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Author Topic: Chronic (non-syndrome) diseases  (Read 1535 times)

WoobMonkey

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Chronic (non-syndrome) diseases
« on: November 14, 2013, 01:30:20 pm »

You never know who's dealing with them IRL; why not in DF?

Imagine - somewhere in that last migration wave is a vampire, sure; but one of the children who came is constantly in and out of the hospital, dealing with lupus.  Or MS.  Or IBS.  Or Diabetes.

Urist and Deduk both put down their tools - little Fath needs medical attention again for his leukemia.  The CMD just isn't fast enough; even Uncle Morul is getting furious.  None of the dorfettes in the fort will even consider dating Fath - there's too much work to be done to spend time caring for him.  The Mayor doesn't care; healthcare reform is a very low-priority for her, somewhere below cleaning the troll blood off the entry hall's walls.

Urist is melancholic; what's a mother to do?  The CMD is *always* 'too busy' to deal with an incurable condition; Deduk is ready to kill anyone who doesn't see his boy as the perfect little angel he is in daddy's eyes.

Sure, an FB shooting poisonous gas sucks hard, but those dorfs were militia - they knew what they were getting into.  Poor little Fath never had a chance to go down in glory; most of the fort sees him as a parasite; even the nurses give him less and less of the food rations every day, while everyone quietly waits for him to die.

tl;dr:  I think that adding chronic conditions (maybe as a random percentage chance in worldgen) to some dorfs would do a great deal to add to the depth of storytelling that DF offers.  Just sayin'.
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Edangzak Utharsanad Gedor - think you have what it takes?
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Manveru Taurënér

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Re: Chronic (non-syndrome) diseases
« Reply #1 on: November 14, 2013, 02:23:28 pm »

Well, one thing to remember is that many conditions we now consider chronic would've been fatal or at least much more crippling back in the day DF is somewhat based on. Even many things we now consider to be a nuisance at most could kill.

As for the general idea diseases are definitely planned, and some of them will certainly fit what you're asking for. No timeline though as with most things :>
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WoobMonkey

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Re: Chronic (non-syndrome) diseases
« Reply #2 on: November 14, 2013, 02:39:34 pm »

Well, one thing to remember is that many conditions we now consider chronic would've been fatal or at least much more crippling back in the day DF is somewhat based on. Even many things we now consider to be a nuisance at most could kill.

As for the general idea diseases are definitely planned, and some of them will certainly fit what you're asking for. No timeline though as with most things :>

It's good to hear it's planned.  The game is already the most amazing thing in the history of ever - I can wait.

However, I respectfully disagree with your reasoning: though I'm only [dabbling] at history, I've never heard tell of a time when undead giant ravens ate people; never heard of Keas stealing 2000 lb gold minecarts; never heard of anyone finding adamantine (even now, the LHC hasn't created that particular element!). . . . etc.  It's not the realism that matters (e.g. doesn't matter what the conditions are named, or how they work, particularly); it's the potential to flesh out parental/family caring as opposed to administrative indifference. 

Yeah, perhaps many treatable conditions were fatal at some point in human history - that doesn't mean that anyone was inured to the loss of a child to one.  It never stopped dedicated doctors from trying to find answers, from Galen on up to modern Oncologists.

But that's a niggling point.  I'm just glad to hear it's already under consideration.
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Manveru Taurënér

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Re: Chronic (non-syndrome) diseases
« Reply #3 on: November 14, 2013, 03:10:49 pm »

Thought I'd dig up some quote as well, the latest mention I could find in the DFtalks were from march 2011 (on the topic of mosquitos as a possible disease vector):

