Iolla Sanitariums

The Iolla Sanitariums are a series of medical facilities located in the Iolla Cliffs of southeastern House Schneeplestein, Duilintinn. They are managed by the Lifeworker Institute.

*Note: Currently, there are no canonical amount or locations of the individual Iolla Sanitariums. They are scattered over the Iolla Cliffs, never going past Fadáite Sólas to the west (black dot #1) and staying a distance away from Iolla Beacon in the east (black dot #2).*

## History

People from other houses send their ill to House Schneeplestein for a variety of reasons- after all, that’s where the best doctors in the kingdom are- but especially when their loved one needs constant care in order to recover or, heaven forbid, be comfortable in their final days.

Not only is House Schneeplestein full of doctors, but the environment itself is good for recovery. The salt in the air along the main coastline and the clear mountain air of the foothills and cliffs to the south are great places for people to visit and recover from various illnesses. None of the other houses have a combination quite like this; House Jameson is too rainy, House Marvin is too humid and low-altitude, House Jackie is too hot and just plain dry, and House Brody’s three regions are basically all of the above (south-west is hot and dry, north is rainy, and east is humid saltwater wetlands where no one can really live anyway). So House Schneeplestein is definitely the place to go when the doctor recommends some “different air."

Of course, the main draw is the doctors. If the doctors of House Schneeplestein can’t save you, no one will, but by God they’ll try their hardest and make sure you’re in as little pain as possible. To care for such patients, doctors even set up practices down in the Southern Mountains, further from the hustle and bustle of Fionport.

Many of these locations have evolved into tiny villages that could be compared to modern day resorts or historical sanitariums (not to be confused with sanatoriums, aka the setting of every hospital horror movie/game ever). Depending on the location, a single doctor or a group of doctors will care for a small group of patients. Some of these patients will only visit for a short time, while others who stay for the rest of their lives, however long that implies. Eventually, these locations were officially termed the Iolla Sanitariums and standardized as an official aspect of the Lifeworker Institute’s work. While doctors working at the Sanitariums are not required to be affiliated with the Lifeworker Institute, the majority are, and those who aren’t are still required to abide by the Institute’s policies.

After a raid upon a quarantined sanitarium in January 1615, in which The Watch nearly jeopardized quarantine efforts by rushing to the sanitarium’s defense, the Lifeworker Institute and the Watch formed a system of communication using the large bells inside and outside of each sanitarium to prevent future incidents. By ringing the bell a certain number of times, the inhabitants can inform Watchers of various dangers, allowing them to defend the facility from any immediate threats without causing long-term harm.

## Residents

While there are also hospitals in House Schneeplestein's capital of Fionport (located along the coast of Loch Domhainn), but if it becomes clear that the patient will require constant care for a long period of time, they are sent to these small, isolated sanitariums.

These small patient settlements never reach populations over 100, and most have no more than 25-50 patient residents at a time. All but two are designed to house patients of all ages; one specifically cares for children and another is exclusive to the elderly.

Individual facilities of the Iolla Sanitariums function like small communities. There is a strong sense of comradery among the patients of each facility, which is extended to the dedicated doctors and staff who live on-site.

Depending on the specific sanitarium and its purpose (i.e. are the residents contagious/immunocompromised or not), visitors might be able to spend time directly with their loved one, either accompanying them in their daily routine or by sitting in dedicated rooms for seeing visitors. However, it some cases, visitors are still separated by some sort of barrier (physical or magical) to prevent the spread of disease in either direction. Finally, the most heavily quarantined facilities don't allow visitors at all, but those are rare.

### Mental Healthcare

There are a few specific sanitariums that focus on providing different sorts of mental healthcare. I’d imagine that someone might stay in one of those sanitariums in order to receive intensive therapy or if their family and friends aren’t capable of providing enough of a support network for various reasons (hopefully relating to inability and not lack of desire to help).

In cases where someone just needs a dedicated caretaker to help them, but otherwise is not a danger to themselves of other and doesn’t need regular medical attention, the sanitariums prefer that someone from the patient’s home community rise to the task and offers caretaking classes to those who want
to help their loved on, but aren’t sure how. However, if that isn’t possible, they are willing to take patients who need caretakers into the sanitariums as well; they just prefer not to, both for the sake of the patients and to preserve the facilities and resources for people who require the assistance of a medical professional.

However, I could also imagine cases where the patient actually *wants* to stay in a sanitarium because they feel more at home around people who struggle with similar mental illnesses and people who have dedicated their lives to understanding how their brain works, and feel that feels more like their ‘place in the world’ than wherever they were previously, but I’d guess that a lot of people would prefer to have the help of someone from their already discovered ‘place in the world’ as a caretaker, rather than moving away to a sanitarium.

## Security

Due to health concerns, many of the sanitariums (especially those under quarantine) choose not to hire guards. Not only does this leave these facilities an easy target for robberies (or worse), the lack of guards makes it difficult to enforce visitation rules when over-zealous loved ones, ignorant of the fact that those rules exist for the safety of the residents and the visitors, insist on seeing a resident.

