Physician, Heal Thyself!: Alternate Healing & Dying

In addition to a handful of options found in the Dungeon Master’s Guide, I made a small handful of ideas and options for grittier and darker D&D games where healing powers aren’t prominent and health is usually a concern.  Whether these are mixed and matched with your games is completely up to you.

NOTE:  This will make your game much more lethal.  More characters will likely die as a result of these house rules.

Sacred Healing:  In worlds overrun with wickedness, it truly takes a toll on the body.  In order to heal up to full HP after a long rest, you must be in a holy site; a temple, a sacred druid grove, a special divine landmark, etc.  Evil characters must seek desecrated and unholy lands.  If the character cannot find a location like this, they do not gain this benefit.

Comfort and Joy:  You may only spend hit dice if you’re resting in a comfortable environment.

Longer Rest Time, but not TOO long:  Short Rest is now 3 hours and Long Rest is 24 hours.  Under this module, you could use a day of downtime during the long rest.

Less Intense Long Rests:  You regain HP = your remaining hit dice + your level.  You regain hit dice after the end of your long rest.

Slower Healing Magic:  Healing magic and healing-related powers (like Lay On Hands) would have ritual casting time.  Higher level and more elaborate spells (like Raise Dead) take a couple of hours instead.

Bring on the Pain!:  Consult the “Death and Dismemberment Chart” for dying characters.

More Pain!:  Here’s my take on Death & Dying.  Roll from either of the following d10 tables when you’d normally roll death saving throw. Getting attacked requires you to roll again.
* Table 1:

  • 1 – REALLY Dead (You are dead but CANNOT be resurrected),
  • 2 – Dead (You are dead but can be resurrected)/
  • (Alternatively) 1 – 2 –  Just Dead (ignore resurrection related content),
  • 3 Almost Dead (Fail 2 Death Saving Throws),
  • 4 – 8 Dying (Fail 1 Death Saving Throw),
  • 9 Not Dead (Succeed Saving Throw),
  • 10 Miraculously Invigorated (Automatically Stabilized)

* Table 2 (alternate):

  • 1 – 2 – Death,
  • 3 – 4 – Almost Dead (2 Fails)
  • 5 – 7 – Dying (1 Fail)
  • 8 – 9 – Nothing Happens
  • 10 – Success (1 Success)

Death and Dying: Nightmare Mode:  You die at 0 Hit Points.

For rules like this and more, please check out the D&D 5th Edition Dungeon Master’s Guide.