Quote
Rainseeker:   Ah, will they spread disease?
Toady:   Well, that's the question right? When you get to the mosquito you can be satisfied in a way just making a creature that bites you that doesn't really suck an appreciable amount of blood necessarily - unless it's a giant mosquitoman, which is disgusting - but it give you this really annoying itchy thing ... If we did all that then mosquitomen would be considered a success for the swamps and so on, probably. But really you want to get to ... you know, do you add diseases and blood borne illnesses and that kind of thing? I don't know, I don't know. It's a question with all of these, really. Bees won so I spent a lot of time on them, and I just don't have time to spend a month on every animal.
Rainseeker:   Please do not.
Toady:   Yeah, that would be five years. It would be a great animal game at that point, but it'd be a long time. It's hard to say with any given animal exactly how much time I'm going to spend on that, because diseases is something we were going to put in in the big nineteen month release - I think it was one of the few items that got redded out on that list, along with formations and brain death and a few other things - so it didn't make it in and so it's fair to say that the game is ready for it and if you want to have world generation and then after that experiencing diseases and plagues and stuff, it's a really important force in world history and if the mosquitoes are the vector for that then that'll be great for them, that addition to the game. I don't know, they're coming though, at some point. We're getting the penguin first though, penguins next. I don't know exactly what's going in with the penguin either, you have to think about it. Every single animal you get to you have to think 'what little feature do I want to try and add to the game'.

...
However, I respectfully disagree with your reasoning: though I'm only [dabbling] at history, I've never heard tell of a time when undead giant ravens ate people; never heard of Keas stealing 2000 lb gold minecarts; never heard of anyone finding adamantine (even now, the LHC hasn't created that particular element!). . . . etc.  It's not the realism that matters (e.g. doesn't matter what the conditions are named, or how they work, particularly); it's the potential to flesh out parental/family caring as opposed to administrative indifference. 
...

I also must respectfully disagree with this argument of yours. Toady obviously takes realism where realism is due quite seriously, so anything lifted from the real world is going to end up as realistic as possible, including any real world diseases. Realism most certainly matters where appropriate. You are of course quite right in that the mechanics are what's really interesting, and it wouldn't be hard to imagine some fantasy disease if any particular niche needs to be filled without there being an appropriate real world disease for the job. However, the prevalence of undead giant ravens etc is completely irrelevant to the discussion, imo ^^
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Azerty

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Re: Chronic (non-syndrome) diseases
« Reply #4 on: November 14, 2013, 04:08:53 pm »

Could we also include rheumatism, asthma, malaria and bilharziosis?

We can also think about neurologic and mental issues, such as epilepsy and phobias, a more refined mental troubles system (cf. here) and implement brain damage (cf. here, here and here).

Thought I'd dig up some quote as well, the latest mention I could find in the DFtalks were from march 2011 (on the topic of mosquitos as a possible disease vector):

Quote
Rainseeker:   Ah, will they spread disease?
Toady:   Well, that's the question right? When you get to the mosquito you can be satisfied in a way just making a creature that bites you that doesn't really suck an appreciable amount of blood necessarily - unless it's a giant mosquitoman, which is disgusting - but it give you this really annoying itchy thing ... If we did all that then mosquitomen would be considered a success for the swamps and so on, probably. But really you want to get to ... you know, do you add diseases and blood borne illnesses and that kind of thing? I don't know, I don't know. It's a question with all of these, really. Bees won so I spent a lot of time on them, and I just don't have time to spend a month on every animal.
Rainseeker:   Please do not.
Toady:   Yeah, that would be five years. It would be a great animal game at that point, but it'd be a long time. It's hard to say with any given animal exactly how much time I'm going to spend on that, because diseases is something we were going to put in in the big nineteen month release - I think it was one of the few items that got redded out on that list, along with formations and brain death and a few other things - so it didn't make it in and so it's fair to say that the game is ready for it and if you want to have world generation and then after that experiencing diseases and plagues and stuff, it's a really important force in world history and if the mosquitoes are the vector for that then that'll be great for them, that addition to the game. I don't know, they're coming though, at some point. We're getting the penguin first though, penguins next. I don't know exactly what's going in with the penguin either, you have to think about it. Every single animal you get to you have to think 'what little feature do I want to try and add to the game'.


