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You can defeat Malus Thorm in the House of Healing either by persuading him to submit to the nurses’ surgery or by fighting him. If you want the Non-Invasive Procedure achievement, choose combat: Malus must die before he performs surgery on a party member. A dialogue-only resolution does not count.
Choose your route before starting the encounter
Malus is an undead surgeon in the operating theatre of the House of Healing in Reithwin Town, Act Two. Four undead nurses accompany him. Approaching the theatre can start a conversation with ability checks; failed checks lead to combat.
| Route | What happens | Best fit |
|---|---|---|
| Talk Malus into surgery | The nurses kill Malus; this can resolve the encounter without a conventional fight. | You want a non-combat resolution and do not need the achievement. |
| Turn the nurses against one another | The nurses fight, after which Malus turns his attention to your party. | You want to reduce the number of active enemies but are prepared to fight Malus. |
| Fight Malus and the nurses | You defeat them in combat. | You want the Non-Invasive Procedure achievement or want to loot the nurses. |
How to defeat Malus through dialogue
Find the Sharran primer first
Before approaching the theatre, explore the rooms behind it and read Surgery and Physiology: A Sharran’s Primer. The book unlocks additional dialogue options listed at DC 18. The checks and DCs are game mechanics, not real-world statistics. The encounter reference lists the book and dialogue options.
Question the nurses’ ability, then offer Malus as their subject
In conversation, challenge the nurses’ skill with their blades. An Investigation check listed at DC 14 can establish that they need more training. From there, steer Malus toward volunteering as their subject. The listed routes include Persuasion at DC 21, or a book-unlocked Persuasion option at DC 18 that invokes sacrifice and mastery. Success ends with the nurses killing Malus.
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Alternatively, make the nurses practice on one another
You can persuade the nurses to turn their practice on each other. This removes some opposition, but does not end the encounter: Malus then attacks your party. Be ready for combat rather than treating this as a complete dialogue victory.
Exact options can vary with your character, what you have explored, and the conversation sequence. The listed DCs are useful guidance, not a guarantee for every build or game version.
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How to win the combat encounter
Control the nurses before they control your party
The nurses can stun or hold party members, leaving them vulnerable while Malus attacks. Prioritize disabling or defeating the assistants instead of sending every attack at Malus. Keep vulnerable characters out of easy reach while you manage the group.
Stop Malus from bringing a nurse back
Malus can reanimate a nurse, including using a nurse’s corpse, so removing an assistant may not keep her out of the fight. If you can immobilize or otherwise control Malus, doing so can limit his ability to restore a nurse. This is a tactical approach based on the enemies’ listed abilities, not a guaranteed outcome.
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Watch for Malus’s attacks and special actions
Malus can attack with claws and multiattack, and his listed bonus action reanimates a nurse. The combat reference also describes once-per-round legendary actions. Avoid leaving a character exposed to the nurses while ignoring Malus’s turn and ability to bring an ally back. See Malus Thorm’s combat reference for the listed abilities.
How to get the Non-Invasive Procedure achievement
Fight Malus and kill him before he performs surgery on a party member. Convincing him to submit to the nurses resolves the encounter without the required combat kill, so it will not earn this achievement. The achievement reference recommends eliminating the nurses first: they can stun or hold characters, and Malus may use a nurse’s corpse to revive her. The achievement reference lists the condition.
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Items and quest context
- Battered Lute: Malus carries the lute used in the “Wake Art Cullagh” quest thread.
- Karabasan’s Gift: The nurses carry this item; it can be looted or pickpocketed.
If you want the nurses’ items, plan to engage them rather than relying on a route that ends the encounter without fighting them. The House of Healing reference lists the nurses’ loot and the encounter’s location.
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