Gotta Get That Healing

Part 4 of Series "Medicine, Malaise, Herbs & Healing" See Part 1, Part 2 and Part 3 for more goodies! If you've played a TTRPG for any length of time you are very familiar with the concept of magical healing. This can be a life saver when having back to back encounters, battling large numbers of enemies or after a really poor roll (Nat1s RIP me). But we don't often dive too deep under the surface of it or how it integrates with our worlds. At most we normally just determine its commonality or cost rather than its functionality. So for this post not only are we going to talk about magical healing taking on a magically corrupted disease, but we will also be looking under the hood to a game function we all have interacted with and look a little closer. As always though we start with the RAW house keeping. There are a few places that we can examine when talking about RAW for magical healing. The PHB Ch 9 - Damage & Healing and the DMG Ch 9 - Adventuring Options. Pretty straight forward so far but lets break it down anyways cause that's what we do here. From our good old Player's Handbook we have -

Rest can restore a creature's hit points (as explained in chapter 8), and magical methods such as a cure wounds spell or a potion of healing can remove damage in an instant. When a creature receives healing of any kind, hit points regained are added to its current hit points. A creature's hit points can't exceed its hit point maximum, so any hit points regained in excess of this number are lost. For example, a druid grants a ranger 8 hit points of healing. If the ranger has 14 current hit points and has a hit point maximum of 20, the ranger regains 6 hit points from the druid, not 8. A creature that has died can't regain hit points until magic such as the revivify spell has restored it to life.

So the damage done to your HP is instantly healed and reversed, but a grievous enough wound that leads to your death CAN'T be magically healed until an even higher magic brings you back to life first. When that happens it only plops you down back into the mortal plane at 1 HP. Here we see the separation of the concepts of HP damage, wounds, and life in the D&D verse. This has lead to some fun spin-off rules that DMs often use like injury charts. (Something we will talk more about specifically in a moment.) From our frequently used Dungeon Master's Guide we see the several possible additional rules we can use in our games in reference to healing, for now we really only need to look at two of them -

Healer’s Kit Dependency

A character can’t spend any Hit Dice after finishing a short rest until someone expends one use of a healer’s kit to bandage and treat the character’s wounds.

Slow Natural HealingCharacters don’t regain hit points at the end of a long rest. Instead, a character can spend Hit Dice to heal at the end of a long rest, just as with a short rest.

This optional rule prolongs the amount of time that characters need to recover from their wounds without the benefits of magical healing and works well for grittier, more realistic campaigns.

Within the provided RAW we see that healing can be alot more complicated and integrated then the hand-waving shablam healed moments we often have in our games. It makes the damage more impactful, it makes encounters more tense, and it gives the players a sense of urgency and need to stay alive. Personally I think it also encourages them not to become murder hobos and to approach situations in unique ways but that is a rant for another time. Especially with the Healer's Kit Dependency the RAW sets up healing to be a powerful thing that someone has to have skills and proficiency in, time spent learning and honing the craft, to really be impactful to the group. The Slaw Natural Healing opens up the possibility that even if healing might make you feel better n a second that the true impact of it can be extended over a time period rather then happening in an instant. We will be seeing alot of this in our discussions below. Housekeeping out the way lets talk about the first step on the path of deeper magical healing integration into our games. How does magical healing effect different things we see as damage in the game? I'm not talking just HP but wounds, injuries, sicknesses, curses etc. Magic doesn't interact with everything the same way or we wouldn't have Schools of Magic. So why would healing magic? The simple answer is it wouldn't. Different levels of healing magic would also interact with the damage taken to different degrees. A cure wounds would become more focused and heal things from an injury chart better and cleaner then a mass healing word. There are vaguely 30ish spells that we will consider to be healing (gained through a search on DnD Beyond for the healing spell tag), some of these don't only do healing like Vampiric Touch but they all do some magical healing. So how do we tackle such a list in deciding how they interact with our world? Well we can break down the damage taken in our world pretty simply: HP, injury, sickness, curse. For categories isn't so bad of a thing to look at. Healing HP doesn't have to be a big change, which will help ease your players into the rest of the changes. You can allow for HP to be healed as it normally would but any injuries, sicknesses, or curses to remain on the PC even after their HP has been restored. I've always thought of HP less as straight correspondence to health and more of a how a player is feeling. I guess technically if you want a direct correlation I think of it more like stamina. If you are out adventuring it might not matter that you are healthy if you run out of stamina there are so many things that can come along and easily off you. So take that as you will. For injuries we can pull in a little more mundane healing, minor magical healing and full on magical healing. A mundane healing that might be applied is a splint or wrap to keep the wound clean via a medicine check. Minor magical healing would include using your healer's kit to create a batch of herbs to apply to the wound to soothe pain and help the healing process. While a major magical healing would be a little bit more complicated. Personally I like adding the need for focus and time, so therefore concentration rolls. If I'm feeling especially saucy I might say that if their concentration is broken before the finish the healing that there is a percentile chance they make the injury worse. For all of you that have read my magically corrupted disease series thus far you know I am a huge fan of Tamora Pierce and her books. Which I mention because they are a great example of this style of healing we often see in fantasy books. This kind of healing requires concentration and focus because you are literally moving your magic through the target's body and willing their flesh, muscles, bones, and veins back together. As such it also requires medical knowledge, so a proficiency in medicine or at least a skill check in it. An example of this might be a Cleric casting Regenerate on the Barbarian who lost a hand in their last battle. If you don't stay focused or know how a hand functions it might not fully grow, be deformed and unusable, if you lose concentration it may only partially grow back with no way to finish or maybe it heals over the stump instead of bringing the hand back etc. Let's talk curses (I promise we will talk sickness and disease in a moment) cause these are an interesting creation of fantasy settings. The RAW that D&D has established has made it so that magical healing is really the only way to get rid of these. A great example is Mummy Rot (see both the Mummy and Mummy Lord monsters) a nasty little extra bit of goodness that you can get while fighting some undead.

