Permanent Injuries and Prosthetics in Delta Green

The Surgery skill doesn’t get enough love in Delta Green so I wrote this house rule for it.

Permanent injuries can be prevented with a Surgery test. This must take place before minutes equal to the victim’s CON score have passed since they were reduced to 2 HP or less. Success prevents the victim from developing a permanent injury. A critical success also restores 1D4 HP. If the Surgery test fails, the victim rolls CONx5 as normal. A fumble imposes a -20% penalty.

Remember that permanent injuries don’t need to result in amputation. They merely have to be crippling enough to represent the -20% modifier or stat loss. Nerve damage is great for this (think of Dr. Strange), so are joint injuries.

You crash through the skylight and land hard on the atrium floor, ten meters down. You take 13 points of damage, shattering both your legs. When you wake up in the hospital’s recovery room, the doctor explains they saved your legs, but only after putting in enough pins and plates to set off every metal detector from here to Anchorage. You’ll never walk again without a cane.

For Agents who haven’t suffered a permanent injury yet, rather than describing the body part as being outright severed and their medic “sewing it back on,” try something like this instead:

Agent Fairfax has crush syndrome. Unless you can perform a fasciotomy right now, he’s going to lose his arm and there's nothing even the world’s best trauma surgeon can do about it.

If an Agent does lose a limb, they can be fitted with a prosthetic to negate some of the penalties. They’ll also need special training to use it properly, likely gained from a Home scene spent in physical therapy. A basic prosthetic is an Unusual Expense and only mitigates the -20% modifier to one skill. Further physical therapy can be undertaken during other Home scenes to mitigate the penalty to other skills (or stat tests). Fancier prosthetics count as Major Expenses and remove all penalties associated with the injury. A top-tier prosthetic (like Oscar Pistorius’ blade runner feet) is an Extreme Expense but provides a +20% bonus to one skill.

Agents will likely pay out of pocket, but at the Handler’s discretion, they can roll Bureaucracy or Criminology to treat the expense as one category lower. This represents falsifying the circumstances of their injury to make it look like it happened while on a legitimate job for their agency, pulling strings with academic contacts to get into a medical trial involving prosthetics, or something else along those lines. A critical success negates Bond point loss from Home scenes spent in physical therapy as the Agent secures paid leave. Fumbles may incur official review.

Handlers should also keep in mind many prosthetics are extremely fragile and could be destroyed if the Agent takes significant damage.