The Ward Acute Edition Review

Happy end-of-November everyone! Today I’m here with a game that I’ve been really enjoying lately and if you are celebrating a colonialist-but-family-oriented holiday this week (just hypothetically) you might want a quick and fun game to try. If that’s the case, I recommend you give The Ward a whirl.

Published by Magpie Games, The Ward is an “ashcan” product meaning that it’s released to establish the game and see what the response is before a company puts in more resources. Magpie Games has taken this route for a lot of their products including the excellent Pasión de las Pasiones which is getting the full-game treatment soon. Like Pasión, The Ward is a game about a very specific, very well-known TV genre but this time we’re going to the modern medical drama. Inspired by shows like Grey’s Anatomy, the older ER, the slightly off-kilter House, and even shows away from the big city like Virgin River. The theme here is, as the book tells us up front, “about life and death… and the stress of dealing with everything that happens in between.”

Image © Magpie Games

Mechanics-wise, this is a Powered by the Apocalypse game so we’re talking basic and special moves, playbooks, two d6 dice, etc. The ashcan version (officially the “Acute Care” edition) is available at DriveThruRPG for five dollars which is about ten cents a page; pretty good even before we get into how packed these pages are. This is an inexpensive option to pick up and try, so let’s dive in and see if this is a game for you!

Character Moves

As in all PbtA games, your narration as a player will trigger moves that you roll 2d6 for results. A 6 or under is a fail, a 7-9 is a success with some compromise, and a 10 or higher is a total success. In this game you also have pushes which are bonuses or penalties carried forward to the next roll (such as acting so confidently that your next social roll is boosted), as well as hold which you can keep and spend when you want (such as succeeding well enough that you have a good mood that might help later).  There are also questions which are like Clues in City of Mist or Hidden Knowledge in Invisible Sun, you spend one to get an answer although in The Ward this is mostly for emotional and personal truths. Some moves might offer Perks (rewards for PC-to-PC social moves) which can be spent for pushes or combined for bigger benefits

Your character also has a set of stats ranked -3 to +3 which describe what medical stuff and what dramatic stuff you’re good at: Brains (your intelligence), Guts (your willpower), Heart (your emotional strength), Nerve (your confidence), Reputation (what other people think of you), and various Connection scores (what you feel for someone) with PCs and NPCs in the story. Your Stress rating will tick up as the drama increases, giving you conditions after your first three Stress, your next two Stress after that, and then your sixth and final Stress after which you have a meltdown or something.

Image © Magpie Games

The basic moves available to every PC are act professionally (keep it together in the face of stress), display expertise (doing medical stuff like diagnosing or treating), feign competence (bluffing when you’re in over your head), show compassion or contempt (ask another character about what they’re feeling or how to gain leverage on them), stick your hand in (inserting yourself into someone else’s business, for better or worse), and assert your authority (badger someone into doing what you want).

Besides these are auxiliary moves which are for specific situations and might not ever come up. These are blow off steam (get rid of some stress by cutting lose) and sleep with someone (get rid of some stress or build Connection in the break room with no clothes on). They do different things mechanically so your character might actually have sex with someone but you’d roll a blow off steam because it’s meaningless.

Playbooks and Characters

There are four playbooks available in this edition (although presumably more in the full game) and they each describe a particular role in the hospital and on a medical drama show. The playbooks will dictate a lot of what you can do in the story but they are also very customizable so doubling-up (or more!) in a single play group probably won’t be an issue. For instance, each playbook has three tags to pick from when you select it and that slightly tweaks your stats from the other variations on that same role (which is how you get the serious doctor, the sarcastic doctor, etc). This being a heavy drama type of story there are also addictions that each character has: not necessarily a drug but just something they turn to when they’re stressed and need a quick release. You might be addicted to morphine or cigarettes but also to always being right or being the center of attention. Last of all you’ll pick some specialties which tell us what specific medical, social, or personal tasks you’re good at.

Image © Magpie Games

The first playbook is the intern, a recent medical school grad who is trying to find their place in this dramatic world. They might be a genius and top of their class, they might be new and truly out to sea, or they might be optimistic and presumably about to have their dreams dashed. In addition to their two specialties, the intern gets two bonuses to moves so they can gain push from being berated by other characters or feign competence very well as they fake it until they make it. Now I’m sad. They might also have an advisor, be especially idealistic and compassionate, or be book smart and ready to show off their knowledge.

Next is the nurse who (according to nurses I know) is the hardest-working, least-appreciated playbook. Never say this blog doesn’t take stances. The nurse could be cynical with the medical field, old with many years of experience, or optimistic and genuinely there to support others. They gain their two specialties and two extras or moves such as working a double shift to get more done, pushing incompetent characters out of the way, showing compassion to patients, more easily getting help from others, and just being tougher with a higher Guts.

After this is the resident who is a regular doctor with a full time position at the practice. They can be arrogant show-offs, new and just making a name for themselves, or young and full of passion. In addition to their two specialties, the resident can choose to use their white coat as a cloak of authority, tough it out when a patient dies, have a winning bedside manner, take up a hobby to blow off steam better, or easily advance their career.

Last up is the specialist who could be a surgeon, a pulmonologist, a cardiographer, a hematologist, or any number of other specific labs in a medical setting. These characters might be arrogant and really full of their specialty, genius and truly gifted, or old and with plenty of experience. They get two specialties and also an ability called focused which gives them a +2 push instead of +1 push for their specialties. In addition, the specialist gets to choose another bonus move to be top in their field with a high Reputation, really smart with a higher Brains, a truly dangerous or nasty vice to blow off steam extra well, or see through feign competence from others.

After each playbook is filled out, there are question prompts to build Connection with the other PCs. You choose any number from your playbook’s list and they give starting situations to kick off the drama such as another character already having it in for the intern or having the resident know that another character hasn’t felt well lately.

Image © Magpie Games

The MC’s Options

As the MC of The Ward, you’re going to be watching all of these characters work themselves into the ground and then heaping even more on them. It’s honestly really fun. There’s lots of advice on how to leverage addictions and Connections for players, what conditions to give as their Stress increases, and how to play out the medical, social, and personal “theaters” that the game involves. Each session can revolve around a list of principles that describe the common tropes of medical dramas and some framework advice for turning those into plots and ongoing stories.

You also have “moves” although they are not as detailed as the players’ moves. Honestly, this is the only part of the game where the “ashcan” status really hit me since the MC moves are just bullet points in a list. Most have a lot of drama inherent in them (“put a life in the balance,” “reveal immediate or dire complications,” and “turn their move back on them” to name a few) but others (like “change theaters” or “offer an opportunity, with or without a cost”) that are a little less clear. This is still totally workable, especially since you most often make these after a failed move by a player so it’s clear what the trigger is, but I’m most interested to see this section developed eventually.

Image © Magpie Games


This is a slim and fast product with a lot of game crammed into these 49 pages. If you like medical dramas then The Ward gives you some excellent tools for bringing those stories to your gaming table, and even if you don’t like medical dramas then the tools here will let you take the big swings that the genre boasts and lets you make them your own. I’m very interested to see this develop into a full game and if you’re looking for a way to kill time with friends rather than spend time with your family this week then consider checking out The Ward.

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