USR Wednesdays: Health Variants

Hit points may be the most significant “mechanic” that roleplaying games introduced to the world of games. Before Dungeons & Dragons, game characters were either “up” or “down” (think of Pac-Man’s lives or even the one-hit armies of chess). And while there’s no exact agreement on precisely what hit points represent — Physical health? Willingness to keep fighting? Raw toughness? — there’s many ways to represent them.

Domino Writing-style USR calls for a lot of hit points: your character’s maximum Action stat plus maximum Wits stat (both physical and mental fortitude). Standard USR replaces maximums with a die roll from both stats, but the idea is the same. Here’s a few ideas to change the way health is used in your game. Note that most of these variants are best in a game with lots of combat, where the health amount will change repeatedly.

The original medusa.
The stunned condition at work.


This comes directly from the most recent editions of Dungeons & Dragons: other effects besides straight hit point loss; things like being stunned, poisoned, or even charmed. They lend themselves very well to simple effects in combat, or occasionally negative Specialisms. Here’s some of the most common:

Confused: Before the character starts his or her turn, roll a d6:

1-2 — the character can act normally

3-4 — the character loses his or her turn, babbling incoherently

5-6 — the character causes 1d6 damage to him or herself from shock, accidentally bumping into something, or for some other reason

Fascinated: The character stays in place, and takes no actions this turn. Any obvious threats to the character immediately end the fascination. This includes a magical charm like hypnosis or even seduction.

Frightened: More severe than shaken, the character suffers a -2 penalty on all appropriate die rolls until he or she gets away from what was frightening.

Poisoned: The character suffers a -1 penalty to all appropriate rolls until the poison is eliminated (by waiting it out or by taking an antidote). This can also represent disease.

Shaken: Less severe than frightened, the character suffers a -1 penalty on his or her next appropriate die roll.

Stunned: The character skips his or her next turn in combat. This can be extended to more than one turn to represent things like being tangled in vines or even frozen in ice.

Decreasing Dice

One of the “unrealistic” things about hit points, especially in older games, is how they don’t have an effect until the end. A hero with 50 hit points can fight just as well as one with 3 hit points — but they both keel over at 0 HP. A simple way to debilitate characters (and monsters) a little bit is by decreasing dice: Each time a character loses 10 hit points from the character’s maximum, they also decrease stat dice by one rank, from D12 to D10 to D8 to D6 to D4. This decrease goes away by one rank as the character heals.

For example, a hero with 22 hit points and an Action stat of D10 who falls to 12 hit points now has an Action stat of D8. At 2 hit points, his Action stat is D6. If he goes back to 3 hit points, it returns to a D8, and at 13 or more hit points, he’s back to his original D10 Action stat.

Usually this effect only applies to a single stat (say, Action if the character is attacked by a life-draining ghoul, or Ego if a character’s honor and status in society is completely obliterated).

This variant can also be used to represent serious injury. The D20 versions of the Star Wars Roleplaying game and the Palladium system games like “Rifts” use something like this, where serious damage has long-lasting effects. Hit points can be healed fully (or at least up to half the character’s original hit points) after every combat encounter, but serious wounds — as judged by the game master — result in a lower die for a stat, and stick around until an appropriate time in the story.


This comes from the Savage Worlds RPG: A character can heal back to full health at any time — as long as they narrate their recovery. It can be a scene where the character is sitting and talking about his or her past, and how it led to today. It can fill in the gaps in the narrative, explaining how something happened that the players haven’t yet heard about (think of a heist movie, where you get filled in on how part of the caper was pulled off after the action is over). The goal is to add more to the story and the world of the characters. The reward for the player is to heal back to full hit points.

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