The game mechanics of pain

[ruleslawyer]

AuraSeer: That's only ONE way to look at it. It does not stipulate in the rules anything about "narrow misses" or "glancing blows." So please don't inclusively state that's what D&D isn't.

Actually, there's a ton of flavor text in the DMG to this effect, right above the section on specific damage options.

Some people play it as heroes who take far more punishment and wounds than any normal person could hope to sustain...much as these characters do other things that normal people can't hope to do. Besides, how else to you explain falling into lava, or down a 300 foot cliff?

I've never liked the Vitality/Wound type sytems of "Okay! You hit him...but you don't"

Well, if you need a system that allows "sensible" results from falling into lava or down 300-foot cliffs while also allowing competent fighters a chance to last through fights, then VP/WP is actually the way to go, since it's easy to specify under a VP/WP system that falling or traps inflict wound damage.

In any event, this brings me to my response. IMHO, introducing pain penalties into a game unless you're using the VP/WP system is adding a bit too much complexity and first-strike advantage to the game. After all, D&D is a heroic fantasy game, meaning that Conan-like characters who can virtually ignore pain that would cripple other people exist; so, in order to account for the macho factor, you have to allow some characters to be more pain-resistant than others. The only way to do this is to base pain penalties on Con bonuses, Fort saves, or max hp, meaning that you've introduced yet another element of complexity into the game. Also, something as specific as pain from wounds does not fit well into the very abstract hp system.

IMHO, if you're interested in incorporating pain into the game, you're best off going with VP/WP, which directly incorporates pain penalties (at least in the UA variant) as follows:

1) The first time an attack deals WP to a character, he is fatigued.

2) Any time a character takes WP damage, he must make a Fort save (DC 5 + number of wound points lost) or be stunned for 1d4 rounds.

I personally don't find it worth it to use VP/WP in my game (I use the Iron Heroes reserve point system instead), but it's not that hard to implement. The main PITA is revising monster stats, though you can do that as you use each monster.