All of my players enjoy epic high fantasy but they also enjoy playing heroes that get knocked around a bit.  When describing their idea of a good campaign a word I frequently hear them use is “gritty”.  Adventures that bring the heroes right up to the edge of failure or have them overcoming tremendous odds seem to be the ones they enjoy most.  One of the things my players have requested from me to help them feel this “grittyness” is incorporating some sort of injury or wound mechanic in our Dungeons & Dragons campaign. 

Although I’m inherently “anti house-rule” I agreed to give their request some thought.  I started by asking the players what types of things made them feel gritty.  Some of the answers I received included:

• Being low on healing surges and unable to rest
• Racing against time / being under the gun
• No longer having any daily powers or daily magic item uses

One response in particular caught my attention.  The player of the party rogue said he felt that gritty feeling most when his character was suffering from a disease, in this case blinding sickness.  In particular he said he liked having a condition that was hanging over him and could become better or worse over the course of days, not turns.

I thought for a while on how D&D deals with diseases.  At their core diseases are simply conditions that weaken or inhibit a character and may improve or worsen over the course of days.  This seemed like the perfect model for an injury, something that could happen to a character and take a while to recover from.  With that in mind I set about creating “injuries” for my home campaign.  In essence this system simply expands on the Dungeons & Dragons definition of the word “disease” to include any condition which lingers with a character, including injuries. 

The Injury Mechanic

Our current play-test model for injury works as follows:

Step 1: After an encounter in which a character suffers a potential injury he makes a saving throw.  Like diseases, on a failed save the character becomes injured.  What constitutes a potential injury?  We are experimenting with the following:

• Whenever a character has been “dying” during the encounter he must make an injury save afterward.  If he failed a death save he has a -2 penalty to the injury save.  If he failed two death saves the penalty increases to -5.
• I’ve designed certain traps that may cause injury.  In one example a bear-style trap does less hit point damage but if a character takes damage from it he must make a saving throw to determine if he suffers a leg injury at the encounter’s end.
• We haven’t tried this yet but we are thinking about including possible injuries if a character suffered a critical hit during the encounter.

Regardless of what constituted the need for the injury save we simply keep track of what kind of attack did the damage that caused the character to be dying.  Currently we base this on damage type; acid, cold, fire, force, lightning, necrotic, poison, psychic, radiant, and thunder, or for untyped damage we base it on where the character was hit.  This is usually determined by whatever seems appropriate or the nature of the thing attacking. 

Step 2: Once a character suffers from an injury the process for either recovering or getting worse is exactly like the process used for diseases.  After each extended rest the character makes an Endurance check (or an ally can use a Heal check) to determine if the injury improves or worsens.  Where this differs from a disease is the DC’s for this check.  Instead of each kind of injury having its own DC’s and a “level of injury”, all injuries are based on the receiving character’s level.  My rationale is that once injured it no longer matters what level you are; a 2^nd level character’s broken arm is just as tough to recover from as a 15^th level character’s. 

Use the following chart to determine if the character’s injury improves, worsens, or maintains:

Level                Improve        Maintain         Worsen            

1^st – 3^rd              DC 15       DC 10             9 or less

4^th – 6^th              DC 17       DC 12             11 or less

7^th – 9^th              DC 19       DC 14             13 or less

10^th – 12^th          DC 21        DC 16             15 or less

13^th – 15^th          DC 23        DC 18             17 or less

16^th – 18^th          DC 25        DC 20             19 or less

19^th – 21^st           DC 27        DC 22             21 or less

22^nd – 24^th          DC 29        DC 24             23 or less

25^th – 27^th           DC 31        DC 26             25 or less

28^th – 30^th          DC 33         DC 28             27 or less

In the following examples I have listed the injury track from top to bottom, with the uppermost entry being Recovered (same as Cured for diseases) down to Wounded (same as Final Stage for a disease).  As a final note I also have redefined the Cure Disease ritual to include Curing injuries and wounds.

Sample Injuries

My home group is still experimenting with these and I would love feedback from anyone who tries it out in their home games.  Let me know what you think.