[Cross Posted from WOTC boards]
Right now, a long rest results in, "At you regain all your hit points and half of your Hit Dice (round up)."
This, for my group, completely breaks the believability line, and takes us entirely out of the adventure. Lingering injuries are a reality. It's not just from hacking off a limb too. Even a torn ACL in your foot [Edit - Knights who say KNEE!] can take months to heal, impairing your ability to move (much less run). And we're talking about a game where PCs get clawed, eaten, char-broiled, acidified, chopped, sliced, spiked, electrified, and all manner of scarily-nasty injuries.
As the rules are currently, there is simply no way to emulate any injury other than a relatively minor scratch that is good to go after a single night of sleeping, without a fairly major house rule (major in its variations from the norm as represented by the rules).
We can debate how much of hit points is represented by actual physical wounds, and how much by experience, luck, endurance, blessing from a deity, chaos, whatever. But, I think we can all agree that SOME portion of hit points is usually represented by a physical wound of some sort, and much of the DM's description of the hit involves describing the physical nature of the hit. Generally speaking, the larger a percentage of your hit points that you lose in a single blow, DMs tend to describe a more dire physical injury from that blow.
Given that some portion of hit points is physical wounds, it makes no sense that resting for 8 hours would automatically heal all your wounds all the time. Some wounds would linger, baring the use of magical healing or much more rest than a single nights sleep.
I am not looking for absolute simulation. I get that the game is intended to have a level of cinematic heroism to it. I don't want that torn ASL to be an issue. But I do want SOME mechanic for lingering injuries that can only heal with magic, or rest that involves a time frame longer than a simple nights sleep.
If published adventures are written assuming the party is at max hitpoints every day, that will drastically change things for parties using a house rule to alter this. It also changes the culture of D&D to expect full hit points on a more frequent basis than almost any version of the game thus far. D&D players across the world have certain shared experiences tying them together, and the difference between "we always start the day at maximum hit points without any magic helping us get there" and "we introduced a common house rule to bring the game more in line with almost every other version of D&D such that not all wounds will always heal with a night of rest" will be a fairly notable blow to those shared experiences. Adventure design will flow differently from the two approaches, which can impact the entire gaming experience.
I think the baseline assumption has to include something less than fully healed from a single nights sleep. Otherwise it alters the game all the way to the most extreme you can make the game as far as cinematics go - a cultural shift in expectations for players, and in published adventure design. All house rules, therefore, would have to be in only one direction. House rules that only occur in one direction are a sure sign that something was set at the wrong point on the scale. It's the least flexibility one can choose to set a baseline at.
I would really prefer a bit more simulation in this rule. Something that sets the baseline between "no healing" and "full healing" from a night of sleep, so that house rules can vary it in both directions as they see fit, and it's easier to adjust published adventures.
One possible example would be rolling your hit dice for healing. Or maximizing the healing from a nights rest at half your hit points. Or any of a dozen possible systems that at least have the potential to leave a more lasting wound represented by not being at max hit points after a single rest.
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