Playing a Doctor, Consent Negotiations and Medical Roleplay

By Michelle Stagnitta

(Editor’s Note: This guest post started as a comment in response to yesterday’s blog, but it was big enough and, I thought, important enough that it received it’s own post. While this seems to apply to more stats-based LARPing, there are healers, medics, and dangerous fight scenes in all ranges of LARP style and these tips are really helpful for roleplay through them in safe, consensual, and dramatic ways! Thank you for your words, Michelle!)

As somebody who plays a healer/physician/surgeon in multiple games, consent is a huge thing. I spend most of my game in very intimate contact with people, many of whom I don’t know very well.

In most games, healing is something players HAVE to seek out in one form or another in order for their characters to survive. I like to think that most people don’t intend to do so, but in attempting to be “authentic” in the healing roleplay, sometimes people get a little too handsy. I am tired of the excuses like: “I’m just playing my character,” or “I don’t really think about it,” or the worst one, “But stopping to check in breaks my immersion.”


If you are choosing to play a healer or doctor type character, your character can be an utter asshole, but YOU the PLAYER need to be somebody the other players can trust not to violate their personal space. I cannot stress that part enough. It’s a caretaker role, but it’s also one with a power dynamic. As such, it is IMPOSSIBLE to do this roleplay without consent from the person who is your patient. As the person playing the doctor, it is your responsibility to ask for that consent. And it is impossible to get consent without checking in somehow with your patient. If you can’t agree to this, do not play this kind of role. Period.

If you’ve reached this point and are thinking: “Ok, you have a valid point, but HOW do I do this without breaking immersion?” Here are some examples of how to do a more entertaining in character exam, give your rp partner better cues AND get consent all in one fell swoop (you’re welcome).

The exam always starts with the initial game mechanic and a hand on a shoulder or arm, which in most games is an accepted, pre-consented location of “ok to touch.” Beyond that, as I move through my exam I quietly talk to my “patient” before I take another step. And this looks slightly different for every encounter, but below are some of the most common examples.

Example 1: Basic exam and diagnosis while patient is conscious

Doc: Ok, let’s have a look at you.  *picks up wrist and takes pulse, counts for a moment* Hmmm. Alright, mind if I have a listen to those lungs and your heart? *pulls stethoscope off neck* (If your game has some sort of skill activation phrase for diagnosing or healing checks, this is where I’d use it.)

This is an example of Ryan Hart’s in/out character consent. He uses it as a technique for escalation but it works here too. Here I’d lean in and quietly ask if I can touch their back with the stethoscope. Most people are cool with this. If the answer is no, cool. Put your hand behind them but pretend you’re doing it and don’t actually touch the tool to the person. If they are ok with it, it’s a good opportunity to quietly ask off game if they’d prefer I just listen via their back or if sternum is also ok. It takes a few seconds.

In most games if you’re healing up straight damage, this is the part of the mechanic where the player tells you how many hit points they have left (or whatever the equivalent is). This is where you make the in character doctor small talk. Adjust the questions for the genre of your game of course.

Doc: Well, that’s no small thing but you’re still breathing, so let’s get you patched up. How’d you get yourself into this condition?  

As they describe those various injuries, ask quietly out of character which of those described locations, if any, they are ok with you touching throughout the roleplay while you are healing them. There is usually at least one. If there aren’t any, ask the player how they’d like to proceed with the healing RP. You’ve already asked an in character question to start the conversation. Now to anyone outside it just looks like doctor and patient are having a hushed conversation. This takes far less time than you might think.

Example 2: Setting a broken limb.

Doc: Ooh, looks like you did a number on yourself there. Lemme just take a look first, it’s probably painful. *do a visual check* Hmmm… alright. Now, is there a spot where you’re feeling less pain where it’s ok for me to touch to move you around and get a better look?

Again, this is in character but it’s giving your patient the chance to steer and give consent of where it’s ok to touch. Note the question CAN be answered with a no. If the patient is hesitant in character, quietly drop character for a second “Off game, can I touch you to examine you more closely, or do you prefer I not touch you?” Remember that the character and the player might have very different opinions. Some people like playing characters that are ornery and hate doctors, but the player might still be cool with the RP. Drop game for a few seconds and ask. The fun this generates is totally worth it.

But Mich, what if they answer no? Then you accept that answer and move on. Getting consent isn’t about convincing somebody else to let you touch them in the manner you want. If that’s what you think it is please don’t ever come near any game I play or run. Consent negotiations are about asking someone what their comfort level is and allowing them to set that boundary. That said, if they said no to you touching say, their leg, ask if it’s the location that’s the issue, or being touched in general. THAT is what we mean by negotiation. Do not attempt to cajole or convince. Clarify.

If they say no to the limb setting question, there might still be some area they are ok with you touching. If you’re setting an arm, most folks are ok with you touching their hand – as mentioned previously, many games have this as a pre-consented area for contact. For a leg, a foot that’s in a boot or shoe is usually ok. Ask.

If it’s still a no, that doesn’t mean the scene necessarily has to end. You can simply mime the actions near their body and quietly instruct the patient what the doctor is doing and they can move their own body in the correct ways. See the Roleplay Cues section for more details on that.

Example 3: Basic Exam and Diagnosis While Patient is Unconscious

This should be a no brainer but I’m going to say it anyway – if the person is unconscious out of character, you should not be touching them! If they are asleep and you have to wake them up for some reason, you should, at most, be touching an arm or shoulder. If they are unconscious for any other reason, unless you are actually a medical professional, GO GET ONE.

