healing/regeneration and non-surgical bullet/arrow expulsion

[acrosome]

Originally Posted by Plane

I haven't really been able to find rules on how stuff like "there's a bullet in me" would impede healing, what kind of rolls you would use to try and remove things, and if there are any advantages which would just let your body be so good at healing that it pushes that stuff out without needing surgery. Anyone know?

In reality there usually isn't much reason to remove a bullet in and of itself. It's usually just a side-effect of fixing the injuries the bullet has caused. Or put another way, there is no need to remove the bullet, but there is a need to fix the hole it made in your colon...

I have left many bullets and shell fragments in people (until a couple of years ago I was heavily involved in trauma surgery in the Army) who have gone on to live quite happily. Ronald Reagan would have been better off if that little .22 slug had just been left where it was- it was basically only removed to make everyone involved look good.

So leaving a bullet or arrowhead in place won't necessarily impede healing at all, absent an infection or unless it is physically interfering with something like it's stuck in a joint or a tendon or such. This is probably more of a worry for arrowheads, which will probably be much dirtier than a bullet, and are likely to still have a shaft or part of a shaft attached. (You'd have to remove an impaling shaft, obviously, but for other reasons.) Bullets were more of an issue back in the days before antibiotics and when bullets were much larger and thus much more likely to track debris and clothing fragments into the wound with them- see the bullet extraction scene in the film Master and Commander. I'd model such things with a penalty on your roll to avoid infection, and then make the infection incurable until the arrow was removed. But moderns bullets, not commonly.

Mind you, I'm simplifying incredibly. I can of course come up with many situations in which I would/have had to remove all sorts of fragments from people. Larger fragments, in particular. The guy who had an RPG hit blow his rifle's stock and buffer spring into his back comes to mind...

But if I had a bullet in my liver, I would definitely prefer to leave it there. Taking it out would be infinitely more dangerous than ignoring it. Bullets and fragments in muscle, tendon, and other mechanical tissues sometimes get bothersome when they cause scarring and contraction (and thus pain or decreased function) and people will come to you wanting them removed, and that's not as much of an issue. If something like that hurts, I've generally been willing to remove them. But that's not a problem of immediate wound healing. Ones close to a neural structure can cause problems, too.

Anyway, in a modern campaign I wouldn't sweat bullets and fragments much, unless you needed it for some dramatic purpose. Just use the GURPS injury system for deciding if someone needs surgery. It's actually not a terrible system, as I have written elsewhere on this forum many times- see my sig below.