a parenthetical note, the Korean War was the first one in real-world history where there were more casualties due to battlefield injuries than to disease; antibiotics and medevac flights made it possible to treat more wounds more quickly than had ever been possible before. The existence of flying carpets and teleportation wands in 1899 means that battlefield mages and clerics could do more for a vanishingly small number of soldiers than would have been possible in the real world, but the overwhelming experience for wounded men and women in that war was agony, surgical amputation and a lifetime of diminshed capabilities.

Enter the technological improvements of Peachtree and the USA. Alchemy is also real; so are technologies undreamed of in the real world. In a society where tens of thousands of soldiers were saved from death but not from disfigurement the mechanical artificers of the United States were spurred to action. Clockwork prostheses are extremely common, with mechanical hands capable of gripping a pen and fine motor control able to let the user write his signature the top of the line and crude-looking metal gauntlets at the bottom (as in all things, the ability of someone to pay for treatment determines the level of treatment they will get, although there are charitable societies in every country other than the 500 Nations' territory that pay for as many injured soldiers and workers to get as high-quality a prosthetic as they can--and it's more that the 500 Nations don't have an official bureaucracy to facilitate things like that than an unwillingness to treat the injured). Arcane spellcasters have also stepped into the field of limb replacement, with alchemically treated metal, stone or wood limbs magically capable of doing anything the flesh and blood arm or leg could do existing by the hundreds. A modified golem-creation ritual can fuse a statue limb to a living human body and make it flexible like skin (although heavier and tougher; some maimed factory workers have been known to go right back onto the line with metal or hardwood arms because they're extremely resistant to the damages that originally crippled them). In many cases, the mages make a number of golem limb procedures available to the poor and desperate as a trade-off for the knowledge and practice that they gain for crafting the magic item. In extremely rare cases, mages are able to craft enchanted glass and metal replacement eyes for maimed inviduals; one or two wizards were known to have blinded themselves once the replacement arcane-sight devices were perfected, trading up from their human vision to sight that could see things nobody else could.

It's not uncommon for adventurers to make use of enchanted replacements for damaged or missing limbs, either by paying cash up front or in some cases to trade a certain term of indentured servitude to an alchemist for improved limbs, eyes, the addition of wings, or other clockwork or magical enhancements. Some military forts in the less-settled parts of the USA that face monster attacks have surgical wizards and alchemists on staff; the medical officers range from dedicated surgeons devoted to the soldiers under their care to barely sane surgeons crafting scarcely human monsters from the injured and dying enlisted men under their control.

Surgical techniques are harsher on the other planets; Venus and Mars both have limited resources compared to Earth and there aren't large enough cities to support teaching hospitals on either frontier planet. But there are people willing to adventure past the edge of Terran science on both planets that can restore injured adventurers to health, or improve their bodies. Implanting or creating the gills that Green Lizardmen use to breath underwater is possible, as is grafting their membranous eyelids to humans (if willing donors can be found, of course). And taking cadaver muscles and surgically attaching it to an existing human is a way to create strength and toughness beyond human levels.

No comments:

Post a Comment