Ok, now that we have that out of the way, assuming the player is conscious but the character is not, this is probably happening because the character is actively dying. Begin the exam the same way as the conscious exam – hand on the shoulder or arm, whichever is the pre-consented location for contact at the game. If your game has a dying timer, activate whatever skills are needed FIRST, while still in just the pre-consented position so as not to lose those precious seconds. Then move on to the roleplay consent questions.

Odds are good that the patient is slumped over or even laying on the ground. You may be in the middle of combat, making it hard to hear. Lean close, but next to, not over your patient. Have a few locations in mind and ask your patient if they are ok to touch to perform some life saving first aid. If the answer is no to that location, go down to the next, and then the next.

My go to’s are: just below the collarbone between sternum and shoulder (this is very close to the already consented to areas and is a convincing spot for needing to control a bleed), the side of the head (also a good place for needing to control a bleed), and lower abdomen, right around the navel. If they are not ok with any of those, don’t stress it. Keep to the pre-consented arm/shoulder area. In the crazy of combat with your own body somewhat obscuring what you’re doing, the fact that you’re not actually in a medically critical area really will not be noticeable. Having a wad of gauze or bandages also makes it more convincing, and places a barrier between your hand and your patient, which for some people may also make the scene more comfortable. Beyond that, sell it with your own roleplay! This is the moment for lines like “Don’t you dare give up on me!” If you have other folks around you that you can pull into the roleplay that aren’t involved in things, have them grab things out your bag for you – disinfectant, more bandages… whatever. Describe what you’re doing, give prognosis updates. Is the bleeding getting under control? “Breathe damn you!” You get the idea.

Giving Roleplay Cues

Ok, so I also mentioned better RP cues. I’m actually going to give a nod here to an in-character workshop run at Utopia Descending by Samara Metzler and Sean Chase (of Alliance Videa) where they were trying to explain to Pillars (their in game term for the protagonists) how to “sell” things to the camera. Medical roleplay can seem daunting to some people.  For others, it can be boring if all you do is tap an arm or repeat stitches for ten minutes to satisfy a mechanic for healing body points or hit points. But it can also be a fantastic scene with just a tiny bit of improv.

Frontier MedicineLet’s say you’ve gotten this far and you have consent to touch your patient. Or if not, you’re giving them instructions on how to move while you’re miming the motions around them. Lead them with instructions by telling them what you’re about to do! Your doctors do this ALL THE TIME IN REAL LIFE. Here are some examples for a variety of procedures”

  • “Ok, now this is going to sting a bit…” *tap them with whatever tool you’re using*
  • “You’ll feel a little pinch and then some pressure.”
  • “I’m going to have to push the arrowhead through. Going to hurt like a bitch but it’s less damage than pulling it back. Ready?”
  • “Ok, I’m going to set your leg. This is going to hurt. One… two…” *move the leg slightly*
  • “This medicine is going to taste awful but I promise it’s good for what ails ya!”

There are many more, but you get the idea. Watch any of the major medical TV dramas to help you build your bank of medical sound bites. Note that each of these do the same thing: they tell the patient what you’re about to do, so that they have an idea how to roleplay their reaction. They can decide the degree of their reaction – a wince, a scream, jumping up off the table… whatever. Out of character obviously what you are about to do to them isn’t really going to hurt (and if it is, you are doing something wrong), but you are giving them cues off of which to play, and making for a far more dramatic scene.

You’re also giving them an opportunity to say STOP, or WAIT or anything else in which they can pause the scene before you do whatever it was you’re about to do so that the scene can be adjusted if needed.

Other Important Notes:

  1. Ask every time. Doesn’t matter if they were ok with it the last 20 times. You don’t know what’s happened between then and now that might have changed something. And it probably doesn’t have anything to do with you or anything you personally have done. Consent to a prior scene does not equal consent to this scene.
    1. Example: I’m normally pretty good with people moving me around. I dislocated my shoulder a few weeks ago. While it’s not a mental or emotional issue, it’s a physical health issue that I cannot be physically handled in a way that was perfectly fine a few events prior.
    2. Example: Someone was mugged at knifepoint in between this event and the last one. Miming using a knife to cut out an arrowhead might not have bothered them last event. This event it might. Ask.
  2. Ask every time, even people you know well. Even if you think they’re ok with it. Even if you KNOW they’re ok with it. Set the culture for those around you. Let it be known that this is a Thing We Do Here. I will admit that even I sometimes forget this step with my super close friends. I’m working on it.

You will make mistakes. We all do. I wasn’t always good at this. LARP as a whole wasn’t always good at this. We need to be better at this.


2 thoughts on “Playing a Doctor, Consent Negotiations and Medical Roleplay

  1. Chris Frueh says:

    Thank you for the continued inspiration for my role-play and for helping me understand the mechanics of the game so I can keep you in your immersion that much better!


  2. Shannon says:

    “This should be a no brainer but I’m going to say it anyway – if the person is unconscious out of character, you should not be touching them! If they are asleep and you have to wake them up for some reason, you should, at most, be touching an arm or shoulder. If they are unconscious for any other reason, unless you are actually a medical professional, GO GET ONE.”

    Sorry to be “that guy” but just in case anyone takes the article’s advice literally, remember that anyone with any first aid training experience SHOULD absolutely put an unconscious but breathing person in the recovery position so they don’t inhale their own vomit. Don’t leave them alone and wait for a medical professional. There is implied consent in most countries for touching an unconscious person to put them in the recovery position since they can hardly change their mind to say “yes, please save my life,” now they’re unconscious.


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