Cat might get more useful because they will remove dieases-carrying vermin from fortresses.
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Neonivek

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Re: Chronic (non-syndrome) diseases
« Reply #5 on: November 19, 2013, 11:31:19 am »

So... why shouldn't chronic diseases be handled by the syndrome system?
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WoobMonkey

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Re: Chronic (non-syndrome) diseases
« Reply #6 on: November 19, 2013, 11:59:49 am »

Don't syndromes require a causal agent outside of the dwarf hirself?  e.g. FB, Vamp blood, Evil Rain, etc.  I'm suggesting conditions that are intrinsic to the dwarf, as a circumstance of birth rather than from environmental factors.
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Edangzak Utharsanad Gedor - think you have what it takes?
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assasin

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Re: Chronic (non-syndrome) diseases
« Reply #7 on: November 22, 2013, 05:34:29 pm »

--------------------------------------------------------------------------------
Quote
Don't syndromes require a causal agent outside of the dwarf hirself?  e.g. FB, Vamp blood, Evil Rain, etc.  I'm suggesting conditions that are intrinsic to the dwarf, as a circumstance of birth rather than from environmental factors.

Chronic just means that it lasts a long time or is recurring, the source of the disease wouldn't really matter. I think there'd be less confusion if another term was used, idiopathic (a disease that arises spontaneously or for which the cause is not known) syndromes might work for different types of cancers or brain aneurisms or whatever, and birth defects for diseases that a dwarf is born with.
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locustgate

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Re: Chronic (non-syndrome) diseases
« Reply #8 on: November 27, 2013, 06:07:08 pm »

Like someone said many of the diseases you listed would be fatal, especially diabetes  best case scenario the child would die shorty after begin to show symptoms, they would slip into a coma and eventually die, I don't recommend the coma part it's not fun. The 'modern' treatment, the one before insulin, was to basically starve the kid, give them just enough food to keep them from dieing of starvation but not enough to put them in a coma.

leukemia is still pretty fatal today, in dwarf age  there wouldn't be snowballs chance on the sun.
« Last Edit: November 27, 2013, 07:04:24 pm by locustgate »
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WoobMonkey

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Re: Chronic (non-syndrome) diseases
« Reply #9 on: November 27, 2013, 07:18:38 pm »

....except no.  You assume that a world which allows magic doesn't allow for alternate treatments.  The insulin I inject every day, before it was synthesized in a lab, would have been derived from pig's pancreas'.  Why not from a forgotten beast's extract (making 'extract from animal' jobs at the butcher's shop finally USEFUL)?

You forget that medieval/renaissance engineers weren't exactly known for mining to the centre of the Earth.

DF is not constrained to human historical precedence, is my point here.

Heck, so what if such conditions were fatal?  Isn't it about time the tragic elements of storytelling were a part of this game, instead of it just being a screwball comedy?

Remember that Armok didn't create the Earth - perhaps that's why human doctors, historically, didn't suture wounds with Adamantine thread?

This game isn't constrained by reality; it's a fantasy game.  Says so on the main page.  I'm not arguing for specific diseases; just the addition of the chronic disease type. 
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The ball softly hits Urist McTrainer in the head, breaking the paper-thin skull and denting the non-existent brain!

locustgate

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Re: Chronic (non-syndrome) diseases
« Reply #10 on: November 27, 2013, 07:51:53 pm »

stuff

I was talking about the animal extracted insulin, which wasn't extracted until 1922.  DF magic is reserved to gods and those few gifted artifacts. What the guy is talking about is treatable chronic diseases, diabetes didn't become treatable till recently for the vast span of time it was a death sentence and still is for many people. 

IF he wants treatable stuff then how about a bum leg/club foot. He is talking about treatable chronic disorders. 