If the target is a creature, it must succeed on a DC 16 Constitution saving throw or be cursed with mummy rot. The cursed target can't regain hit points, and its hit point maximum decreases by 10 (3d6) for every 24 hours that elapse. If the curse reduces the target's hit point maximum to 0, the target dies, and its body turns to dust. The curse lasts until removed by the remove curse spell or other magic.

Just take a moment to appreciate how truly terrifying that can be. If you just got done with an encounter, all spell slots are gone, you are still in a hostile zone and far from a safe haven of a town or city you could quickly lose a PC or two. Now Remove Curse is not a healing spell but the RAW does mention other magic that could remove the curse. You can choose to either in your game say that it is considered a healing magic, and you could in fact create several spells in that area if you wanted a campaign where curses and cursed object were aplenty. (It spawns ideas so if anyone is interested in me doing like a campaign primer post about a world like that leave a comment below!) But what about the other magic it references? Honestly that is extremely hard to find with a few simple google searches because Remove Curse dominates the conversation. We can assume as with most spells in D&D there is a potion version for those without a healer in the party. From our pool of healing spells we can look at Greater Restoration.

You imbue a creature you touch with positive energy to undo a debilitating effect. You can reduce the target's exhaustion level by one, or end one of the following effects on the target:

• One effect that charmed or petrified the target
• One curse, including the target's attunement to a cursed magic item
• Any reduction to one of the target's ability scores
• One effect reducing the target's hit point maximum

