Heal

You are skilled at tending to the ailments of others.

**Check**

The DC and effect depend on the task you attempt.

**Action**

Providing first aid, treating a wound, or treating poison is a standard action. Treating a disease or tending a creature wounded by caltrops takes 10 minutes of work. Treating deadly wounds takes 1 hour of work. Providing long-term care requires 8 hours of light activity.

**Common Uses**

**Identify Drugs/Pharmaceuticals**

The Heal skill is used to identify and understand pharmaceuticals. The character must make a heal check against the saving throw DC vs. the drug if there is one, or against the purchase DC of the material. Success indicates that you understand what drug it is. A creature with knowledge chemistry gains a +2 bonus to heal checks made in this situation.

**Provide First Aid**

You usually use first aid to save a dying character. If a character has negative hit points and is losing hit points (at the rate of 1 per round, 1 per hour, or 1 per day), you can make him stable. A stable character regains no hit points but stops losing them. First aid also stops a character from losing hit points due to effects that cause bleed.

***Action/Time**:* 1 standard action.

***Retry?*** You can always retry a check to provide first aid, assuming the target of the previous attempt is still alive.

**Provide Long-Term Care**

Providing long-term care means treating a wounded person for a day or more. If your Heal check is successful, the patient recovers hit points or ability score points (lost to ability damage) at twice the normal rate: 2 hit points per level for a full 8 hours of rest in a day, or 4 hit points per level for each full day of complete rest; 2 ability score points for a full 8 hours of rest in a day, or 4 ability score points for each full day of complete rest.

You can tend to a number of patients equal to your number of skill ranks in heal. You need a few items and supplies (bandages, salves, and so on) that are easy to come by in most towns and cities, but may be difficult to find depending on the condition of the city or social discourse. These items can be found in a medical kit. Giving long-term care counts as light activity for the healer. You cannot give long-term care to yourself.

***Action/Time**:* 8 hours, or 1 hour per creature being tended to, whichever is longer.

***Retry?*** Varies. Generally speaking, you can’t try a Heal check again without witnessing proof of the original check’s failure.

**Treat Deadly Wounds\***

***Requirement**:* You must expend two uses from a healer’s kit to perform this task. You take a –2 penalty on your check for each use from a healer’s kit that you lack.

When treating deadly wounds, you can restore hit points to a damaged creature. Treating deadly wounds restores 1 hit point per level of the creature. If you exceed the DC by 5 or more, add your Wisdom modifier (if positive) to this amount. A creature can only benefit from its deadly wounds being treated within 24 hours of being injured and never more than once per day.

***Action/Time**:* 1 hour.

***Retry?*** Varies. Generally speaking, you can’t try a Heal check again without witnessing proof of the original check’s failure.

**Surgery**

**Requirement:** With a surgery kit, a character can conduct field surgery. This application of the Treat Injury skill carries a -4 penalty, which can be negated with the Surgery feat. Surgery requires 1d4 hours; if the patient is at negative hit points, add an additional hour for every point below 0 the patient has fallen.

Surgery restores 1d6 hit points for every character level of the patient (up to the patient’s full normal total of hit points) with a successful skill check. Surgery can only be used successfully on a character once in a 24-hour period. A character who undergoes surgery is fatigued for 24 hours, minus 2 hours for every point above the DC the surgeon achieves. The period of fatigue can never be reduced below 6 hours in this fashion.

A creature can perform surgery on itself, however it suffers from a -10 penalty to the check.

***Action/Time**:* 1 hour + 1 hour per negative hitpoint the creature has.

***Retry?*** Not in the same 24 hour period.

**Treat Disease**

To treat a disease means to tend to a single diseased character. Every time the diseased character makes a saving throw against disease effects, you make a Heal check. If your Heal check exceeds the DC of the disease, the character receives a +4 competence bonus on his saving throw against the disease.

***Action/Time**:* 10 minutes.

***Retry?*** Varies. Generally speaking, you can’t try a Heal check again without witnessing proof of the original check’s failure.

**Treat Poison**

To treat poison means to tend to a single character who has been poisoned and who is going to take more damage from the poison (or suffer some other effect). Every time the poisoned character makes a saving throw against the poison, you make a Heal check. If your Heal check exceeds the DC of the poison, the character receives a +4 competence bonus on his saving throw against the poison.

***Action/Time**:* 1 standard action.

***Retry?*** Varies. Generally speaking, you can’t try a Heal check again without witnessing proof of the original check’s failure.