EDIT: The synthesized stuff wasn't possible until 1982. It was only during the 1860s someone proposed that it was the pancreas that produced some kind of substance that 'prevented' diabetes.
« Last Edit: November 27, 2013, 08:11:05 pm by locustgate »
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WoobMonkey

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Re: Chronic (non-syndrome) diseases
« Reply #11 on: November 27, 2013, 08:11:12 pm »

stuff

I was talking about the animal extracted insulin, which wasn't extracted until 1922.  DF magic is reserved to gods and those few gifted artifacts. What the guy is talking about is treatable chronic diseases, diabetes didn't become treatable till recently for the vast span of time it was a death sentence and still is for many people. 

IF he wants treatable stuff then how about a bum leg/club foot.

EDIT: The synthesized stuff wasn't possible until 1982. It was only during the 1860s someone proposed that it was the pancreas that produced some kind of substance that 'prevented' diabetes.

I think the 'he' you're referring to is me.  And 'treatable' is not the same as 'manageable.' 

I am painfully, intimately aware of the history of Diabetes; its diagnosis, treatment, and consequences.  Sounds like you are, as well.

But, to reiterate - I'm not pushing for any specific conditions - just that the incurable, debilitating, sui generis condition type be included.  The history of medicine is one of Pyrrhic victories; tragedy compounded on tragedy, confounded by hope of a better way to live.

Once again, it's about the story in my eyes.  Dwarves are already 'born' with certain genetic traits - why not have some that will make a major difference, instead of just suiting them ever so slightly to certain tasks?  It's a small step from 'she is weak and quick to tire' to 'she is  battling a constant, losing war against [insert congenital disease descriptor here]'.

As it stands right now, the medical/hospital system is a tragicomedy, a Keystone Kops sort of deal.  I'm just looking at the potential of 'hospital' meaning more than 'battlefield clinic.'  DF needs some sadness injected, IMHO, and this is one way to do it; one that resonates with human [players, not the DF race] motivations, struggles, triumphs, and failures, throughout history.

Disease has been responsible for more of the development of our history than all wars, accidents, cruelties, and politics combined.  Seems a shame to not include such story-telling power in a game based on telling a story.
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Edangzak Utharsanad Gedor - think you have what it takes?
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The dog misses the ball!
The ball softly hits Urist McTrainer in the head, breaking the paper-thin skull and denting the non-existent brain!

locustgate

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Re: Chronic (non-syndrome) diseases
« Reply #12 on: November 27, 2013, 08:37:47 pm »

stuff

IF you want diabetes in the game then have something along the lines of 'x has been acting lethargic and urinating frequently' then 'x has collapsed and can not be awoken' then 'no matter what y tries x will not awaken' and finally ' x has died',  if you have a very observant/experienced doctor 'y has notices that flies are unusually attracted to xs urine' the first recorded instance of diagnosed diabetes was by the ancient Egyptians in which the doctor-priest noticed that the child's urine smelled and tasted sweet shortly before the child slipped into a coma/died, this gave the egyptian name to diabetes, later on people noticed flies were attracted to the urine.
« Last Edit: November 27, 2013, 08:40:10 pm by locustgate »
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WoobMonkey

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Re: Chronic (non-syndrome) diseases
« Reply #13 on: November 27, 2013, 08:41:24 pm »

It's starting to seem that you're intentionally missing the point - this is not about any specific condition; just that there be any sort of genetic, incurable disease system at all.

Anyways, I've said my piece on the matter.  Either Toady likes the idea, or he doesn't.
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Edangzak Utharsanad Gedor - think you have what it takes?
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The dog misses the ball!
The ball softly hits Urist McTrainer in the head, breaking the paper-thin skull and denting the non-existent brain!

Zancor Mezoran

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Re: Chronic (non-syndrome) diseases
« Reply #14 on: November 30, 2013, 05:30:39 pm »

Sounds like a fine idea to me.

Also, I think all of you are missing something: human history =/= dwarven history because humans < dwarves.  Heh.
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Anyway, I figure that the dwarves are only marginally less wasteful of metal than they are of wood. The moody dwarf's selecting only the best 5% of each bar of metal, and eats the rest to sustain him as he works on the artifact.
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