Hurt, broken, sliced and torn – long term damage in RPGs or lack thereof


RPG combat wounds are boring (usually “lose hit points” which means either “nothing” or “you lost your last one, gg”) and unrealistic because most people short term don’t want their player agency impacted, and long-term don’t want to play crippled characters, or don’t want their character to die in their bed. Those who want to play crippled characters are ok with long term wounds, but the real consequences of wounds can be unfun even for them. And magical healing can either do nothing against these long-term consequences, or fix them at a leisurely speed and make them immaterial, as if they never happened.

I have a few examples here of scenarios that are totally realistic. Well, the first scenario happened to me.

Case 1 – Broken

Last year, while bouldering, I fell. From the proverbial 10′ up. Breathless, squirming on the ground for a minute, was overcome by the pain.

Then I got on my feet, shrugged it off and kept on climbing for hours.

That night the pain kept me awake quite a bit. Bad bruise.

And it kept on keeping me awake. Breathing was painful. Walking was painful. Getting dressed was so painful. Don’t get me started on putting on shoes. I was basically in pain all the time and severely impaired by it. Every movement, iincluding breathing, was hard or impossible.

Case 2 – Sliced

Andrea is a soldier, and gets bayonetted in the arm. Andrea manages to stab their opponent in the face, and survives. But who knows where that bayonette has been, and Andrea wound gets infected. The wound is septic, but the arm is perfectly usable. The army medic amputates the arm, because Andrea gets worse and worse and does not want to die. Andrea is now an armless war invalid.

Case 3 – Torn

Jools is a dragoon, currently busy in a mounted charge against a unit of musketmen. The crossbowmen shot them, and bullets bounce off her cuirass. As the charge connects, mayhem ensues as per use, and Jools somehow gets shot in the lower back. Nothing dramatic, as they manage to get back on their feet, win the battle and route the enemy, and the wound gets treated, but the wound is really deep and the bullet perforated bowels and Jools dies of sepsis a few days later.


The consequences of damage could be more varied. Your characters could end up in one of the three above scenarios: fine but later one of the following:

  • medium-term disabled
  • permanently disabled
  • totally dead

I have the above results in my critical hit tables. I had player characters suffer those outcomes.

Sometimes they had magical healing staving off long-term death: as if it never happened, because “you’re going to die in 3 days/be invalid from wounds surgery can’t fix” means nothing if you can get magic healing before the PC dies.

Some other times, people were left with no limbs or eyes, or bedridden because they had no access to magic or modern healing. Players abandoned their characters. Hell, once a player abandoned the campaign after their PC lost an eye playing with a black pudding. At level 2.

The Gamable Part – And lack thereof

There is no good gamable part in this post, sorry. I think it’s kind of useless. So instead you get a rubbish table.

Every time a pc gets a critical hit or they are dropped to zero (depending on the august Referee), roll 1d4 in secret on this following “Long Term Additional Damage Table” after the combat, and then roll a hidden save: if the save passes, nothing happens. If not, this is what happens:

  1. hurt. Nothing beside the wound itself
  2. broken. In 1d6 hours you’re borderline paralysed, or can’t use a limb (roll at random). Lasts for (3d6 drop highest) weeks.
  3. sliced. One of the wounds on your limb is festering. In 1d6 days, unless amputated, save or die.
  4. torn. Something went bad with that wound to your head/torso/abdomen. Sepsis is going to kill you in 2d4 days.

Magic healing fixes these problems.

Case 1 – Followup and reflection

I went to the hospital because after a month that bruise was still hurting a lot.

Turn out? I broke two ribs, and while I had scores of bike crashes and motorbike accidents (mostly because people driving cars only dodge pedestrians and cars) I never broke anything (I’m seriously not a frail person) so, what are the chances, right? I broke two ribs because when I fell on the security mat I connected with my elbow, and my ribcage banged on my elbow, and elbows are damn hard. Harder than ribs. My elbow was fine all the time.

This is the poster child of the argument, for me. I fell and took 1d6 damage. I was fine climbing until nightfall, then more or less useless at most physical stuff for a month. I could not dodge an attack. I had effectively 1 hit point for weeks, as was not in shape for dodging in melee, and pretty much any amount of shuggling would just make me bowl over.

Maybe the only good part about not dying the now on a critical hit is that you get to fight for a few more rounds and kill the opponent. So, you win, but you’re going to die anyway. Grim.