Doctor Orlan Fesk, the Kindly Knife

Level 6 Human Rogue (Thief)

Available with DM subscription
STR
8 (-1)
DEX
18 (+4)
CON
15 (+2)
INT
14 (+2)
WIS
12 (+1)
CHA
10

Defense

Armor Class 16 (studded leather + Dexterity)
Hit Points 45 (8 + 5ร—(5d8+2) + 2ร—6 (Con) = 43 at level 6 +2)
Speed 30 ft., swim 30 ft., climb 30 ft.

Proficiencies & Skills

Saving Throws dexterity, intelligence
Skills Stealth +7, Sleight of hand +7

Features

Plague Vial (Weeping Contagion)

custom villain resource Level 1
action or Bonus Action (via Fast Hands)

Fesk throws a sealed glass vial (range 20/60 ft., improvised weapon +4 to hit). On impact the vial shatters in a 10-foot-radius cloud of sweet-rotten vapor lasting 1 minute. Each creature that starts its turn in the cloud or enters it for the first time must make a DC 13 Constitution saving throw or be Poisoned for 1 minute and infected with the weeping plague (a magical disease; while diseased the target gains one level of exhaustion that can't be removed until the disease is cured). A poisoned creature repeats the save at the end of each of its turns, ending the poison on a success (the disease persists until cured by magic or Fesk's notes). Fesk carries 6 vials; the cloud is not blocked by glass โ€” only the Plague Doctor's Mask or a disease-warding effect protects the wearer fully.

Hypocritic Oath

custom villain resource Level 1
special

Fesk prefers captives to corpses. If reduced to 15 HP or fewer, he attempts to parley, offering the location of the sunken shrine in exchange for his life โ€” a lie. If captured alive instead, his coded ledger and notes can be used by Sister Neris to brew a partial cure for the weeping plague.

The Doctor Is In

custom villain resource Level 1
reaction, 1/round

When a creature Fesk can see within 30 feet fails a saving throw against his plague vials or poison, Fesk can make a DC 15 Wisdom (Medicine) check as a Reaction; on a success, that creature cannot repeat its saving throw this round โ€” he has judged the infection 'taking hold.'

Cunning Strike

class Level 5
special

When Fesk uses Sneak Attack, he can forgo up to 2d6 of it to impose an effect: Poison (1 poison damage die, target makes CON save DC 14 or is Poisoned until end of Fesk's next turn), Trip, or Withdraw (move 15 ft. after hitting without provoking).

Clinical Precision

custom villain resource Level 1

Fesk has studied anatomy for decades. His first weapon attack against any creature that has not yet taken damage in the combat deals an extra 7 (2d6) damage as he opens exactly the wrong vein. He narrates the procedure as he does it.

Cunning Action

class Level 2
bonus action

Fesk can take the Dash, Disengage, or Hide action as a Bonus Action. As a level 6 rogue he can also use this feature to make a Dexterity check as part of the Bonus Action (Cunning Strike options available).

Fast Hands

subclass Level 3
bonus action

As a Bonus Action, Fesk can Sleight-of-Hand, use thieves' tools, or take the Utilize or Magic action with an item. This is how he draws and hurls plague vials without spending his action economy.

Sneak Attack (3d6)

class Level 1

Once per turn, Fesk deals an extra 3d6 damage when he hits with a finesse weapon he has advantage on the attack roll with, or when a conscious enemy of the target is within 5 feet of it.

Alert

background (Criminal) Level 1

Fesk adds his proficiency bonus to Initiative rolls and can swap Initiative with a willing ally immediately after rolling. In the laboratory ambush, he always acts first.

Evasion

class Level 7

If Fesk is subjected to an effect that allows a Dexterity saving throw to take only half damage, he takes no damage on a success and half on a failure.

Expertise (Sleight of Hand, Stealth)

class Level 1

Fesk's proficiency bonus is doubled for Sleight of Hand and Stealth checks โ€” slipping vials into waterskins and vanishing into the temple row's fog.

