089 - Iatrogenic Gremlin

Unnatural Entity: Iatrogenic Gremlin

Healthcare costs rampantly inflated by a runaway insurance system, doctors influenced in their choice of prescription by “rebates” from the manufacturers and the additional expenses of unnecessary tests to be heaped onto the insurer, patients transferred or held on the basis of financial cost or benefit rather than medical need. Surrendering excess was once a form of securing future safety by entreating the protection and blessings of gods and spirits. Now done without that direction, medical sacrifice flows out of those universal furrows into the closest approximate shapes dreamed of by the people around them.

Created by perverse excess of healthcare working against its own purposes, iatrogenic gremlins are colony organisms that try to encourage the same foul maladaptation that spawned them. Requiring a significant wellspring of anguish to spawn they usually need the patient density of a poorly-run hospital to spring up, but there’s no limit to how far they can spread as long as they have something to eat. They live to consume the resulting pain caused by the negligent or financial hardship of misapplied medicine.

Iatrogenic gremlins are sneaky creatures. They can’t move or interact with the world when someone is looking at them (under scrutiny they look like giant dust bunnies or puddles of sludge unless they’ve just come out of someone or been injured) but wreak havoc when no one is watching. They meddle with charts, make phone calls pretending to be medical staff and patients and sabotage medication and instruments. They aren’t terribly bright so their mischief isn’t sophisticated, in many cases it has the opposite of the desired effect by driving patients away.

Working or being treated in a facility where one or more is active is disgusting, they leave slimy, little handprints (with four fingers) everywhere they go. With a tendency to move around via ventilation systems, most people think vermin problem before gribbly. People paying closer attention hear the phlegmy chuckling and the whispered schemes and threats echoing through the ducts. As entities created by inadvertent sacrifice you can bargain with the gremlins if you know how, give them opportunities to sicken new people and infest new places and they'll tell you all sorts of things. Mostly secrets about people’s medical conditions and finances, but that’s pretty handy among the folks gross enough to truck with them.

Iatrogenic Gremlin, Imp of the Perverse Incentive
Wound Threshold: Gremlins gain wound threshold based on the damage of medical negligence incentivised by money done to patients on a 1-to-1 basis. They start out at 10 but there’s no limit to how big they can get. More often they’re capped by a tendency to bud new gremlins. Damage one without destroying it and the remaining wound threshold splits evenly between two new, smaller gremlins and skitters away. Unfed, they lose 1d10 points per week.
Mischievous 50%: Substitutes for Secrecy, Substitutes for Lie, Substitutes for Notice.
Chronic 10-100%: Sometimes a gremlin will adopt a person and go home with them by crawling down their throat while they’re asleep. This identity is equal to the gremlin’s wound threshold, it can be rolled once per week or be divided up into chunks totalling its value for the same period. While inside their host they can flare up in inexplicable ways, a successful opposed roll against Fitness or Status causes temporary health or money troubles. Resulting damage, if any, adds to the gremlin’s wound threshold. If their wound threshold ends up exceeding the host’s, it purges itself of them violently and they squelch for the nearest hole or vent they can squeeze through. They look like a bunch of transparent amoeba or heavily magnified skin cells piled together when they do this.