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Message: <blockquote data-quote="Manbearcat" data-source="post: 6007554" data-attributes="member: 6696971">Absolutely.  However, I think you can accomplish a lot of this without too much house-ruling.  My standard game has a few specific changes such as + 1 damage/2 levels for all creatures/hazards (and an extra + 1/tier for single target attacks and traps/hazard abilities), etc built into it so all means of HP attrition is elevated and a significantly higher level of threat.  Beyond that, you can easily produce scenarios such as "Appalachian Trail Attrition", "Lost in the Forest/Jungle/Desert" (or exposure to any ruthless environmental conditions) by leveraging:  1)  Handling Fatigue/Exhaustion by way of Disease Track mechanics.2)  An Extended Very Difficult Skill Challenge where a failed check is extremely punitive (healing surges, gaining a condition such as "Fatigued, Exhausted, Disease", moving along in the "disease track" for any relevant condition).3)  Keep the heat on the characters with further non-sentient threats or hazards or the possibility of combat encounters with severely diminished resources.  This isn't something I would do all of the time, but I ran one of these over the course of 3 sessions and it was fantastic.  The tension at the table was palpable.  The "Environmental Exposure" condition that 2 of the 3 of them were perpetually suffering had them unable to take an extended rest and then unable to take a short rest.  After the 1st day, for much of the next two days, 2 of the 3 characters (we run with 3) had 0 healing surges and 0 encounter powers and no way to restore them.  Once their Dailies were spent, the fear was immense.  1 of the PCs improved on the condition track and thus got back their ability to take short rests (and thus regain encounter powers) on the third day.  However, both of them still had no healing surges and no Dailies for the final day.  All in all, all 3 characters spent an extraordinary amount of the 3 day period with 1/4 to 1/2 of total to 0 healing surges, no encounter powers and no daily powers.It was brutal.  2 failed High Difficulty Extended Skill Challenges and a barely achieved third (if they wouldn't have won the third, it would have almost assuredly have been a TPK).  A very, very easy way to "grimify" 4th edition.</blockquote>

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