**Treat Wounds from Caltrops**

A creature wounded by stepping on a caltrop moves at one-half normal speed. A successful Heal check removes this movement penalty.

**Restore Hit Points**

With a medical kit, if a character has lost hit points, the character can restore some of them. A successful check, as a full-round action, restores 1d4 hit points. The number restored can never exceed the character’s full normal total of hit points. This application of the skill can be used successfully on a character only once per day.

**Revive Dazed, Stunned, or Unconscious Character**

With a first aid kit, the character can remove the dazed, stunned, or unconscious condition from a character. This check is an attack action.

A successful check removes the dazed, stunned, or unconscious condition from an affected character. The character can’t revive an unconscious character who is at -1 hit points or lower without first stabilizing the character.

***Action/Time**:* Standard action

***Retry?*** Varies. Generally speaking, you can’t try a Heal check again without witnessing proof of the original check’s failure.

**Mental Treatment**

If a character possesses ranks in heal as well as in Knowledge Behavioral sciences, they can attempt to provide psychiatric or mental health treatment to creatures suffering from sanity based effects.

 Long Term Psychiatric Care

##### **Immediate Psychiatric Care**

When someone suffers an episode of temporary insanity, a therapist can bring him out of it—calming his terror, snapping him out of his stupor, or doing whatever else is needed to restore the patient to the state she was in before the temporary insanity—by making a DC 15 Heal check as a full-round action.

A therapist can also use immediate care to stabilize the Sanity score of a character whose current Sanity is between -1 and -9. On a successful DC 15 check (requiring a full-round action), the character’s Sanity score improves to 0.

##### **Long-Term Psychiatric Care**

Providing long-term care means treating a mentally disturbed person for a day or more in a place away from stress and distractions. A therapist must spend 1 hour per day doing nothing but talking to the patient. If the therapist makes a DC 20 Heal check at the end of this time, the patient recovers 1 Sanity point. A therapist can tend up to a number of patients equal to his number of ranks in the heal and ranks in knowledge behavioral science added together and then divided by 2; each patient beyond the first adds 1 hour to the total time per day that must be devoted to therapy. The check must be made each day for each patient. A roll of 1 on any of these Heal checks indicates that the patient loses 1 point of Sanity that day, as she regresses mentally due to horrors suddenly remembered. The heal DC is increased by +5 on a day in which the patient has already lost sanity.

**Sabotage Healing**

Although the Heal skill is traditionally used to aid the injured, treat poison and disease, and otherwise provide comfort to the wounded and infirm, the anatomic knowledge granted by this skill allows it to be used for far more nefarious uses as well. Any character may attempt to torture a living target with physical and mental anguish; the results of such torture can be determined with a Heal check. Note that torture is an heinous act, and as such may have repercussions on characters with a strict moral code.

**Check**: The DC and effect depend on the task you attempt.

**Prevent Recovery**

A victim in the care of a torturer can be prevented from naturally healing from wounds or ability damage by worrying the victim’s wounds, keeping him malnourished, and using various substances to promote prolonged sickness. Preventing recovery counts as light activity for the torturer, and requires an hour’s work per day per victim. A victim successfully treated with this form of torture does not heal hit point or ability damage naturally from rest for that day. This can be hidden as a benevolent action with a successful bluff check against a DC of 10. If the creature or another creature is suspicious, instead it is against their sense motive.

**Time**: 1 hour.

**Torture**

Over the course of an hour, you can torture a victim with intent to subdue or kill. If the Heal check is successful, you cause nonlethal damage or lethal damage (your choice) equal to the victim’s character level (or number of hit dice for targets without class levels). Note that the results of this skill do not guarantee answers if you are torturing a subject in order to gain knowledge he might have; the subject of torture can always decide to divulge such knowledge if he wishes to avoid more pain and suffering. Against NPCs, assume that with each hour of torture, they must make a Will saving throw against the result of that hour’s Heal check (modified by a cumulative –1 morale penalty to the check for each hour the torture has continued) to avoid breaking under the pressure and answering your questions. Even then, results are not guaranteed. A particularly crafty or brave victim might try to Bluff an answer and give false information; use this method if the torture victim actually does not know the information you are seeking and is trying to just make something up to stop the pain. Do not use this method when a player character is being tortured; the player should decide when and if he wishes to give out information to his torturer. Prolonged torture can be very detrimental to a creature’s mental health. If a creature is tortured more than once within a week, they take 1 sanity damage. If tortured multiple times a week for at least 1 month, they suffer 1d4 sanity damage. If the torture continues on after this, the creature no longer takes sanity damage every week but 1d4 every month.

