320 Healing

Agreed! No matter the game (Call of Cthulhu, D&D, Star Wars, etc.) once you name a thing it becomes understood - leave it to a description only and then people assign all sorts of abilities/worries/powers/fears with it :slight_smile:

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Count me in!
(Mostly because I’m a fan of the Knights of the Dinner Table cartoon.)


I never mentioned that this was an undead aboleth in my Avalon game, I just described it as a giant rotting fish with tentacles and three hollow eye sockets, but it came across pretty creepy in the moment.


Awesome!! I’m gonna have to steal this idea :slight_smile:
Do you have official stats for this somewhere?

It’s in the first Kobold Press Tome of Beasts, the Niheleth.

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Just finished listening to this episode. Great discussion!
I’ve been able to appreciate the different takes on healing implemented by the various systems I’ve played. As always, a lot of it comes down to the vibe you’re going for, and perhaps the genre you’re emulating.

I generally enjoy systems where harm results in lasting consequences that need time for recovery. I feel like Blades in the Dark and Fate both handle this very well, for example. In contrast, for a game that generally errs more on the simulationist side, D&D’s hit points pool can feel a bit silly at times. Everyone is at perfect fighting capacity until they hit 0 points (at which point death is on the table), and a long rest (at least in 5e) restores everyone back to full hit points. While I’m mostly ok with this abstraction, it means that characters are rarely encouraged to think of longer term consequences, which would force them to make smarter or more cautious decisions.

In my upcoming Hot Springs Island campaign, I’m going for a different vibe. Perhaps more gritty, but also less balanced, and with more meaningful long term consequences in general. So I decided to introduce some house rules around healing, which I mostly lifted from Into the Unknown (a fairly straightforward take on O5R; poorly edited but with some good ideas):

  1. Characters can only spend 1 HD on short rests (2 if they use a healing kit)
  2. Characters only regain 1 spent HD on long rests; they can spend as many HD as they like and roll these with advantage
  3. Failed Death Saving Throws don’t clear when stabilized; expending 1 HD also clears 1 failed Death Saving Throw

I feel like these house rules should perfectly support the vibe I’m going for. For example, characters should think twice about unnecessarily engaging in combat. Perhaps they’ll opt for a stealthy approach, use diplomacy, or find other ways to achieve their goals instead. Otherwise, they’ll have to spend significant days (especially at higher levels, when they have more HD) to recover, which in itself may be difficult or risky (do they have safe cover?) and may prompt interesting actions.

Of course, this might end up not working out at all, in which case we’ll tweak or abolish these rules as needed. Happy to report back in a few weeks. :slight_smile:


While this episode felt more like a discussion on damage, you can’t have one without the other (unless you’re in a madcap game where hit points only go down… hold on, writing that one down.)

My opinion on the role of either has changed a lot recently as I try to find new ways to bring that same level of tension you can get from watching your character’s life trickle downwards without the constant tracking that comes with constant combat scenes. I do very much like the combination of harm & complications in Fate and even some PbtA games where harm is just a series of check boxes or others (like Fudge) that use a stress or damage track to weigh the characters down over time.

I know hit points in many games are intended to be abstract, but it’s hard to reinterpret a great axe swung at someone in leather armour as being anything other than your rib cage chopped into kindling. So to imagine these characters getting constantly hacked and slashed over and over and over again only to be magically healed so they can get hacked up some more? That’s a deep level of Hell right there. I think I’d rather push that fucking boulder uphill for eternity, thank you very much.

Regardless of how damage and healing occur, I feel how harm of any kind should occur in a game is based on these three questions.

  1. Do I need/want all or most of these characters to survive to the end of the story? Or can anyone finish it?
  2. Do I want characters to be temporarily removed from a scene?
  3. Do I want to use harm as resource management or to create complications/obstacles in a scene?

The first two questions really help me determine what happens to these characters when they are subject to a successful attack roll. If I expect them to die or go down often and their survival to the very end doesn’t matter, slashy slashy! Otherwise, I want damage to reflect the pace of the story. Let them take harm, yes, but not every fight. In this case, games with hit points and healing spells tend to get hacked so characters can simply recover their own hit points. Healing is for dire situations, such as critical attacks.

The third question can apply in many outcomes and combinations, but I very much want to have some level of complications added to a fight scene to create a more dynamic fight scene. It can also depend on the players because if you have a group that will use something like @Fafhrd’s narrative bonus approach, they can easily be encouraged to make their own complications in exchange for bonus XP or a future +2 bonus after they remove their complication. But the first two questions do help me determine how I want to handle the third.

It’s a balancing act to help create the tone, theme, and spirit of what you want to play. These are things you can do without hacking a game by simply applying them narratively or you can strip that game for parts and build something new or new-ish. How damage and healing are applied helps to sell the goals you set for the game.

Now what’s this about team play I’m hearing so much about…? :stuck_out_tongue_winking_eye:

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Loved the ep!

I appreciated @Warden’s thought process on how to manage harming the PCs in the game.