Second-Story Work

subclass Level 3

Fesk's climb speed equals his walk speed, and he can jump double the normal distance when he moves in a straight line before the jump.

Skilled

feat (human origin feat) Level 1

Fesk gains proficiency in Medicine, Investigation, and Deception โ€” the tools of a physician who now practices on the city itself.

Uncanny Dodge

class Level 5
reaction

When an attacker Fesk can see hits him with an attack, he can use his Reaction to halve the attack's damage against him.

Behind the character

Character Information

Doctor Orlan Fesk is a tall, gaunt human in his late forties, all sharp angles and stillness, dressed in a stained long coat over a physician's waistcoat with a long-beaked plague mask pushed up onto his forehead. His face is deliberately unremarkable โ€” the kind of face that vanishes from memory โ€” but his pale, unblinking eyes hold the flat attention of a man cataloguing a specimen. His hands are immaculately clean, ink-stained at the fingertips from his ledger, while his apron bears blood he never bothers to hide; he considers stains on the cuffs a professional failing, not a moral one.

Across his chest hangs an oilskin bandolier of green-glass plague vials, each sealed with wax and labeled in his own tight cipher. At his hip rests a blackened surgical scalpel that has opened more veins than sutures.

Fesk speaks of death as a medical procedure: calm, precise, faintly regretful about complications. He narrates his killings as surgeries, keeps exhaustive notes on every victim, and refers to the plague he spreads as 'the treatment.' He lost his wife and daughter to the Grey Fever years ago, and the grief calcified into doctrine: the weak must be culled so the strong may be purified. He feels no cruelty, only clinical certainty, which makes him far more frightening than any sadist.

He prefers captives to corpses โ€” living subjects yield better data. He cannot be redeemed; the man who might have been died with his family, and what remains is the Kindly Knife, a physician who has decided the entire city is his ward and the plague his prescription.

Before the adventure

Character Background

Orlan Fesk was once the finest diagnostician in Nostramus, a temple-trained physician whose lectures on anatomy drew students from three cities. He lived modestly with his wife Cettine and daughter Wren in a crooked house above the temple row, and his only ambition was a chair at the physicians' guild. Then the Grey Fever came, riding a grain ship from the south, and Nostramus learned what a real plague was.

Fesk worked the wards for nineteen days without sleep, and he watched his own household sicken despite every precaution his science could devise. Cettine died on the eleventh day. Wren โ€” small, stubborn Wren โ€” fought for eleven more, and Fesk broke every rule of his profession trying experimental regimens on her, his own daughter his first unauthorized test subject. She died of the treatment, though he has spent fifteen years telling himself otherwise. When the fever burned out, the guild commended his 'dedication' and reassigned him to the poor ward. That was the day something finished breaking.

He spent years drifting through back-alley practice and grave-side dissection, chasing the question the guild would not ask: why do the weak die and the strong linger? His notes grew darker, his subjects less willing, until Corvane Ashgrove found him in a rented cellar over a corpse that had no business being opened. The Ratbound Bishop offered him what the guild never could โ€” purpose, a god-shaped framework for his arithmetic of survival, and eventually the ley-touched means to craft a plague no prayer could cure. Fesk did not embrace the Choir's faith; he tolerated it, the way a surgeon tolerates an assistant. His religion is the ledger.

Now he works from a hidden laboratory in the Crypt of Mercy beneath the Temple of Mercy, breeding the weeping plague by hand and infecting the dying one cot at a time, hidden inside the one place no one thinks to search. He walks the plague wards openly in his doctor's mask, welcomed as a savior by the families whose relatives he has marked. His cultist assistants handle the rough work; his scalpel handles the precise work; his vials handle the rest.

He keeps a coded ledger of every subject, every strain, every outcome โ€” a book that is simultaneously his masterpiece, his confession, and, if the right hands seize it, the seed of the cure that will undo him. Sister Neris, once his most gifted student, works fifty feet above his laboratory, and he considers her his unfinished experiment. He has buried his family twice now: once in earth, once in doctrine. The second burial holds.