**Time**: 1 hour.

**Deep Hurting**

This method of torture is similar to standard torture, except that it targets a victim’s ability score rather than his hit points. Inflicting deep hurting is more time consuming than standard torture; a single session of deep hurting takes 2 hours to finish. With a successful Heal check, you deal 1 point of ability damage or ability drain to one of the victim’s ability scores chosen by you. To inflict ability damage the DC is 20, but if you make a DC of 30 with the roll you can opt to inflict ability drain instead. All other rules governing deep hurting function identically to the rules for standard torture. Prolonged torture can be very detrimental to a creature’s mental health. If a creature is tortured more than once within a week, they take 1 sanity damage. If tortured multiple times a week for at least 1 month, they suffer 1d4 sanity damage. If the torture continues on after this, the creature no longer takes sanity damage every week but 1d4 every month.

**Time**: 2 hours.

**Prevent Fast Healing**

By using potent acids, applications of fire, and mechanical devices designed to prevent wounds from properly healing, you can prevent a creature’s fast healing ability from healing damage inflicted upon it. One check must be made each day to keep the creature from healing. In all other ways, this form of torture is treated as if the torturer were preventing recovery. Preventing actual regeneration is beyond the scope of the Heal skill; a torturer is better off simply using things that cause lethal damage to the target. Prolonged torture can be very detrimental to a creature’s mental health. If a creature is tortured more than once within a week, they take 1 sanity damage. If tortured multiple times a week for at least 1 month, they suffer 1d4 sanity damage. If the torture continues on after this, the creature no longer takes sanity damage every week but 1d4 every month.

**Time**: 1 hour.

**Erode Willpower**

The erosion of a target’s power to resist with his mind is a different form of torture, and one that usually does not require direct physical harm. Rather, this form of torture relies upon subjecting the victim to horribly uncomfortable living conditions for an extended period of time. This may consist of imprisoning the victim in a cage sized to prevent him from doing anything but crouching, or it may consist of keeping the victim in a room filled to the neck with rancid water, or it may involve exposing the victim to repetitive loud and jarring noises (such as the constant sound of nails scraping on slate). Each day that you make the DC to erode a target’s willpower, the victim’s Will saving throw suffers a cumulative –1 morale penalty for the length of the next day. As soon as one day passes without having his willpower eroded, all accumulated morale penalties vanish. Prolonged torture can be very detrimental to a creature’s mental health. If a creature is tortured more than once within a week, they take 1 sanity damage. If tortured multiple times a week for at least 1 month, they suffer 1d4 sanity damage. If the torture continues on after this, the creature no longer takes sanity damage every week but 1d4 every month.

**Time**: 24 hours

**Heal Unchained**

Characters who have selected the signature skill feat for heal unlock additional abilities when they attain 5, 10, 15, and 20 ranks in a skill.

With sufficient ranks in Heal, you earn the following.

**5 Ranks**: When you treat deadly wounds, the target recovers hit points and ability damage as if it had rested for a full day. When you use long term psychiatric care to heal a creature’s sanity, you heal 2 sanity. If using heal to torture a creature, you cut the time in half that you need to spend torturing the creature to get the effect.

**10 Ranks**: When you treat deadly wounds, the target recovers hit points as if it had rested for a full day with long-term care. When using immediate psychiatric care to heal a creature’s sanity, you grant them 1d4 temporary sanity that slowly fades over the course of 24 hours. If using heal to torture a creature, You double the penalties given.

**15 Ranks**: When you treat deadly wounds, the creature recovers hit point and ability damage as if it had rested for 3 days. When you use long term psychiatric care to heal a creature’s sanity, you heal 3 sanity. If using heal to torture a creature, you cut the time in half that you need to spend torturing the creature again (Down to ¼ time now) to get the effect.

**20 Ranks**: When you treat deadly wounds, the target recovers hit point and ability damage as if it had rested for 3 days with long-term care. When using immediate psychiatric care to heal a creature’s sanity, you grant them 1d6 temporary sanity that slowly fades over the course of 24 hours. One point of this temporary sanity is permanent and remains. If using heal to torture a creature, You can spend a number of days equal to ½ your character level without torturing the creature before returning and their penalties maintain over that time instead of needing to be tortured every day.