The next step, moving right along, is to get into all the ways the Leeches have specially developed to take advantage of the general populace and each other.
The first aspect of this is the Kiss-Up Lines. There are ten of these, of which only a couple will be available to you, depending on your Plan; only Midwiffs may choose freely, because they weren't bound through the strict discipline of medical school. You only get three lines to spread among these, which isn't much, but these are used to build your place within Leech society, and everyone has to start at the bottom.
The Kiss-Up Lines are:
Animosity: Subtle and blatant annoyances and hostile rumourmongering.
Auspice: A patron who looks out for you.
Celebrity: Being well known both within and without the profession.
Domicile: A fancy house can make a major impression on what people think.
Attitude: How cocky you can be despite your real station.
Obsequate: Working your way into others' good graces.
Patients: A pool of loyal patients.
Pretense: The art of deception and outright falsehood.
Partyin': Throwing parties everyone wants to go to.
Pharmacurgy: The skill of prescriptions; very arcane to most Leeches.
Don't forget to read up on your Plan before choosing, or you're likely to be sorely disappointed!
Secondly, are the Backrubs. These are mostly the little perks of being a Leech. There are ten of these, too, but you get almost twice as many lines for them - specifically, five. It's still not much, but deal with it. When you get your Killer Bee points, you can get more then.
The Backrubs are:
All-Lies: A certain freedom from medical school; your degree is fake.
Con Tracts: Involvement in the lucrative field of real estate.
Frame: A learned knack for blaming others when you goof.
Generosity: Contributions to the right charities can have real paybacks.
Nerd: You actually studied, rather than spending eight years in the frathouse.
Insurance: Can be vital, especially to the Malpractivans.
Genter: Knowing how to act with chivalry, making a good impression.
Remorses: You've found out some people's regrets...
Tee-Timers: Membership in a country club with a good golf course.
STATs: Ability to get things done -now-.
And finally, among the three Spur/Glues, you get seven lines to add, over and above the one with which they each start.
The Spur/Glues are what keeps your character going and holds you together; your base motivations in the field, as it were. These may be used in various circumstances to see if you can overcome the morals your parents tried to ingrain into you to do something that will further your personal ends instead.
The three Spur/Glues are:
Control Freak: Your desire to be in control of yourself and the situation at all times.
Unconscionable: The extent to which your morals didn't stick in the first place.
Incorrigible: Fundamental selfishness and ability to just not think of the consequences.
Note that these three also help determine your Hum-A-Ditty and Pill Power, so consider them carefully.
At the end here, we hit a few things that you don't get to decide for yourself, because that free will thing seemed to be getting a little redundant.
First is Pill Power. Every Leech carries around a small bottle of brightly colored pills, which can be used to control your character's actions, especially in times of stress. For example, you've just seen both your parents squashed by a limo. The owner gets out, and it's the mayor - who happens to be about to sign a bill that would give lots more money to one of your projects. Rather than bickering and arguing about who killed who, you pop a soft lavender "happy" pill and smooth the situation over, calmly asserting that hey, they were old anyway, you've been really looking forward to that nice china set you're pretty sure they left you in their will, as a doctor you can say confidently your dad's caffeine habit had him one leg in the grave as it was, etc.
In effect, whenever you want to do something that's a radical departure from the norm, just pop a pill and go with it - you'll even get a bonus of +1 to all LTs relating to the mood the pill induces for the duration of the `scene', though doing anything against it can be extremely difficult. Oh, yeah, and they work on other people too, if you can get 'em to take it...
Note that there are effectively two Pill Power ratings that need to be tracked; your maximum Pill Power, which is how many pills your little bottle can hold, and your current Pill Power, which is how many are in it at the moment. They start out the same, but, lo and behold, will gradually drift apart as you use Pills.
Regaining Pills can be difficult, if only because it's wildly illegal, but you can generally be assumed to restock between adventures. Increasing your bottle capacity is an actual character development thing, which I'll get to when I get to...actual character development things.
The second thing determined by your Spur/Glues is your Hum-A-Ditty, which is critical for determining how far you've descended into depravity. The further along on the Leech lifestyle you are, the higher your Hum-A-Ditty, representing your ability to relax, reflect on how well you're doing, and, well, hum a ditty. (You can sometimes gauge another Leech's rating by hanging around when he's distracted - most Leeches hum unconsciously, and the cheerfulness of the ditty is a pretty reliable indicator.) Your Control Freak and Unconscionable ratings combined equal your Hum-A-Ditty score.
