Mind Flayer's Snack Time

Serious injury in D&D

In part one I discussed some of the "historical" game basis for wound recuperation. Part two continued the discussion and how to make the healing surge mechanic more palatable for those that have issues with it. This article will cover how to actually sustain serious injury in 4th edition D&D. Several methods will be discussed to expand the "injury" design space of the game, and make recuperation times more "like the past". I say "like the past" because I hate the use of the word "realistic" to handle anything in a fantasy milieu, specially when the past didn't handle anything more "realistically" either. What I will discuss here is designed for long term campaign play and probably inappropriate for one-shot games or even short adventures, though it is easily incorporated.

A word of caution is appropriate here. There is a very good reason why the game was already moving away from long term recuperation. If you recall 1e had a very long recovery time. So long that most game tables were completely ignoring the "rules" for it. 3.x had moved away from any penalties and was already making long term injury a thing of the past, by making magic cheaply available. There are repercussions when you "fiddle" with the resources that a character will have to go adventuring. Those repercussions might inject more "realism" into your game but you will pay with less flexibility of outcomes. In addition, you will pay with more "paperwork". Each player or the DM will have to manage one or more resources to inject wounding into the game.

Pay me now, or pay me later
Healing surges are a daily resource that allows a player to manage the level of risk his character will take in a given day. In 1e and 3.x the resource was spells from the wizard or cleric, when you were running low on those you knew it was time to start looking for a campsite. In 4e the resources are healing surges and daily powers. Daily powers determine the amount of kick you will have in an encounter, healing surges determine if you will even survive the encounter.

As I mentioned in the first article, D&D has never had a death spiral mechanic per se. You are either combat ready (1+ hit points) and able to kick ass, or you are not (0 and lower hit points). There is never a penalty to your combat readiness if you were injured in the same fight, or even the previous fight. As long as you have at least one hit point you can kick ass. I'm not going to introduce a death spiral mechanic into the game, as I believe it really does not make the game any better, all it does is add more mechanics for the sake of mechanics. However, there are consequences to getting injured in fights. He who has the last hit point wins, and you can't do that indefinitely if you continually deplete your healing surges. A combat at the beginning of the day might be a piece of cake because you have all your resources. What would happen if you did not begin the day with your full complement of resources because you were injured the previous day? The adventures start taking a different challenge flavor when you already begin the day injured. Usually you can't go as long as you thought.

This is the challenge and danger of messing with the healing surge mechanic, your adventuring day can turn out to be very short indeed, but you are forewarned.

Kick them when they're up, kick them when they're down
Imagine if you will a combat that is hard fought, but inconsequential. Your group of adventurers dispatched the opposition handily and with little injury to themselves, no one was even dropped to bloodied value. In this case nothing changes. After an extended rest your group recovers all their healing surges as normal and life goes on.

The next combat doesn't go as smoothly as planned. Half your group is bloodied at some point during the combat, and your striker went down into negatives, not once but twice. This combat was definitely a challenge and you have the scars to account for it. After an extended rest your group recovers all their healing surges but your striker is having some aches and pains from the previous day. He is showing some signs of wear and has a chance of not recovering all his healing surges.

The next combat is brutal, you encounter a force that is much stronger than you initially thought, and their reinforcements caught you unawares. Your entire party was at least bloodied, the striker went down again, this time failing 2 death saves before being stabilized and the defender went down and failed one death save. The leader went down but was brought back before he failed any saves. After a well deserved extended rest your group is a little worse for wear. The defender does not recover one of his healing surges, the leader failed to recover one of his, and the striker does not recover 2 of his. It is very possible that today is a good day to head back to town.

What I've narratively described above is a system that I've used to simulate short term injuries attributed to aches and pains, etc. This "system" changes the availability of the healing surge from a Daily resource to an adventure resource, use with caution.

The system is rather simple but requires some paperwork overhead. The DM, or player will be keeping track of two additional resources Wounds, and Injuries. On any combat that a character goes into negative hit point territory he receives a wound. Wounds represent a chance of not recovering healing surges after the next extended rest. To determine if a character does not recover a healing surge, after the next extended rest, make a Hard DC Endurance check using the level of the encounter as a base target DC. For example, creatures in a 2nd level encounter drop a character into negative hit points once, but he does not fail any death saves. He receives one wound, and will have to make one DC 20 (hard 2nd level challenge DC) Endurance check, after his next extended rest, to not lose a surge. If he went down twice in the encounters but did not fail a save he will receive 2 wounds and would have to make 2 checks.

The endurance check can be assisted by up to 2 other characters that are trained in HEAL, the DM should also assign modifiers as he sees fit. +2 modifier for keeping a clean wound, -2 penalty for being in filth, etc. Get as creative as you'd like.

If on the other hand he fails a death save, he receives an Injury. Injuries represent a wound that cannot be recovered. The character will not recover as many healing surges as saves he failed (injuries received). Fail one, don't recover one. Fail two, don't recover two. Of course, if you fail three in a row without a rest you will be dead so usually you will only lose 2, but if you fail 2 in combat 1, and fail 1 in combat 3, you will not recover 3 healing surges.

One day of FULL REST (no activity) replenishes all lost healing surges due to wounds or injuries.

This can get brutal rather quickly because the longer you adventure the greater the chance of getting dropped.

You can modify the system to be easier or harder as you see fit. Change the DC to moderate rather than hard to make it easier. Increase the number of checks to make it harder. Only make a check when you fail saves instead of when you get dropped to negative HP to make it easier. Have everyone that goes bloodied make moderate checks to go harder. Increase the number of days of FULL REST needed to fully recover to make harder. Tweak the system until you are satisfied.

I've used this system twice and it worked well for the desired intent, but as I mentioned one of the side effects is that your adventuring day can get much shorter the longer the characters adventure. So I use it very sparingly now, limiting its use to major battles.

Why won't you die? - Austin Powers

Some sadistic bastards will also want to include a way of "simulating" long term injuries. This was handled completely by DM fiat in previous edition, which would still be my preferred method if I was to do something like this. Unfortunately some need rules for everything so here you go. Fortunately for you RBDMs, 4e introduced a very good mechanic to use in these cases, diseases.

The following system presents a way to represent long term injuries, such as broken limbs, dislocated shoulders, broken ribs, concussions and worse. I will present 3 entries and include a document you can use to expand this for your own sadistic campaign.

LONG TERM INJURY
When a creature is exposed to an Injury as described in the RBDM manual they risk a long term injury. Injuries of this type work exactly as diseases see DMG pg.49. One thing you might want to do is to have everyone cured after 4 weeks of rest. Why 4 weeks? Because that is what 1e did and I'd like my system to be at least as arbitrary as that one.

Example Long Term Injuries






Conclusion
I have presented in this series several ways to tweak the system to represent short term, and long term lasting injuries. Sometimes you want to pull the stops and go full hog with things like this, I'd advise against it. As a matter of fact I'd go very easy with any of this system. Even though you might want to challenge your characters, any system that inherently screws with the characters chances of defeating encounters will eventually become a drag on the game. Think carefully about the repercussions, long term injuries are simply designed to sideline the characters. I'm sure that most of your players would rather have their characters immersed in the action than spending time on bed rest.

LongTermInjuriesTemplate.zip