The game’s rules about healing can lead in another directions, which I’ve used in systems where healing was not instantaneous. When healing is a skill check, that can lead to an interesting scene. It can be a complication in a fight or about performing a complex medical task, such as the party working together to heal someone else. I ran an encounter in Alternity which required the players to work together in a medical intervention to remove some mind control implants from an NPC they wanted to rescue. We even got the combat oriented person to use their “powered melee weapons” skill to direct the shocking probe which disabled the implants. It was a nice change of pace from the talking-sneaking-fighting pattern which had become the norm for challenges.

In a game where fast healing is not readily available, the complications of injuries could provide content for a whole game session. I had an Alternity game in which the diplomat was badly injured by an enemy laser, and since nobody had the appropriate medical gear or skills (like surgery and a portable surgery kit), the party had to help her limp around while ducking enemy patrols until they found an infirmary with an automated medical robot they could hack.

These kinds of things can make healing the spotlight rule for a while, without turning the whole game into the Grey’s Anatomy RPG.


I mean, if you want a Grey’s Anatomy RPG:


Oh, you didn’t mean the TV series.



That looks fabulous

I got to play it at a convention, and it was a lot of fun. My character was the underappreciated nurse.


One of the games I’ve been dabbling with for a while only provided healing when the party is at camp. To remove a wound, you have to share something personal about your character as part of a fireside chat. Loved ones back home, a lost sweetheart, your first car, etc. Little touches that turn these gritty warriors into people who will be missed when they’re dead.


Yay. I’m a character type.


That’s awesome, and very much like the leveling mechanic in The Black Hack. You have to carouse and share one or more stories about your PC’s past to hit that new level.

This topic was a weird one for me, because it seems pretty dialed in on just the D&D experience. I like all sorts of damage / healing systems, depending on what game I’m playing and what fiction or genre I’m trying to emulate. (Magic healing is frankly one of the things that drove me away from D&D, decades ago. I’m a low fantasy grunt at heart.)

Anyway, some of my favorites:

Barbarians of Lemuria has an excellent, fairly gritty system that models the hit points abstraction that D&D goes for in a more sensible way, IMHO:

  • Characters have a Lifeblood score of 10 + Str (0-3)
  • Weapons deal, on average, 1d6 damage. Armor reduces damage.
  • After a combat, participants can take a knee and recover up to half of the Lifeblood that they lost.
  • Each night of good rest, get back 1 Lifeblood
  • Death is at -5 Lifeblood, and if you’re below 0, you’re losing 1 per round. You’re dying, and this can only be prevented by your friends helping, the Gods intervening, or spending a Hero Point.

Into the Odd and it’s offspring (Electric Bastionland, Mausritter, etc.) have very cool mechanics where characters have relatively few HP… and where the “HP” actually means “Hit Protection” in the latest incarnations of those games. Once those are gone, damage goes straight to your STR attribute and you have to make a save to avoid a critical injury every time you take a hit. HPs return right after the battle, but it takes a long time to heal attribute damage. (A week, if memory serves.) So you have a buffer, then is gets serious, fast.

In general, I don’t think any system can touch Fate for realism, since ‘Consequences’ can model any kind of injury – mental, physical, social or spiritual, and it can take a long time to recover from these, depending of if they are Mild, Moderate, or Severe. Mild clears after one scene, Moderate after one session, Severe only after a milestone, which might mean “the whole adventure.” I also highly recommend the optional Extreme Consequences, which forever change the character (and one of their aspects). Basically, “you live, but…”

If you limit the conversation to D&D-styled play, I agree with Warden and a few others upthread – ask how do you want the game to feel? Dangerous but heoric fantasy vs. gritty OSR play vs. epic heroes bristling with healing magic who never need to worry about injuries. Very different styles, even within the same overall game.


I really like the mechanics that you describe in Into the Odd. Those are smart. Does AC factor into that system, too? Armor class + hit protection?

It surely does not, @Gabe !

Into the Odd and its more refined successor Electric Bastionland lean hard into speeding play, into allowing the PCs to do things without a roll if they are playing smartly, and in marking the rolls that do happen really matter.

There are really just two types of rolls – Saves, which are based off one of three stats and are intended to prevent something bad happening to you, and attacks… which are straight-up damage rolls based on the weapon you’re using. It’s usually a d6, a d8 or the like, but if you’re impaired for some reason, you have a d4. If your attack should be particularly effective, you roll a d12. The effectiveness of your attack is wholly determined in one go with your damage roll.

It takes some wrapping your head around, but it means combats are fast and dangerous. In play (I’ve played EB exactly once), I really liked it.

The other neat element that factors into the equation in EB is that the only way to increase your hit protection is to be reduced to exactly 0 HP. That gives your a ‘scar’ and you consult a table to find out what form it takes. Some of those entries actually add to your total HP… so you get tougher by surviving your wounds. Love it.


How do we sign up for the Eberron give away?

@sean and he’ll tell you!

That’s a game that is on my list to check out - might have to snag a PDF of it. I keep hearing interesting things whenever it comes up

It’s a goodie. If you dig swords and sorcery, definitely check it out. The Lemuria bit is optional – it’s very adaptable and does any type of S&S very well. You could easily connect it to Hyborian Age stuff pretty easily. There are fan hacks and such out there, including a very cool end-of-Norse-days campaign called Fjarrstrand. Page is here, PDF that uses BoL rules here.

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