While the bell policy instituted in early 1615 (see the end of the History section) allows for these sanitariums to receive aid during major threats and addresses the former of these issues, it doesn’t address the latter.

Therefore, as an additional layer of security, it is forbidden by national law to create a map showing the locations of the individual Iolla Sanitariums, either for public use or private distribution. The only people who officially know the location of these facilities are stationed in the town of Fadáite Sólas, which holds the secondary hub of the Lifeworker Institute specifically tasked with managing the sanitariums.

For this and many other reasons, the town of Fadáite Sólas is a critical element of the sanitariums’ security. Not only does the guild hub within the town secure and manage every record ever produced by the sanitariums, but it has evolved into a launching point for medical professionals, arriving residents, and visitors traveling to the sanitariums.

Not only does this policy protect the privacy, dignity, and peace of the residents and doctors of the sanitariums, but it also allows visitor traffic to be carefully controlled. Almost like a massive reception desk, anyone who wishes to visit the Iolla Sanitariums must first pass through the town of Fadáite Sólas and receive a guide from the Lifeworker Institute after being carefully vetted. With the sanitarium locations kept under wraps, all visitors will need this guide from the guild hub to show them the way to the correct sanitarium, who will also supervise them to make sure they follow all of the health and safety rules. Obviously, some people will probably start to remember the route after a few visits, but they still won’t be let into any of the sanitariums without such a guide to vouch for them.

## Experimental Treatments

Verified scholars and doctors with multiple credentials and letters of recommendation from the Lifeworker Institute can visit these places and ask for volunteers for experimental treatments among the terminally or chronically ill.

Recently, Watchers in Iolla Beacon Outpost have also been granted permission to conduct similar research, so long as they work alongside and under the supervision of one of these vetted medical experts.

## Architecture and Layout

While some of the Iolla Sanitariums were built from the remains of Feadhainn Era architecture, the vast majority were built specifically for their modern-day purpose.

This hospice in France (c. 1400) gives you a pretty good idea of what I imagined the medical facilities for the terminally or chronically ill in the Iolla Cliffs to look like. These places are a place of rest and comfort for people who need constant care, so I like how the entire facility is a single, interconnected building.

Granted, the tiles and cross-lattice architecture feels more like House Jameson’s architectural style than House Schneeplestein’s, but in a way, that kinda works. The Iolla Cliffs are directly adjacent to the eastern parts of House Jameson and within a few day’s journey of Noefrach, so it makes sense that there’d be some cultural overlap like this.

Most of the sanitariums consist of a central courtyard enclosed on all sides by the interconnected building mentioned above. All of the facilities needed to care for the residents of the sanitarium are located within this structure, including wards, treatment areas, and visiting spaces. Very few residents are cooped up in rooms all day. Those who can are encouraged to spend some time in the courtyard each day to get some fresh air, stretch their legs, and mingle with the other residents. Patients who are bedridden, but otherwise able to handle spending some time outside, are wheeled out in chairs or beds as well.

Within the building itself, the wards where the patients stay are very simple.  The beds are in lines from head to foot, with heavy drapes for privacy. This allows nurses and doctors to go down the line in order to easily distribute food and care, while allowing patients who can't otherwise get out an opportunity to socialize.

Tumblr user @theshapeshifter100 (who took these photographs) also toured the inside of the hospice, with these observations:

* “Right, this is part of the largest ward, free beds, curtains on both sides so that private procedures could be done, bed warming pans. Fireplace at the end and about thirty beds lining the walls. Tables along the middle for meals (if the patients could leave the bed).”
* “This also in a more private ward you could pay for. Fewer beds, similar rooms for the elderly.”
* “There was also a room with large windows and a low ceiling for the gravely ill, basically the ones who weren’t going to make it. Lower ceiling made it easier to the heat the room, basic idea was that their final days were comfortable.
* “I am under the impression there was also a ward for the ‘frantic and distressed’ (mentally ill), just in a different building.”
* “Different sections of the hospital had their own equipment, which was engraved with the symbol/initials of that section so there wouldn’t be any mix ups.”

This fits what I imagined when first developing the idea for the Iolla Sanitariums, that there’d be different facilities for different types of treatment. At the time, I said there would be at least one for the extremely elderly (i.e. a nursing home) and one for children (i.e. a pediatric hospital). Since then, I’ve also mentioned the possibility of at least one facility specifically for mental illness patients.

I’m torn about whether there are or aren’t separate sanitariums for terminally ill and chronically ill patients. On one hand, those are two different problems. Terminally ill patients are trying to live comfortably before the end, sometimes while also trying to delay that end for as long as possible. Chronically ill patients don’t have that threat of death hanging over them, but other than that… the goal is still to help them live a comfortable, fulfilling life despite their health problems. My internal debate is whether intermingling the two would help or hurt morale among the patients and if there is even any treatment overlap between terminal illnesses and chronic illnesses in the first place.