Mind Flayer's Snack Time

Serious injury in D&D

In part one I discussed some of the "historical" game basis for the discontent with the healing mechanics of 4th Edition D&D. In this part I'm going to continue showing some of the historical background for the issue, and cover what can be done to "improve" those mechanics and make them "better".

Click here if you prefer your character to spend his time recuperating rather than kicking ass and taking names. (previous article)

As discussed previously 1e D&D had a very draconian recuperation mechanic, and any substantial healing was entirely left to magic. This made recuperation an issue that was entirely handled by the DM, as he was the source of any magical items, etc.

Third edition went in a similar direction but started to change the recuperation paradigm and eliminating the long wait times. First by removing the "penalties" of going into negative hit points (3.5 PHB p.145-146). Second by making natural healing, after stabilization, easier. Every day after an 8 hour rest you could naturally recover hit points equal to your level (3.5 PHB p. 146). Third by making magical healing extremely commonplace. Healing Potions and wands of cure light wounds were the healers kit of this edition. In reality what 3.x did was shift the burden of healing from a time resource into a financial one, or one of having the right class in your party (cleric/druid/bard). If you could afford the magic you had no penalties for getting whooped in combat, or the cleric could spend all of his spells after every rest to recover everyone. BTW, if you had no stabilization from outside forces you were pretty much guaranteed to die.

These solutions might seem to promote a more "realistic" game. Unfortunately, they are just as arbitrary as saying that you need to spend 10-60 minutes in a coma after getting to positive hit points, and a minimum of 7 adventuring days (a week) out of commission. The solutions in 3.x were put in place to make the game play "better". But "better" is a value judgement that can only be made by the players. Essentially they were put in place to keep the players playing, instead of wasting time recuperating.

Healing became a speed bump, and by 5th level not even a significant one. The only way to make recuperation times "realistic" was to restrict access to potions and "heal sticks". These resources were so cheap that not allowing them always seemed like a strained solution. Even though the paradigm was starting to shift you pretty much still needed a cleric in the party. As healing was mostly a divine caster exclusive ability.

Enter the Warlord
One of the significant changes brought forth by 4th edition was discarding the dependency on magic for healing. No longer was healing something that only the cleric could do or that could be only achieved by spending money on magical items. This change opened up an entire spectrum of classes that did not require magic to "heal" their comrades. However, the game did not go to the same lengths to decouple hit points from physical and metaphysical damage, which still created some problems.

One thing that 4th edition really pushed is the abstract nature of Hit Points, putting it at the forefront. The description in the PHB, still uses the "classic" definition of Hit Points, but the healing paradigm forces them to be almost completely abstract. Unsuccessfully, I might add or I wouldn't be writing this.

Where this becomes "problematic" is in the "healing" of the "physical" aspects of the "wounds". Do wounds all of a sudden close up because the Warlord gave you a pep talk? No of course not, but the problem is more in the narrative getting to the wound. We are still crowding the hit point "game space" with a dual purpose and it is still not working appropriately.

So what can be done?

Semantics
The problem is not what you say, but how you say it
Healing, healing, healing.... One of the problems stems from what WotC decided to call their "healing" mechanic.

Your DM narrative about wounds can be entirely clashing with the mechanics. If I describe the hit that took you down as one that ripped into your side and broke your ribs, it's kind of hard to get you to "heal" because the warlord said, "get up you bum, do you want to live forever?" This is where the pedantic in me comes out, remember when I mentioned that in 1e the recuperation time did not seem to take into account the "metaphysical" damage. In this case the warlord's inspiring words can be completely accounted for as "healing" your "metaphysical" hit points and since these all come from the same pool, there is no "real" dissonance except the one we want to make for ourselves. Your physical wounds are not being healed, you're just getting a shot of "chutzpah" to propel you to bigger and better things.

The real problem that causes a clash is the semantics of healing. If instead of Healing Surges they had decided to call them "Visceral Reserves", or "guts", or "candy-stripes" the majority of "suspension of disbelief" problems go away. Because "healing" has a language value that means restoring health, the "game terms" are colliding with the "language terms" and this creates a dissonance that is displeasing to some. Because if you got "hit" and there is no real physical damage, then what is there to "heal"?

It's only words
Because the semantics are causing the most heartache, let's try an example by changing a few things. Any mention of "Healing Surge" will be called a "Visceral Reserve", any mention of healing will be called a recovery or restore, and any mention of unconscious will be called "out of it" and you are simply drifting in and out of consciousness. We will also remove the "unaware of surrounding" from the unconscious condition. If you want to allow Magical Healing to be "different" then any mention of healing from magical means is not a RECOVERY but a HEALING keyword and remains just the same.

CONDITIONS
OUT OF IT (formerly unconscious)
While a creature is OUT OF IT, it is helpless and drifting in and out of consciousness, it can’t take actions, and it takes a -5 penalty to all defenses. It also can’t flank. When a creature is subjected to this condition, it falls prone, if possible. See also helpless and prone.

POSSIBLY DYING (formerly dying)
When your hit points drop to 0 or fewer, you are OUT OF IT, you are drifting in and out of consciousness and are POSSIBLY DYING. Any additional damage you take continues to reduce your current hit point total until your character dies.

Death Saving Throw
When you are POSSIBLY DYING, you need to make a saving throw at the end of your turn each round. The result of your saving throw determines how close you are to death.
Lower than 10: You slip one step closer to death. If you get this result three times before you take a rest, you die.
10–19: No change.
20 or higher: Spend a visceral reserve. When you do so, you are considered to have 0 hit points, and then your visceral reserve restores hit points as normal. You are no longer possibly dying, and you are conscious but still prone. If you roll 20 or higher but have no visceral reserves, your condition doesn’t change.

Death: When you take damage that reduces your current hit points to your bloodied value expressed as a negative number, your character dies.

POWERS
Inspiring Word
You call out to a wounded ally and offer inspiring words of courage and determination that invigorates your comrade.
Encounter (Special) RECOVERY, Martial
Effect: The target can spend a visceral reserve and regain 1d6 additional hit points.

Majestic Word
You utter words laden with preternatural inspiration, restoring your ally’s stamina and making wounds seem insignificant.
Encounter (Special) Arcane, RECOVERY
Effect: The target can spend a visceral reserve and regain additional hit points equal to your Charisma modifier. You also slide the target 1 square.

Healing Word
You utter a soothing word that mends wounds of the body and spirit.
Encounter (Special) HEALING
Effect: The target can spend a visceral reserve and regain 1d6 additional hit points.

ITEMS
Potion of RECOVERY (formerly potion of healing)
This simple potion draws on the body's natural RECOVERY ability to cure your wounds.
Power (RECOVERY) Consumable (Minor Action)
Drink this potion and spend a visceral reserve. Instead of the hit points you would normally regain, you regain 10 hit points.

By those very simple semantic changes the "healing" issues start to dissolve away. Because we are not calling it HEALING, which has somehow become a loaded word.

Don't get me wrong, as I've mentioned throughout, I understand where people are having a cow about healing surges. I don't particularly agree, but I understand the discontent.

In previous editions only MAGICAL healing would allow you to recuperate at an "accelerated" rate, but as I've already demonstrated 1e had a very "draconian" recovery. So much so, that I remember specifically doing away with those type of recovery times for my games. I found that having the heroes involved in the game seemed to be better than having them on bed rest. 3.x made it a game of finances. You could completely remove the challenge by simply using the cheap magic. 4e finally gave us something that does not REQUIRE magic and can work. Unfortunately it used the wrong words, and confused the issue.

Click here if you prefer your character to get kicked in the shins. (next article)