The Consultation Room

Having looked at Emergency Departments in the previous article, we now close in to a somewhat more personal and intense space - the Consultation Room.

Now you're probably wondering just how exciting a consulting room can be, and why you should set your rpg scenes within the room rather than in a dungeon or on the city rooftops as is more traditional. The consulting room actually has a lot of storytelling potential, and can be an extremely evocative environment if used right.

We'll consider the features of a consulting room one by one, and discuss how they can be modified and used to enhance your rpg experience.

Face to Face

First, consider that a consulting room is a closed social environment where two or more people come face to face and must interact within the constraints of an implied social contract.

Does this sound familiar? It ought to, because RPGs have the same features! Roleplaying out a consultation can therefore have all the intensity of an actual consultation, with minimal need for description of actions. If you want to indicate that the doctor is sat back, busily scribbling on a clipboard as the player character enters, then you can act that part out yourself, studiously avoiding eye contact till you have finished what you're doing. If you want to get the character to lie back on a couch while you listen to their problems, then why not get the player to do that too? Its not quite LARP, but it slots into the middle of a traditional rpg session far more readily than more prop-intensive scenes.

Because of this face-to-face closed environment, it is much easier for you to evoke certain emotional responses. Going to the doctors makes a lot of people nervous, so you can capitalise on that to create feelings of claustrophobia and unease that can support the horror genre well. In a more action-based story you can use the consultation room as a place of safety, or as a metaphor for beign trapped. Consider Scorcese's The Departed, where Billy Costigan (Leo DiCaprio) and the counsellor Madolyn (Vera Farmiga) have their initial intense encounters. The consultation room is the only place where Billy Costigan can let his guard down and stop feeling scared for a moment. Because of the environment, and because of Madolyn's role, Costigan develops a sense of trust in her that will be his only lifeline later in the story. There's a certain bared honesty to be found in the consulting room - you need only compare it to the social masks worn in the Sullivan-Madolyn restaurant scenes elsewhere in the films to see the contrast.

Layout and Setting

Having established that the consultation room is all about the people in the centre of it, now consider how those people are arranged in their environment.

Modern medical thinking has the idea that there should be an open space between doctor and patient of a few feet, with the desk to one side for the doctor to work on and each facing the other at a slight angle, so it is familiar but not confrontational.

Despite this, there's still an element of power differential. You'll note that almost always the doctor has a nicer chair, and the examination couch is behind a curtain, under a bright light, where the doctor establishes his power and control by standing over the patient.

In older days, and in the consultation rooms of more old-school docs the desk will sit between the doctor and the patient. This forms a barrier, which modern-thinking decries as a bad thing as it shows that the patient is on one side and the doctor the other. In fact, in the 1950s, it wasn't uncommon for consultation rooms to have a small side room attached where the patient would undress before even entering to speak to the doctor! Imagine how vulnerable this would make you feel, and how much in power of the physician that would put you!

So when describing the consultation room, don't just think about what items are there. Also think about the furniture and how it's laid out, and describe these things to the players. You may be able to subtly direct their moods without them even realising.

Speciality

The speciality of the doctor will also affect consulting room contents, style and layout. An ENT doctor may have a magnifying loupe, laryngeal mirrors and otoscopes. A gastroenterologist may have a rigid sigmoidoscope kit in his room. A gynaecologist may have a medieval looking examination couch complete with leg stirrups and drawers full of probes and speculums.

A particularly interesting consulting room is that of the psychiatrist. A psychiatrist's room will not usually (in the UK at least) have a special couch to relax on as is often seen on the television. Psychiatrists prefer to sit themselves and their patients in comfortable chairs, but tend towards less clutter in their consult rooms than most clinicians. This is possibly because many keep offices separate from the consult rooms, and for the sake of good communication will not type at a computer while talking with a patient. Psychiatry consultations are much longer too (fifty minutes consult followed by a ten minute break is normal, compared to ten to fifteen minutes whole appointments for many specialities). Another psychiatrist tendency is to make sure that the clinician is set closer to the door than the patient, in case a quick escape is needed...

Of course, when running a game you can take a lot of liberties in set dressing, especially when realism is secondary to achieving a certain mood. Still, consider the layout, the paraphernalia and the furniture, and use these elements to focus the mood of the character interaction at the centre.

For example, consider the following: a classic D&D healer's temple, a Pardoner's Haunt in a Wraith game, a 1920s psychiatrists office in Call of Cthulu and a friendly Federation Sickbay from Star Trek. Decide the mood you want to create and decide how the NPCs are going to act. Move back and out, and think how the people within the room are going to be placed relative to each other, and what the furniture is, as well as where it lies. Imagine environment and lighting, and the room as a whole. Finally, decorate it with paraphernalia that supports the mood... Got it?

Now roleplay.

Next month, we'll finish off the Medical Environments theme with a look at the Operating Theatre and the Intensive Care Unit.

Till then, game more, take these tablets three times a day, and make an appointment to see me in four weeks, okay?