Dungeons and Dragons and Medicine

In 1974, Gary Gygax and Dave Arneson introduced the world to Dungeons and Dragons, or D&D. Although inspired by miniature wargaming – games played with miniatures to represent various fighting factions – D&D shares as much with childhood games of pretend as it does wargames. Players are given templates to create their own characters, able to combine various species, classes, and skills to create a being that is uniquely theirs. Players roleplay as their characters as they encounter challenges orchestrated by the Dungeon Master, who serves as lead storyteller for these collaborative adventures. 

I was introduced to D&D in college, I spent the next decades world-building regularly with friends and family, sometimes as a player and sometimes as a Dungeon Master.  Although I no longer have a steady group to game with, I enjoy the occasional one-off campaign when someone chooses to break out their D&D handbook for an evening session at a conference. FYI the Association for Academic Psychiatry attendees often have a session going – keep an eye on your Whova app to see who’s organizing the session and when!) 

While D&D certainly helps me keep in touch with my creative side while socializing and building hilarious memories with friends – any habitual D&D player has a few stories to share – there are also some lessons to be learned about medicine from the game. Here are a few:  

1. Like D&D, medicine is a team sport.

D&D is designed to be played as a team. The social aspects are as much a part of the game as the fantastical creatures. Although there are solo variants of the game, playing as a team will net the most benefits, both within and outside of the game. Likewise, in medicine, patients will receive the most benefit from a skilled team.   

2. An interdisciplinary team is the most effective.

In D&D, a character’s class guides what they specialize in. Rogues are effective at picking locks and detecting traps; fighters are good at combat; clerics have special healing skills, et cetera. An ideal team has a balance of skills so that they can be prepared for any challenge. In medicine, we call this an interdisciplinary team, and it’s crucial to excellent patient care. As a physician, I may be the expert on diagnosis and medications, but I lack the ability to monitor a patient continuously like our technicians and nurses do, and I don’t have the level of awareness of social resources of a social worker. We need all of the team members to come together to plan effectively for a patient. Research shows that effective interdisciplinary teams have the best outcomes.  

3. Open communication is key to an effective team.

These interdisciplinary teams must communicate effectively to provide the most value, though. In D&D, this communication takes two forms: in-game communication and meta-communication. In-game communication is handled as though the player’s characters are speaking directly to each other. Meta-communication occurs when the player takes a step back from their character persona to communicate player-to-player.  This meta-communication can be important for taking stock of current resources or reorienting the team to the task at hand. In medicine, an effective interdisciplinary team  must be capable of open communication between members and must also display reflexivity, the ability to reflect as a group on the team’s goals and processes. Both types of communication are key to the team’s success. 

D&D teaches us that the team is our most important asset. Nurture your team, or else you may find yourself victim to the old D&D adage: 

“Beauty is in the eye of the beholder. Unfortunately, the rest of the party is in its stomach.” 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.