Threads to follow

Unresolved Plots

  • Fesk's coded ledger contains a final page written in a cipher even Corvane cannot read, addressed to someone called 'the next doctor' โ€” Fesk has been grooming a replacement, and their identity is unknown even to Malchus.
  • Nine of the twelve 'chosen vessels' Corvane demanded are missing from the temple ward's death records entirely, meaning someone besides Fesk has been taking the dying โ€” and that someone knows his routes.
  • A vial of the refined strain was lost during the Tallow Yard trial, unaccounted for in Fesk's inventory; it is somewhere in the temple row, and its finder could weaponize the plague without Fesk's knowledge.
  • Fesk's daughter's grave was disturbed by someone before he began his exhumation โ€” the soil was turned by hands smaller than his, and he has not told Malchus.
  • Father Theron, the mad hermit of the sunken shrine, was the priest who administered last rites to Fesk's family, and he has begun dreaming of Fesk's face โ€” dreams the Choir's ley line may be amplifying into true visions.

Beneath the surface

Secrets

  • Fesk did not lose his family to the plague that killed them โ€” he was the one who brought the infection home on his instruments after an unauthorized autopsy, and his entire philosophy is a monument built over that guilt.
  • Fesk's daughter did not die of the Grey Fever; she died of the treatment Fesk himself administered in desperation, an experimental regimen he has since refined into the foundation of the weeping plague.
  • Fesk keeps a locket containing his family's portraits beneath the plague mask's chin strap, and he speaks to it every night before sleep โ€” the only ritual in his life he has not clinicalized, and the single detail that could humanize him to an observant party.

What haunts them

Fears

  • Dying of disease himself โ€” the one death his philosophy cannot reframe as procedure, and the reason he has never once drunk from an unsealed cup in fifteen years.
  • Being forgotten as a physician rather than remembered as a monster; his ledger's title page still bears his old medical credentials, crossed out but never inked over.
  • That Neris is right โ€” that his culling theory is not medicine but grief wearing a mask, and that the proof will arrive in someone else's handwriting.

What drives them

Aspirations

  • To complete the immunity serum and stand untouched in the center of his own plague cloud โ€” proof, to himself alone, that he has mastered the thing that mastered him.
  • To see the weeping plague written into medical history under his name, so that Nostramus's dying becomes his textbook's first chapter rather than an atrocity.
  • To make Neris understand โ€” not forgive, understand โ€” that everything he does is the medicine she was too gentle to prescribe.

Personal quest ยท 1

The Triage of the Tallow Yard

Fesk keeps a coded list of 'candidates' โ€” citizens he believes are too weak to survive his purification. The Tallow Yard has been designated his next testing ground, and his cultist assistants have begun seeding the corpse-staging district with weeping plague vials. Fesk must oversee the trial personally, recording infection rates and mortality curves in his ledger while his assistants herd the sick into the yard under the pretense of treatment.

He views this as his most important experiment: proof that his culling theory works on a district-wide scale. The party can interrupt the trial, but if Fesk completes his observations, he gains the data Corvane needs to time the airborne ritual precisely.

Current Stage

Fesk infiltrates the Tallow Yard at night, planting six vials in the water cisterns while his assistants mark doors with chalk crosses.

