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Message: <blockquote data-quote="Ainamacar" data-source="post: 5600906" data-attributes="member: 70709">All this talk about healing surges and hit points (across multiple threads too) has really gotten me thinking.  I share some discontentment about hit points since they abstract serious physical wounds and a large number of other possible influences into the same pool.  I realize that not everyone in the thread feels this way, and I don't feel the need to argue about it.  In addition, I like healing surges as a gamist resource, but find them rather uncomfortable from a simulation perspective.  Finally, in heroic fantasy of the D&D type, in principle I like the idea of a wound/vitality system, but not one that has a treacherous death spiral or results in multiple wounds for every combatant after every encounter.  Keeping the game moving is key.My first thought was to adapt healing surges as a measure of actual physical damage, but then it struck me that I what I really want is a separation of truly grievous ailments (I will call them traumas) from any source (physical, mental, or spiritual) from minor ailments that can always be handwaved away quickly. Healing surges can stand in for the former, while hit points really excel at representing the latter.  Diseases and the like are also traumas, though not all traumas are so fiddly.Here is my random idea:Characters have surges, more or less as currently defined in 4e.  Maybe there should be different buckets for physical/mental/spiritual ailments, or at least contribution from different stats, but I think that is of secondary importance.Surges can be spent as normal to gain hit points, which represents healing minor cuts and bruises, morale boosts, luck, etc.Traumas are injuries that, until the trauma is removed, make one or more surges unavailable and usually have a secondary effect.  Healing a trauma requires appropriate time, care, and usually a check, but most of all requires expending additional healing surges equal to the number it makes unavailable, at least for combat healing.  In some cases the care is a spell, traditional medical care, or even a session with Dr. Bard, musician/psychiatrist (no relation to the archer).  The type of trauma (i.e. physical, mental, or spiritual) defines what kind of care is needed to remove it, perhaps reflected in a keyword.  So Healing Word would be good for most physical injuries without dismembering, Psychic Surgery for mental traumas, etc.  By decoupling serious injuries from lesser ones, I can buy the Warlord healing hit points and perhaps certain kinds of trauma much more readily.Traumas are generally dealt by a critical hit, or after any hit that leaves the target's hit points at 0 or less.  They may also, rarely, be the normal result of special attacks such as from disintegrate, dragon breath, or a Bodak's gaze (effect: if you die while under the influence of this trauma you join the Bodak club).  Come to think of it, a lot of undead creation and most poisons could be handled this way.  I admit, I'm not a fan of poison damage, although the Executioner poisons are a big improvement.Dieing is a function of having no surges remaining, but needing to spend one.  A character with 0 hit points is not unconscious, not until some threshold like negative surge value, at which point they are unconscious and dieing.  A failed death save causes the loss of a single surge.The type of trauma gained could be rolled on a chart, drawn from an appropriate deck, or defined specifically.  As long as they happen infrequently enough, and most traumas don't require tons of book-keeping, careful adventurers might make it quite a while before they are a serious impediment to an adventure.  And exactly this is possible, since spending a surge with a second wind, a Healing Word, whatever, still restores hit points.  Since even the weakest trauma (1 surge) removes a surge when it first applies, and takes another one to remove, the game progresses under the assumption that falling to 0 hp is still a really bad idea, and staying there will get deadly fast, whether the target is conscious or not.  As long as the party can keep a character with a trauma in the positive hit points there isn't an inevitable death spiral.A trauma might also create some interesting tactical decisions.  For example, suppose a character with 7 healing surges suffers a very serious 3-surge trauma that inflicts a very inconvenient penalty.  Now the character has 4 surges remaining, and the cleric must decide whether to heal him at the cost of 3 more surges.  Maybe, if its effect makes the character useless, but then he is left with only 1 surge remaining, which isn't much of a buffer.  Furthermore, if many or most traumas require a check to remove, for some traumas the risk of failure in the moment might be high.  I suppose it is also possible that a character with many, many traumas might survive but not have enough healing surges to actually remove any of them.  Such a character may need special care, like a spell that lets a healer spend healing surges for the target, a ritual, or just lots of rest.This seems pretty flexible as a framework, as all long-term injuries or ailments can be represented this way.   For example, with minor alterations this could be used to define a sanity system that automatically has some interaction with the rest of the game.  I also have a much easier time picturing them as the fundamental unit of health, which the hero happens to be able to spend to gain hit points to avoid something even worse.  It's burning the candle at both ends, and fundamentally exhausting despite the very temporary boost.  Perhaps I'm the only one, but from a flavor perspective I find it more plausible than hit points alone, or healing surges + hit points in vanilla 4e.Other ideas, just off the top of my head:1) Bloodied could mean there is a new (this encounter) trauma, or perhaps a trauma and the target has 0 hp or fewer.  Something besides half hit-points, though.  This would have some pretty significant balance effects, so perhaps not in 4e as we know it.2) Spend an action point to ignore the effect of a trauma for some period of time.3) Minions can't handle traumas.  They die, they go into shock, but they don't stick around.  They can still get a lucky crit, though, and lots of minions means lots of danger.  It could be a middle ground between 1 hp minions and standard monsters, for those that care.4) Regeneration could interact with traumas in fun ways.  You can definitely cut of a troll's arm, and then watch it come back.5) Some traumas become permanent (dismemberment) and eventually the healing surges come back as your body reaches a new normal, even though the limb is still gone.6) For people that want to make injuries more like disease (say an arm wound doesn't heal in time and becomes gangrenous) traumas make a good framework.  I wouldn't put that into the default system, though.7) Possible framework for results of called shots that isn't totally ad hoc.8) Tome of Forgotten Traumas is a hit splat book, found in every sketchy therapist's library.Maybe I've only reinvented the Wound/Vitality wheel, or have provided  evidence that I've suffered a mental trauma of my own? <img src="https://cdn.jsdelivr.net/joypixels/assets/8.0/png/unicode/64/1f642.png" class="smilie smilie--emoji" loading="lazy" width="64" height="64" alt=":)" title="Smile    :)"  data-smilie="1"data-shortname=":)" /></blockquote>

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