This is RPG-ology #100: Plague, for March 2026.
Our thanks to Regis Pannier and the team at the Places to Go, People to Be French edition for locating a copy of this and a number of other lost Game Ideas Unlimited articles. This was originally Game Ideas Unlimited: Plague, and is reposted here with minor editing [bracketed].
It should be noted that the original publication of this article was in the early aughts, more than a decade prior to the appearance of COVID.
Wolfgang Amadeus Mozart may have died of trichinosis. So says infectious disease specialist Dr. Jan V. Hirschmann of Puget Sound Veterans Affairs Medical Center in Seattle, Washington. The cause of the great composer’s death has been a matter of speculation for centuries now, but this may settle it. The parasite was unknown at that time; no autopsy was performed which would have revealed it. All reported symptoms are consistent with this, including those which were thought to be evidence of a different disease process. There is an incubation period for the worm of about fifty days, and forty-four days prior to the beginning of symptoms he mentioned in a letter to his wife that he was about to go eat pork cutlets. In short, he died of a disease that was not diagnosed and little understood in that time; there was an epidemic in Vienna then which could have been more of the same.
Disease in most of our games is a sideline. Players get told that their character is sick, and so someone has to administer a magical cure (and even in our sci-fi games such cures are so miraculous as to be for practical purposes magical). He misses a day or two of adventuring, which passes in a few minutes because the other players just take the day off waiting for him. But disease in our world is and has been much more devastating than that, throughout history (and we have no reason to believe it will not continue to be so in the future). Decades ago in some film I saw a man stumble into a village of dead bodies, and immediately upon realizing where he was he pressed his hand into the fire, hoping to cleanse it of whatever it was that caused bubonic plague. Smallpox and influenza viruses have swept through the world multiple times, killing millions in their wakes. Polio killed and crippled uncounted people in the twentieth century alone–the century in which not one but two vaccines were developed to stop it. Tuberculosis spent most of the century fading out of existence, but solely due to sanitary standards; toward the end of the century there was some suggestion it was making a comeback, as public spitting became more common.
There is a college that prepares its professors each year with a statement of the nature of the world in which the incoming freshman lived. It is shocking to some of us to realize that those who are in school now never experienced the true fear that swept the nation under the acronym A.I.D.S. The very name says we don’t know what it is: Acquired Immune Deficiency Syndrome, in which Syndrome is a technical medical term which means “a collection of symptoms which are observed to occur together with no known cause”. (The correct name of the disease today is H.I.V., Human Immunodeficiency Virus, because we know the cause; the name A.I.D.S. holds on because of media preference.) There was this rapidly debilitating illness which was sweeping the world, and no one had any explanation for why. It was noted to be prevalent among the “H” people–homosexuals, heroin addicts, hemophiliacs, and Haitians–and no one knew why. There were a few cases which suggested it could expand outside this group, but no one knew why. Something was killing people, and threatening to kill far more people, and no one had any idea how to identify it, contain it, or stop it. It could very well move on to kill the rest of the world.
I don’t mean to minimize the danger of H.I.V. today. I know that many are still dying, and that there is no cure, and that a lot of people who were reasonably careful to avoid situations in which infection was likely managed to get infected anyway. But the very concepts of avoiding situations and being careful were completely alien to the world at that time. No one knew how you got it, or even what it was you were trying not to get. There was the disease itself, but even more deadly there was the terror of the disease.
That is missing from our games. We don’t have worlds in which people are dying from unknown causes, the doctors baffled and helpless, the characters worried for their own safety. We have games in which clerics pray for curatives which deliver the people instantly, or medics inject Wonder Drug which is guaranteed to stop whatever the problem might be. Certainly there is some difficulty with the idea that players would get sick and die; it’s not at all heroic to be slain by lockjaw from a cut you got shaving (as Thoreau’s brother was) or killed by a strep infection that blossomed into rheumatic fever or acute nephritis. But must they always get sick and live? Can they never face the possibility that this unknown infirmity that is spreading like wildfire might strike them down in the prime of youth? Let one of their number become infected, initiating a quest to find whatever might cure it. Let the village in which they have been staying become a quarantine zone or a graveyard, leaving them to attempt to solve the mystery.
Mozart wrote to his wife that he believed he was being poisoned, and this notion led to suspicion that rival composer Antonio Salieri was somehow behind his death. That is the nature of a real plague: no one knows what it is or how to stop it. No one is certain whether they have what everyone else has or something else (how would your characters react if they discovered that in the midst of a smallpox epidemic they contracted cowpox or chicken pox?). No one knows how to avoid getting sick or what to do if you are sick. Often diseases are carried by those who flee their homes and diseased families, unaware that they are already infected and cannot escape. Often social structures strain and collapse under the pressure. Disease is so much more than an inconvenience characters undergo periodically on a bad die roll.
[Next week, something different.]
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