Choice
A temple nurse recognizes his gait and must be silenced or recruited.
Silencing her adds a name to Neris's ledger that draws suspicion; recruiting her gives Fesk a spy inside the Temple of Mercy ward.
Alternative
Fesk must choose between completing his observations or extracting his assistants when an Ash Watch patrol sweeps the yard.
Abandoning the data means Corvane questions his usefulness; abandoning his people means the cultists talk if captured.
Mechanical Rewards
  • Refined Strain: After completing the Tallow Yard trial, Fesk's Plague Vial save DC increases from 13 to 15 and the vapor radius grows to 15 feet.
  • Immunity Serum: If the blood-serum experiment succeeds, Fesk becomes immune to poison and disease, allowing him to walk unprotected through his own clouds.
  • Staff-Bound Potency: Accepting Corvane's essence adds +2d6 poison damage to all Fesk's plague effects but creates a fatal vulnerability to the staff's destruction.
  • Cultist Retinue: Successful quests can grant Fesk up to four additional Cultist assistants with improved loyalty and Plague-Masked Chanter training.
Narrative Rewards
  • Fesk's coded ledger expands with each quest, containing increasingly explicit proof of the Choir's plans that becomes more valuable to the party if seized.
  • Fesk's reputation in the temple row shifts from trusted physician to whispered horror, changing how NPCs react to descriptions of him.
  • Surviving Corvane's scrutiny solidifies Fesk's position as the Choir's plague-father, unlocking his presence in later acts as a recurring threat.

Personal quest ยท 2

The Blood Beneath the Stones

Long before the Ratbound Choir found him, Fesk buried his wife and daughter in a paupers' field outside walls that no longer exist on any map he can reach. The quarantine has sealed the graves inside Nostramus's expanded boundary, in a forgotten corner of the catacombs beneath the temple row. Fesk visits them in secret, and he has begun a terrible project: exhuming his daughter's remains to study how her body resisted the old plague for eleven days longer than his wife's.

He believes her blood held the key to natural immunity, and he intends to render it into a serum โ€” not to cure the city, but to make himself and the 'worthy' immune while everyone else drowns in sickness.

Current Stage

Fesk infiltrates the Tallow Yard at night, planting six vials in the water cisterns while his assistants mark doors with chalk crosses.

Choice
A temple nurse recognizes his gait and must be silenced or recruited.
Silencing her adds a name to Neris's ledger that draws suspicion; recruiting her gives Fesk a spy inside the Temple of Mercy ward.
Alternative
Fesk must choose between completing his observations or extracting his assistants when an Ash Watch patrol sweeps the yard.
Abandoning the data means Corvane questions his usefulness; abandoning his people means the cultists talk if captured.
Mechanical Rewards
  • Refined Strain: After completing the Tallow Yard trial, Fesk's Plague Vial save DC increases from 13 to 15 and the vapor radius grows to 15 feet.
  • Immunity Serum: If the blood-serum experiment succeeds, Fesk becomes immune to poison and disease, allowing him to walk unprotected through his own clouds.
  • Staff-Bound Potency: Accepting Corvane's essence adds +2d6 poison damage to all Fesk's plague effects but creates a fatal vulnerability to the staff's destruction.
  • Cultist Retinue: Successful quests can grant Fesk up to four additional Cultist assistants with improved loyalty and Plague-Masked Chanter training.
Narrative Rewards
  • Fesk's coded ledger expands with each quest, containing increasingly explicit proof of the Choir's plans that becomes more valuable to the party if seized.
  • Fesk's reputation in the temple row shifts from trusted physician to whispered horror, changing how NPCs react to descriptions of him.
  • Surviving Corvane's scrutiny solidifies Fesk's position as the Choir's plague-father, unlocking his presence in later acts as a recurring threat.

Major Decision

Context

Fesk's daughter's body resists decay in the crypt, showing an immunity trait he can harvest.

Choice Made
Harvest the immunity for his serum, or preserve the grave untouched.
Impact

Harvesting grants Fesk the Immunity Serum (immune to poison and disease, advantage on saves against his own plague) but desecrating the grave becomes a clue the party can trace. Preserving it keeps his humanity's last anchor intact: he gains no immunity but retains the Hypocritic Oath parley option at full sincerity, and his Medicine checks gain +2 from unbroken focus.

Major Decision

Context

Corvane offers Fesk a vial of the ratbone staff's essence to bind his work to the Choir's magic.

Choice Made
Accept the essence and become staff-bound, or refuse and remain an independent plague-father.
Impact

Accepting adds +2d6 poison damage to his vials and Clinical Precision, but destroying the ratbone staff deals him 30 psychic damage and disables The Doctor Is In for the encounter. Refusing keeps him unbound but Corvane withdraws his escort of chanter-priests, reducing Fesk's bodyguards by two in the Crypt of Mercy fight.