Finally, determined simply by the role of a die (the usual ten sided sort, please, even if you have one of those hundred siders), is your Billfold. Usually carried in the shirt pocket, every Leech has a billfold, with a single, neatly folded hundred dollar bill for every point of Billfold. In a very real sense, this is the Leech's lifeblood. Unfortunately, a standard billfold can only hold up to ten bills; this is why Leeches don't waste them on anything smaller than a hundred.
These can be used to perform such superhuman feats as impressing starlets, getting into sold-out concerts, or not having a single point marked off your license when you're pulled over for driving a defective vehicle through a red light the wrong way down a one-way street while intoxicated with three underaged starlets and a yak in the back seat.
To utilize Billfold points, simply determine how many you wish to allocate to the endeavor, and roll that many dice against an LT determined by the Storytiller. If you succeed, congratulations! If you fail, well, sorry. If you Splortch...well, flashing that much money around unsavory sorts isn't ALWAYS that bright an idea, but hopefully you'll just wake up in an alley wishing you knew a Leech who could perform real first aid.
You can, of course, replenish or even increase your Billfold during play. Whenever you have the opportunity to Bill a patient for something, you can drain their bank account, directly taking up to three `points' on the spot. Many patients can be conned into more, being billable later on. If more than half of a person's total worth is taken in this way, their lifestyle is in serious danger. More than three-fourths gives them little chance to recover, as they become destitute, their insurance provider cuts them off, and they will probably die within a few years...this is considered wasteful by most Leeches, but fun by a few.
Animals, of course, are generally useless in this regard, but a veterinarian Leech can sometimes get up to an absolute maximum, including later billing, of five Billfold points from a loving owner. Lost and stolen credit cards are generally good for only one or two points before the owner calls it in. Note that you don't always even have to be in a hospital setting to bill people; you might get lucky, and see someone hit by a truck right in front of you. Just call out, "Everybody, stand back! I'm a doctor! You, check his pulse while I look in his wallet for, uh, ID."
Note too that Old Money can be a rich source for Billing. Indeed, some Old Money patients will pay in THOUSAND dollar bills, vastly increasing the total actual points the Leech can hold in his Billfold at one time. Such patients, however, are hard to come by and fiercely contested.
Now that everything has been basically decided, you can tweak it a bit with Killer Bee points.
Leeches have a tendency to poke around places they probably don't belong (like your abdomen), and at one time or another very likely annoyed a swarm of bees this way. As the bees fly out and sting, of course, your character swells up...a painful process, but you get a slightly bigger character out of it, and happily, you get to decide WHERE you get stung, and therefore, what swells. Isn't that swell? You get stung by fifteen bees; any more, and you'd go into anaphylactic shock. Each of these bees can be used to swell one part of your character...attriboats, liabilities, whatever. Except that some bits are tougher than others, so it takes more stings to build them up. You can add another line to your Kiss-Up Lines with seven stings, while it only takes five to build up an Attriboat. Liabilities and Spur/Glues are a bargain at just two stings per line, and you can finally put those Liabilities past Submarine now (because bees don't like to go underwater anyway). Finally, increasing your Backrubs, Pill power, or even Hum-A-Ditty can be done for just one point a pop, swelling right up. You DO have some baking soda handy, don't you?
Oh, and one tiny little last detail: Your Rice Cakes.
This is actually a nine-layer health cake. The first layer is Peachy, where you're fine. The second level is Whole Wheat, where you look a little rough but are actually quite good for you. Third is Rice, where you actually are a bit roughed up. Then comes White, which may look okay but isn't really that hot. Then comes Cake, where you're getting softened up and maybe losing some teeth. The sixth is a kind of Jello-Fruit Mix, definitely lumpy and jiggling. After that is a Cream-Filled, but with some pieces cut out already and definitely leaking. Eighth is Toasted, which looks pretty bad and IS that hot. And the final layer is what we call a Shotgun Wedding Cake, wherein you're dead.
Some of these layers will keep you from rolling some of your dice, as per the following handy-so-dandy easy-reference chart:
Peachy: Jus' fine.
Whole Wheat: Just looks a little rough
Rice: -1, Actually is a little rough
White: -1, Looks a bit soft
Cake: -2, Soft, maybe losing teeth
Jello-Fruit Mix: -2, definitely lumpy
Cream-Filled: -5, Leaking badly
Toasted: Can't actually do anything
Shotgun Wedding: Corpse
Left to be Gnawledgeable.
Right to check out the Ineffable Plans.