320 Healing

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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Sweet - thank you!

Here you go @GrinReaper


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Thank you sir.

Thanks to @sean and @Fafhrd for reading this one on the latest episode. I didn’t realize how good this is when I originally read it in the thread. I kept rewinding 10 sec. to capture all the details. This is brilliant! I started a file for all the Homebrew ideas I get from this forum and this idea is going right up there with no uncommon races! :+1:

I think that healing is a really personal thing that is dictated by past experience.

For me, I can’t stand how a character can potentially just spend an hour and regain all his HPs in 5E. I have a high tolerance for pain and a stab wound in the shoulder takes at least three days before you can do anything of value with that arm! And that’s with proper medical treatment!

(I wasn’t stabbed BTW. :smile: I have a heart birth defect so I have a pacemaker that needs to be changed every 7-12 years. I’m on my third. The operation is basically a 2 inch incision in the shoulder which is as close to a stab wound as you can get.)

Of course, I’m not looking for exact representation. But if I’m going to play a real human (or humanoid) just give me Indiana Jones / Aragorn toughness. Not Spider-Man super healing.

Also, I’d love to try a system where your fighting abilities diminish with the accumulation of wounds/exhaustion. This would create a real effect of suspense where a fight would become more and more difficult towards the end. (I know it exists, I just can’ remember where I’ve seen it)

On the other hand, it would drag fights out. Plus, if it was going to be fair, the monsters/NPCs would also have to be affected by this mechanic. And that’s most likely additional work for the DM who is already busy enough, IMO.


To clarify, RAW state that one hour of rest is a short rest, and the PC can only regain full HP with an 8 hr (long) rest.

While I’m sometimes not hip on that, I can see 1 hr of rest per HD they want to spend…

Thanks, @Judge_Mathieu! I can’t claim credit for this house rule (it’s from Into the Unknown), but I agree that it feels like a good way to add more gritty healing rules.

With regards to consequences: A couple of folks on the chat mentioned the idea of adding 1 level of exhaustion when a character drops to 0 HP. Possibly give them a chance to do a CON save first. That would add some tangible consequences, so may be worth experimenting with. I believe @huscarl may also be experimenting with some variation on this.

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We all know there are many, but two that come immediately to mind are Rolemaster, which probably provides the genesis of the now common term “death spiral,” and what I’ve been playing the most recently, Conan 2d20. In this latter, each Wound causes the Difficulty of physical tests to go up by one each (there is something commensurate for mental Trauma).

As far as it dragging out fights… I know we’ve hashed this to death, but an actual option for a PC is to try to run away or sue for peace. I recognize that this PC Action is less common in D&D, again because this approach is a form of “failure.”

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Hey @digitalhobbit,

Yes I have a “HOOS rule” below. I may amend it with your CON save suggestion. Since I implemented the rule only 6 hours of games time has elapsed, so I don’t have any feedback yet. I think that it adds a level of grit to 5e. The remaining HP thresholds are a little arbitrary and may be confusing, but I used the language that 5e uses to discuss going to ZERO HPs. I contemplated doing a percentage of Max HPs below ZERO, but some people have problems with math…

My HOOS Rule
Recovery and Healing & Dropping to 0 Hit Points
Level 1-4: no special rules
Level 5+: If a PC is rendered unconscious they will immediately suffer levels of exhaustion based on remaining hit points after being reduced to zero. See tables below.
Remaining Hit Points Effects 5th - 12th Levels
• 1-4 2 levels of exhaustion
• 5-9 3 levels of exhaustion
• 10+ 4 levels of exhaustion
Remaining Hit Points Effects 13th - 20th Levels
• 1-3 2 levels of exhaustion
• 4-6 3 levels of exhaustion
• 7-11 4 levels of exhaustion
• 12+ 5 levels of exhaustion

To recover levels of exhaustion you must complete a long rest to remove 1 level. To remove 2 levels takes 2 long rests, no more than 1 long rest can be done in a single 24 hour period.