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4e has been out for two weeks now. So, what are your house rules? I don't have any, yet, but I have been toying with one. Here it is, for those gamers that want a grittier feel and for DMs who like to give players an incentive to avoid hitting negative hit points.

Inspired by Keith Baker's modeling of a long-term injury, like a broken arm, with the 4e disease system, here's something I'm tinkering with:

System Shock: Where Abstract Hit Points Yield Tangible Injuries
The 4e system assumes that a loss of hit points represents a glancing blow, a minor cut or bruise, or some other injury that a character can easily shrug off. Many DMs still describe blood-letting strikes and injuries, but the game pretty much gives you a free pass until you hit zero hit points.

Some players find this less than satisfying. That long, hard fight against a minotaur fades away as the players tick off a few healing surges and continue on. I built the following rules to give a little more sting to attacks that drop a PC. In addition, they add an element that I think makes tough fights more memorable and more important in the adventure.

The system shock rules give a chance that a PC suffers some lingering effects from being dropped to zero hit points. The rules as written confine those effects to the immediate encounter, but you could easily extend the effects' durations (or the length of a few of the effects) to last until the character takes one or more extended rests.

I went for effects that cleared quickly because I wanted to limit them to the immediate encounter. If I play with the rules, I might modify that based on how they work in play.

System Shock
When a character rises from below 0 hit points to back above that threshold, he must make a system shock check. This is a 1d20 roll + the character's Constitution modifier (remember, that does not include half-level, since it specifies Con modifier; this isn't a Con check). The DC of this check is 10. If the check fails, the character sustains an injury that might hamper him for the rest of the fight. Roll 1d10 and consult the table below:

1. Sprained Arm: -2 on attacks, checks, and all defenses including AC (save ends).
2. Arm Crippled: Right or left arm useless until after short rest.
3. Wrenched Knee: Immobilized (save ends).
4. Hamstrung: Slowed until after short rest.
5. Foot Smashed: Can't shift (save ends).
6. Bell Rung: Stunned (save ends).
7. Concussion: Dazed until after next short rest.
8. Gut Shot: Weakened (save ends).
9. Bleeding Wound: Ongoing 5 damage (save ends).
10. Cracked Rib: Vulnerable 2 against all attacks until after next short rest.

If an effect says "until after short rest" it means you suffer the drawback until you take a short rest.

So, what do you think? Would you use this as a DM? Would you be happy as a player if your DM used it?

I think adding in a penalty when you are bloodied is a good idea. It's a flag that something serious has happened, and makes a nod toward injuries you sustain that hurt, but don't drop you.

I'm not sure you want to cause characters to lose healing surges on a failed check. There's already a healing surge "charge" for dropping - spending surges to get back up. However, it would make for a much grittier game that really, really makes you pay for being dropped. I could see that working well for a game like Midnight.

The interesting thing, to me, is that you could take a system and make it work very different based on the timing. Charging multiple extended rests is a good way to model long term injuries. In Lord of the Rings, I could see the injury Frodo suffered at the hands of the Nazgul as something like that. You might even create skill challenges for overcoming such injuries, with the wounded character making Endurance checks and his caretakers using Heal, Arcana, and so forth.

By the same token, you could swap out extended rests for short rests, and so forth, and shift injuries from things that mess with you for one scene, a day of adventuring, or a long-term complication.

One of the things I've also toyed with is a little system for scars or injuries, stuff that gives a PC flavor and ties his appearance to his adventures. For instance, it might be kind of cool to have a dwarf barbarian who has no beard, because it was burned off when he fought and destroyed the Lich King.

OK, here's a first take for a scar system.

Any critical hit on a bloodied PC may produce a scar. This can either be left to DM discretion, or rolled. On a d20, a 1 indicates a potential scar. For every 10 points of damage above 10, add 1 to the range. So 50 points of damage gives a 5 in 20 chance of potential scarring. Otherwise, a DM may decide that a highly dramatic strike produces a potential scar.

If a potential scar results, the DM decides what is it and informs the player. The party must pass a skill challenge (or maybe just a skill check) to fix the wound before an extended rest is taken. I would rule that others must help the PC - no one can fix their own scar wounds. After an extended rest takes place, any unhealed potential scars are now permanent.

WotC Mearls wrote:

One of the things I've also toyed with is a little system for scars or injuries, stuff that gives a PC flavor and ties his appearance to his adventures. For instance, it might be kind of cool to have a dwarf barbarian who has no beard, because it was burned off when he fought and destroyed the Lich King.

A friend of mine and I have tried something similar, inspired in part by Jonathan's Tweets "You can always flee" rule. If the party decides to flee and your PC is unconscious or dead then it is assumed you were carried by the party but something bad happened to you during the fight. It can vary a lot from loss of equipment, to scarring, or the much more nebulous loss of prestige. I liked putting it on a chart and letting the dice decide he likes choosing based on the story.

Wow HP means something again!