To kick this off, compare the two following spells:

Take goose-fat, and the lower part of elecampane and viper’s bugloss, bishop’s wort, and cleavers. Pound the four herbs together well, squeeze them out, and add a spoonful of old soap. If you have a little oil, mix it thoroughly and lather it on at night. Scratch the neck after sunset, and silently pour the blood into running water, spit three times after it, then say, “Take this disease and depart with it.” Go back to the house by an open road, and go each way in silence.

And…

You imbue the subject with magical energy that protects it from harm, granting it a +1 resistance bonus on saves. Arcane Material Component: A miniature cloak.

Note any difference? I'm going to go out on a limb here, but I think the most obvious example of the dichotomy of role-playing games exists in how healing magic is used. On one hand, there’s the “real life” magic of healing, how magicians in the Middle Ages used spells and charms to (supposedly) heal people. On the other side of the gold coin, you have the trope of videogames that heal instantly, just by finding a piece of food on the ground. See TraumaInn for more information on that particular genre (not to mention America’s Finest News Source).

This means that you have people losing hit points by getting hit with a sword, and gaining hit points by laying on hands. It’s great to balance the numbers this way, but less so in real life, partly because real life doesn’t handle damage like numbers, especially when scaling down. In AD&D, a 1st level commoner can have 1-4 hit points. A cure light wounds potion heals 1d8+1 hit points. You do the math – a single 50gp potion can bring a person from negative hit points up to full health. Instant health beats a slow and risky path to wellness. In the real world, doctors treated what they could using practical, well-proven techniques, and turned to the supernatural only when their skills proved useless. But proven techniques are risky, even more so in the middle ages, before patients were given little more than wine as antiseptic and anesthesia. A broken leg could result in a limp for life if not set properly. And a limp means you don’t work the farm, which means you starve. Diseases are both mysterious and more deadly, and we take for granted basic nutritional facts, like vitamin C tablets, fresh fruit shipped in from foreign countries, and fluoridated water.

In all of this, in scrapes and maladies, PCs come on the scene where they can heal anyone. So, who do they heal? Other player characters and important NPCs are obvious choices, but what beyond that? You can barter for your healing power, something players don’t normally do (or at least they don’t in my campaigns). However, this may have unintended consequences, especially if word gets out.

“She twisted around and saw that the room behind her was filled with jokers of every variety, and among them, forcibly restrained, were two nurses and a doctor…. She backed away from their questions, into the waiting arms of the jokers. A misshapen man whose features had been scrambled thrust his distorted face into hers and demanded, ‘Can I be next?’” Down and Dirty, Wildcards Volume V. When people are close to death, when they have nothing to lose, it can turn ugly. And I’m not even going to start on resurrection spells – that will have to wait for another article.

Of course, people aren’t the only ones who can heal. Sometimes places heal, either because of a famous healer, or because the location itself is magical. For example, the Sanctuary of Our Lady of Lourdes has supposedly healed dozens of people, and handles millions of pilgrims. It turned a sleepy town to a religious tourist spot.

Lourdes shows us another side – the link between healing and religion. AD&D grokked this quite well, with clerics being the walking first aid kit, even if they made the clerics the second-best fighters in the class spectrum (and what’s the deal with “can’t use weapons that shed blood,” as if hitting someone with a 15 pound pointy metal club is just going to tickle, but I digress). However, faith healers are also in our zeitgeist. They’re also in our history, although with the existence of magic, you’ll also see a lot of fake healers as well. For example, in the 16th century, “I have observed marvelous strange matters done by some of the Mountebanks. For I saw one of them hold a viper in his hand, and play with his sting a quarter of an hour together, and yet receive no hurt; though another man should have been presently stung to death with it.” (Thomas Coryate). Again, desperation breeds belief, and in a world where anything is possible through magic, then, well, anything is possible.

But the fake healers are overshadowed by the real deal. There seems to be a universal theme of doctors, barbers, and physicians helping people, even people who don’t necessarily deserve the help (or health). Maybe it’s because of the modern take on doctors’ Hippocratic Oath, which if you think of it, isn’t that modern at all. Healers heal.

Finally, diseases can be a plot device itself. Lycanthrope and vampirism are magical diseases in of themselves. Some think that the stories came from the classic symptoms of Porphyria cutanea tarda. A more technical viewpoint is from GURPS Technomancer, with Magic-Resistance Deficiency Syndrome and Ambulatory Necrotic Plague (long live toxic zombies). Of course, any of these need to be resistant to the simple cure disease spell to be truly effective. And given the proliferation of said spells, would we see magic-resistant bacteria, similar to how modern day diseases can be resistant to antibodies?

Next on the list: a dance with Doctor Faust.

Spell Name: Resurrect Plot
Components: V, S, M
Casting time: 1 hour
Duration: Permanent
Range: 1 gaming table
Description: Enables caster to take an old nemesis, situation, or storyline and re-use it. Players get a Save vs. Will to recognize the plot.
Material component: a Piers Anthony or David Eddings book.