Major Decision

Context

Cornered at 15 HP or fewer, Fesk offers the sunken shrine's location for his life โ€” a lie he intends to escape from.

Choice Made
Fesk decides mid-parley whether the lie is worth the risk, based on how much the party already knows.
Impact

If the party seems ignorant, Fesk lies fully and escapes to the Plague Vault, returning in Act II with a refined strain (+1 vial, +1 save DC) and a personal grudge granting him advantage on his first attack against the party. If the party clearly knows too much, Fesk instead offers genuine information plus his coded ledger, trading his freedom for Neris's partial cure โ€” permanently losing his plague vials but gaining a bodyguard of two Crypt Wretches bound to his service.

Transformative Moment

Trigger

The party destroys his vial rack in the Crypt of Mercy

Transformation

Fesk abandons vials for direct infection, gaining a poisoned-scalpel attack that contracts the weeping plague on hit (DC 13 CON) and losing his ranged options.

Mechanical Changes

attack

Scalpel becomes +4 to hit, 1d4+4 piercing plus weeping plague on hit

Loss of ranged resources forces close-quarters adaptation

Transformative Moment

Trigger

Fesk witnesses Sister Neris curing one of his victims with his own stolen notes

Transformation

His clinical calm breaks for the first time; he becomes obsessed with Neris, gaining +3 to attacks against her but disadvantage on Insight against anyone impersonating her voice.

Mechanical Changes

targeting

Obsession: Fesk prioritizes attacking Neris or her protectors

Emotional rupture overrides tactical judgment

Transformative Moment

Trigger

Fesk's immunity serum succeeds

Transformation

He stops wearing the plague mask entirely, revealing his unremarkable face as a statement of godhood over disease; his Charisma-based intimidation improves but his disguise capability dies.

Mechanical Changes

identity

Immunity to poison/disease; loses ability to blend in as an ordinary physician

Physical transformation marks his ideological completion

Ally

Brother Malchus, the Masked Acolyte

Relationship ally
Influence 7/10
Loyalty 8/10

Shared History

Malchus was a novice physician at the Temple of Mercy twelve years ago, the youngest student in Fesk's anatomy lectures, and the only one who stayed when the Grey Fever took the ward. Fesk remembers him as the one pair of hands that did not shake while the dying screamed. When Fesk's family died and he vanished from the temple rolls, Malchus searched for him for two years, convinced his teacher had been killed by looters.

They reunited three weeks before the quarantine, when Malchus โ€” now hollowed out by watching the poor die untreated โ€” found Fesk's coded notes in a dead patient's effects and recognized the handwriting. He sought Fesk out not to arrest him but to join him. Malchus now serves as Fesk's chief assistant in the crypt laboratory, mixing vials, tending the caged specimens, and maintaining the fiction that the doctor still makes ward rounds.

Fesk trusts him with everything except the ledger's final pages, and he has begun teaching Malchus the refined strain's formula โ€” a transmission of knowledge that Fesk privately considers his only remaining act of parenthood.

Potential Breaking Points

  • If the party captures Malchus alive, he will trade the vial formulas for his life, and his testimony corroborates Neris's ledger.
  • If Fesk's serum succeeds, Malchus realizes he was never intended to receive it, and his loyalty can crack with a DC 15 Persuasion check.

Enemy

Sister Neris

Threat Level 6/10
Conflict Type ideological

Personal Stakes

Neris was Fesk's most gifted student before his fall โ€” a charity orphan he took into the ward at fourteen, taught to read fevers, and trusted with his keys. When his family died and his philosophy curdled, it was Neris who reported his unorthodox dissections to the temple elders, forcing his quiet expulsion years before the Choir ever found him. He has never forgiven her for choosing the institution over him; she has never forgiven herself for not reporting sooner, before the dissections became something worse.