Which means there do exist magical healing spells that can help with curses already. If a campaign and world where they are going to be frequent in your game is your aim then I would suggest a dive into reading up on them and picking out the ones that will be relevant. For curses though I also suggest you add in the possibility that a magical healing may slow the effects of a curse but removing it may not be as simply as the PCs thought. Don't be afraid to homebrew some curses that take a stronger stance and are harder to knock out, or that have a chance to come back, then a mundane curse. Curses are magical so make sure they act like it. Now last but certainly not least considering our series topic, sickness and disease. Similar to curses these are things that effect our PCs and NPCs in the long term by wearing them down till there is nothing left of them and they die. Sickness does this in a more subtle way at the starts and then kicks it up to visible levels typically when its already to late to easily stop. As such you would first need to be able to even determine someone is sick to help out. We talked about that in the previous posts while creating our mad genius diseases. Diseases and magic could combine in an infinite number of ways so you would definitely need to know what exactly you were battling against to have a chance. Healing someone's HP wouldn't rid them of their problem though it may make them feel better and give a false sense that it is all taken care of. For normal diseases and sickness spells like Lesser and Greater Restoration, Heal... okay so less spells that directly effect diseases then I thought but that works for us. It makes the fact that a PC could help during an outbreak an even bigger deal as NPCs would be desperate for someone with the skill set who can help. These would also be the bases we would use when applying normal disease healing spells to our magically corrupted disease, which we will talk about a bit now and in more detail in the last installment of this series. We've broken down damage into four different types (HP, injury, sickness, and curse) and discussed how magically healing could effect each differently. But our big three (excluding HP damage in this discussion) have nuances within there type that could even further effect magical healing if we wanted it to. I'm talking severity, type and magical corruption. We could go a simplified route and only apply one to each so severity to injuries, type to curses, and magical corruption to sickness. Which would certain make it simpler and still add alot of depth to healing in your world. If that is the route you want to take then you only need to pay attention to what I say for those combinations. Should you want to be a McCrazyPants with me then buckle in cause we are turning our big three into a whole lot of possibilities. When I say severity the easiest thing to think about is an injury. A paper cut verse a slash across the torso. Both are still injuries but one is a lot more painful, alot more likely to be deadly, and cause alot more strife on the PC. To be clear I am saying this about the slash across the torso. (Though if you wanted the paper cut to get infected you could really screw over a PC before they know it because sepsis is a BIOTCH! Just ask my arm and my narrow avoidance of it at the end of my last trip home.) The less severe something is the easier it is to deal with, the quicker it can be all healed up, and the less the PCs have to worry about. This can be easily be applied across the board to sickness and curses just as easily. A cold vs the plague. Mummy rot vs a blood curse. We already have RAW for healing spells that have limitation its why we have both Lesser and Greater Restoration. Things have limits on what they can handle and the severity of what they can help with. Now with type you can kind of end up going a little too crazy with if you aren't careful. I try to limit it to 5 if possible, but sometimes you can't. (Please see the Schools of Magic and Monster types) Curses are really easy to break out into types that can then be determined to be handled in different ways. You have cursed items, blood curses, degrading curses (see Mummy Rot), curses from the gods, and eternal curses. Those types are all obviously best handled differently and with varying degrees of difficulty. A cursed item is easily detached from a PC with a Remove Curse, even if it doesn't break the curse on the object itself. A blood curse though like lyconthropy takes alot more effort to get rid of. With our cursed item section you can see how we can easily have nuance in the type itself depending on your PC's goals. Getting the cursed item off of the fellow player is easy but completely breaking the curse off of the object? Now that is campaign quest worthy. If you'd like to apply types to the others all you need to is break down how you want the PCs to interact with them. Use the intended interaction as your guide for type creation (said the cricket that clearly isn't named Jiminy). Magical corruption is the name of the game for this series when it comes to sicknesses. We have been all about releasing that mutated plague upon the world for the players to deal with. So we have talked at length about what that looks like and how its creation breaks down. Let's add some of that to injuries and curses, we will tackle the less complicated of the two first. Injuries with magical corruptions could honestly just as easily use our charts from magically corrupted diseases if they became infected. You could also base the magical corruption on what caused the injury. One from a werewolf would be different then an undead that would be different then an elemental. The werewolf might cause an corruption similar to the Crown of Madness. Undead may trigger rotting and easy corruption by necromatic command.  While an elemental could either cause the PC to start burning up from the inside (fire) or solidifying slowly out from the wound (earth). Curses is where the magical corruption could get complicated since most curses are already themselves magical in nature. It may be best to keep the confusion down to work off of similar rules to corrupted sickness and injuries. But if you are up for the task I suggest instead to really think about how a corruption by each of the Schools of Magic would change the function, to further the goal of whatever the intent of the curse is. Maybe a PC has a family blood curse because of a deal that was made to saved a loved one's life that becomes corrupted (thru nefarious intentions) with necromatic magic. This corruption brings back to life the members of the family when they die to serve as undead slaves to the being the made the deal with. You could make the magical corruption part of the creatures long term plans for the family and the blood curse. I'm sure this has all been alot for you and will probably take awhile to digest. It is alot to suddenly add to something alot of us handwave. Getting rid of the handwaving means more work on your the DMs plate which we all know is quickly filled up. But I think depending on the type of campaign you want to run really examining things like healing makes our worlds richer. It gives meaning to them, it integrates them throughout the game rather then relegating them to a single moment post an encounter. The work is worth the pay out because it brings more life to the world your PCs explore and lays out all sorts of story hooks for you to grab and run with. With that little rambling over with, I’m JustKay your regular DM Dalliance on the web and I’ll see you next post.