The Houses of Healing: Minas Tirith

The primary public health service of Minas Tirith the Houses of Healing comprise a main building on the Sixth Tier of the city and several smaller buildings scattered throughout the lower tiers. The Houses of Healing oversee the certification and training of all Healers within the city of Minas Tirith and its surrounding lands as well as the training of all Healers and Surgeons who serve in the army of Gondor.

The Houses are paid for with money taken in from the city and large endowments from the Noble Houses. While all treatment is free donations are recommended following treatment.

Some noble houses will elect to contribute to the Houses by providing a child and paying attendant costs for their training and upkeep throughout their lives. These healers are typically groomed for leadership positions from a young age and for the most part the Masters and Wardens of the Houses of Healing come from the nobility or established families.

Wards

The Houses of Healing make use of a simple ward structure which varies depending on whether the city is at peace or at war.

At peace the main House is divided into four wards: Physical Accidents, Disease, separate enclosed rooms for Captains of the army and members of the nobility, and a special ward for women. The Houses also maintain a vast storage of healing goods and a library of medical texts as well as scribes for the copying and development of new texts. Smaller buildings throughout the city serve more specialized purposes such as apothecaries, rest-houses, convalescent homes, or surgeries.

At war the Houses move to a triage system, with Upper and Lower Wards: Upper for severe cases likely to survive and the Lower for those unlikely to survive (these replace the disease and women's wards). There remain the Surgery and Captain's Rooms and the library is kept for recovering cases which require only some observation.

Leadership

The leadership structure of the Houses divides them into groups based on function. The houses are currently lead by Warden TorchĂșn but the overseeing of day-to-day functions is left to six Masters. Both men and women can serve as Masters but traditionally the Master of Surgery is almost always male and the Master of Midwives is always female.

Master of Apprentices: Curuden
Primarily responsible for organizing courses of education, examinations, and the intake of new physicians.

Master of Stores: Gallion
Responsible for storage, purchasing, and organization of the houses.

Master of Healers: Nestin
Responsible for the overseeing of all healers within the houses and the intake and examination of travelling healers to the area.

Master of Surgeons: Feladir
Responsible for the overseeing of all surgeons within the houses and the intake and examination of travelling surgeons to the area.

Master of Midwives: Fanriel
Responsible for the overseeing of all midwives within the houses and the intake and examination of travelling midwives.

Master of Apothecary: Nimanor
Responsible for all pharmacists and apothecaries in the city as well as the examination and certification thereof. Responsible for overseeing the physical structures of the apothecaries.

Processing Entry: Traditional
Typically aspiring healers enter the Houses between the ages of ten and fourteen. They serve as pages for a term of four years, learning the structure and rules of the Houses and take classes relating to general medicine. After the four year page term they serve apprenticeship terms of two to four years with an older healer in the field they have proven best suited for during their general education.

For midwives and pharmacists the two year term is more typical while healers and surgeons tend to serve a four year term, but all four groups can be given leave by their masters to examine after two years. The examinations comprise six parts related to diagnosis and treatment of the sick and comprise written, oral, and practical portions. These examinations are administered by the Master of Apprentices, the Master of the school they are examining in, and the person they served as an apprentice under (or another Master).

Upon passing the examination all full-members of the Houses are referred to as Healer and at some point are expected to swear a vow renouncing claim to all family titles. Most healers, especially women, also swear vows of chastity to ensure their focus remains predominantly on their work.

After their certification, established healers are permitted to set up practices of their own, serve in the army, or travel to client regions and strongholds to set up practice there. They receive a formal letter of introduction indicating that they are established and known.

Processing Entry: Visiting Healers
Legally within the city of Minas Tirith and its surrounding towns no person may refer to themselves as a Healer or practice any type of medicine without formal consent of the Houses of Healing. The process for this application varies on a case by case basis but typically takes six months. A practicing healer should have a letter of introduction from their teacher or some other indication that they have trained with an established and known healer.

A period of up to six months is observed wherein the aspirant is shadowed by an established healer and introduced to the running of the Houses and their practices. At any time the shadowing healer can declare the aspirant fit to stand for examination however if a letter of introduction cannot be produced or cannot be verified the shadowing period can be extended between six months and a year.

The aspirant sits the full examination or a portion thereof (at the discretion of their shadowing healer) and is then expected to serve a term of no less than five years in the city in exchange for the certification.

On the occasion a visiting healer does not wish to be certified they will be paired with an established healer and, though watched, be permitted to serve wherever they feel most capable.

Regulations on Healing
The Houses of Healing serves as the regulatory body of all Healers within the jurisdiction of Minas Tirith as well as the main regulatory entity of Healers in Gondor. In theory this means that all Healers within Gondor answer to the Houses in Minas Tirith, in practice regulatory groups with different rules exist regionally. Dol Amroth being particularly independent. The regulations below should be assumed to only be enforced within the immediate area of Minas Tirith.

The Houses keep a formal list of all certified Healers and, possessing a monopoly on the training and certification of these Healers, will prosecute anyone found to be practicing without certification.

In general the prosecution goes as follows:

A non-certified Healer will be brought up on charges at the local court at which point a representative of the Houses will come forward to serve as the official plaintiff in the case. The trials are typically short, consisting of a request for certification and then when that certification cannot be produced the trial moves on to sentencing.

In most cases the defendant will be required to pay a large fine in addition to turning over all profit made while treating patients. The defendant's equipment will also be turned over. In cases where the defendant has caused or contributed to a death of a patient the penalty might be death or exile depending on whether the defendant is a citizen or not.

Malpractice
Just as the Houses can sue to protect their monopoly on Healers, patients can sue either the House or individual Healers for malpractice. These suits can be incredibly varied and might relate to someone practicing without proper training (a midwife attempting to treat kidney stones), someone botching a surgery, or a misdiagnosis by a Healer.

These malpractice suits are handled like any other civil lawsuit and the Houses will either set the accused Healer as a defendant or else the Master of the particular school being accused.

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