Now they work fifty feet apart โ€” she above, tending the dying; he below, manufacturing the dying โ€” and each keeps a private file on the other. Neris's ledger of the dead is slowly becoming a map of Fesk's infections, and Fesk knows it. He has twice sent Scalpel Leeches through her quarters' drains as a warning she has not yet understood. For her part, Neris keeps a vial of the partial cure she is developing from his stolen notes, and she has sworn that if she ever confirms the Kindly Knife's identity, she will use her last dose on herself rather than let him bargain with it.

Fesk considers her his unfinished experiment: the one student whose weakness he cannot diagnose, and that uncertainty is the closest thing to fear he has felt since his family died.

Possible Resolutions

  • If the party seizes Fesk's ledger and gives it to Neris, she can complete the partial cure, permanently weakening Fesk's plague (save DC -2, disease curable by lesser restoration).
  • If Fesk captures Neris, he attempts to 're-educate' her in the crypt; a rescue mission becomes available with the Plague Doctor's Mask as reward.

Faction

The Ratbound Choir

Standing 5/10

Influence

Fesk joined the Ratbound Choir a year before the Weeping Sister sailed, when Corvane Ashgrove found him experimenting on grave-robbed corpses in a rented cellar and recognized a kindred purpose. Corvane offered what Fesk had lost: a framework in which his culling philosophy was not heresy but liturgy, and a staff that could make his plague something no prayer could touch. Fesk accepted, but on his own terms โ€” he refuses to wear the rat mask, insists his laboratory remain beneath consecrated ground where the temple's sanctity shields him from the Inquisitor, and answers only to the title 'Doctor.'

Within the Choir he occupies an uneasy position: indispensable, because the weeping plague's refinement is entirely his work, yet distrusted, because Mirelle Vantt whispers that a man who keeps notes keeps evidence, and Corvane's priests mutter that Fesk treats their god as a pathogen rather than a divinity. Fesk has survived two purges of 'insufficiently faithful' members by making himself too valuable to burn, and he keeps a coded contingency page in his ledger detailing how to collapse his own plague strains โ€” insurance that Corvane suspects exists but has never found. His standing currently sits at wary usefulness: one more failure, and the Bishop will decide the Choir no longer needs a physician.

Obligations

  • Fesk must deliver a refined strain demonstration before the ritual at the Sunken Shrine.
  • He owes Corvane twelve 'chosen vessels' โ€” living subjects for the ley-line ritual โ€” of which he has provided nine.
  • He is forbidden from infecting Choir members, a rule he tests weekly with trace exposures on Malchus.

Benefits

  • Access to the ley line beneath the shrine amplifies his plague magic when he works within a mile of it.
  • Choir couriers move his vials through the undercity faster than any legitimate route.
  • The Choir's priests can suppress one investigation into his laboratory per month through misdirection and bribed Watch informants.

Faction

The Ash Watch (infiltrated)

Standing 2/10

Influence

Fesk's criminal background left him with contacts among the Watch's payroll, and he has spent a year cultivating Quartermaster Bree's clerks and two checkpoint sergeants who wave his corpse carts through without inspection. His greatest infiltration asset is the quarantine itself: every body the Watch burns destroys evidence of his work, so the enforcement he despises is his best accomplice. He has recently identified Inquisitor Quill's spies inside the keep and begun feeding them curated misinformation โ€” false cultist sightings near the Harbor Kin's warehouses โ€” to keep the Inquisition's attention away from the temple row. If the party exposes his Watch contacts, Fesk loses his corpse-cart route and must risk the catacombs for specimen transport, slowing his operations by half.

Obligations

  • Monthly bribes totaling 40 gp from stolen temple alms keep two sergeants and a clerk compliant.
  • Fesk must provide Bree's clerk with 'clean' death certificates for his specimens' disappearances.

Benefits

  • Unimpeded movement of corpse carts between temple row and the Tallow Yard.
  • Advance warning of any Watch sweep of the temple district, giving him one scene's notice to hide evidence.

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