You are not doing it wrong, but change it anyway: injuries and healing spells in D&D

I wrote this post yesterday, but for some reason, the auto-save function isn’t working, which means I had to write it – again.

Long story short, this is the second part of a well-received post I wrote a long time ago about how to interpret Hit Points in D&D (or similar games) in light of the literature that inspired it. The basic idea was that Hit Points shouldn’t be understood as an absolute value, at least if you want to “visualize” or describe what is happening when character lose hit points. By the way, this is not an esoteric interpretation because even the gamey 3.5 edition acknowledges that:

Hit points mean two things in the game world: the ability to take physical punishment and keep going, and the ability to turn a serious blow into a less serious one.


It’s just that it’s easy to forget it and hard to understand what that means (not that anyone truly knows.)

An ingenious counterargument to what I wrote in the original post is, “And what about healing, eh, eh?” Let’s accept that Damage is not an absolute value (i.e., 12 points of damage don’t necessarily imply twice the harm or injury than 6 points of damage*,) then why do we need spells like Cure Light, Moderate, Serious, or Critical Wounds?

*Obviously, using a gaming reference (and you are playing a game) it does imply that, but we are talking about description or narrative, not number-crunching play.

In a nutshell, the problem is this: If for the HP system to make sense (narratively speaking, that is) we have to believe they do not represent constant or objective wounds, what about healing spells? Why would a pathetic Cure Light Wounds heal a wretched peasant who suffered a lethal injury (e.g., 6 points of damage) and bring him back to perfect health condition but then, when trying to heal Ragnar Ragnarson, level 8 Fighter (52hp) from certain death, the same spell only brings her back to “barely alive”? For Ragnar, those six o eight healed points of damage were indeed “light,” but poor Cletus almost died from the same damage! Do we have to assume clerics can save an average man from certain death with a single spell but if they have to heal Batman the whole thing breaks down? Well, yes. The problem, however, is not the game, which works fairly well, but how do you explain what is happening.

First, remember that your character doesn’t know how many hit points* he or she has (or that the concept even exists, for that matter.) In fact, in “real-world” terms, what we understand as Hit Points would be explained as combat condition, fighting skill, survival instincts, or even Luck.

*Has anyone tried playing a game where players don’t know their Hit Points, only a general description of their health status?

Second, and most importantly, what hit points (and their loss) “mean” is not a function of their absolute value but of how many HP the character had in the first place, how many he has left, how many “base” hit points his race/species have (4-6 for a human,) and the order of the wounds. Let me give you an example:

A normal human has 1d4-1d6 Hit Points, and that’s where the 95% or more of humanity is. Anything above that line is an extra due to combat conditioning, experience, fate, or plot armor to delay the inevitable (i.e., death.) And when the hero’s hit (not “health”) points approach that human base-line (around 3-6 hit points,) it means that his luck is running out. To use a movie analogy, it’s the point when our suspension of disbelieve is near its end and we know the next hit is going to be fatal. The hero may not be critically wounded, but he certainly looks beaten and he is not in a state to withstand any extra damage. He probably looks like John McClane at the end of Die Hard.

Now, imagine the aforementioned Ragnar Ragnarson is fighting a dragon, and being the tough hero that he is, he has 52 hit points, or around 46-48 more than the average human. The dragon uses his breath attack and inflicts 49 points of damage. Now, you may think that’s a lot, and it’s true – for gaming purposes – but not necessarily from the point of view of Ragnar or the narrator of the story if this were a book. He has probably suffered some nasty burning injuries and may be rethinking his adventuring career, but nothing lethal or critical. He can still run, walk, jump, and fight well.

A normal person may die from 5 points of damage, but that doesn’t mean Ragnar has survived the burning equivalent of ten times that tissue damage. In fact, the injuries he has sustained are probably minor compared to the 5-6 points of damage that can kill a normal person.

Imagine that after being (almost) burned alive, a sneaky kobold stabs Ragnar in the back, dealing 4 points of damage. That’s not much and, in fact, it’s just a 1/12 of what the dragon inflicted, but if you saw that in a movie or you were reading that scene in a book, the lethal and worse injury would be THAT dagger wound, not the dragon’s attack. And if a doctor/cleric came and healed him, the first thing he would try to heal would be the knife wound since that’s the critical injury that almost killed him, not the first or second-degree burns from the dragon breath attack (which are ugly-looking, but not lethal.)

I know this is not easy to understand to people who have grown used to see Hit Points as “Health” points, so I’ll flip the example:

Imagine that Ragnar, with his 52 hp, it fighting a pathetic kobold. The creature hits him and inflicts 4 points of damage. In the previous example, that very same wound sent our hero to the Intensive Care Unit, but now it’s just a scratch. It’s obvious the description or interpretation of both injuries cannot be the same even if their absolute value is.

If now the same dragon came and torched our hero, dealing the same damage (49) the burning damage would be the critical and potentially deadly injury, not the first stabbing wound. And, again, if a doctor/cleric tried to heal him, the first thing he would heal would be the awful burning injuries (e.g., third-degree burns in the face, for example,) not the small knife laceration he had suffered before.

In short, for the “narrative” of the game (something that doesn’t concern the players and, in most cases, not even the DM,) the severity of a wound is a function of how close it brings the character to the 0 Hit Points line. The farther they are from that point, the less critical and grave the injuries are to the physical integrity of the character.

Keep in mind that this interpretation is the opposite of how the game (as a game) work, but here I’m not talking about rules but how to relate, in words and images, like in a movie or a short story, what those numbers mean. And remember that D&D was designed to translate, in a game setting, the feeling of those novels, movies, and stories. We know that 30 points of damage are, for gaming purposes, worse than 6,  but that’s because we see the genie behind the curtain and know how the game works.

And now, to the issue of healing spells.

It’s obvious that whoever named the healing spells had in mind a high-level character in perfect health, which is why the first level Cure Light Wounds spell is named like that although, for the average Joe, there is nothing “light” about being brought back from the brink of death and into perfect health. It’s only a “light” wound if you are playing a high-level character and these 1-9 points of damage are the first you lose. If you are bleeding to death from a severed aorta, there is nothing “light” about healing that wound. The solution to the apparent problem? Just change the name of the spell and remove any reference to wound severity. Assume that what makes the high-level spells more powerful is not that they heal worse injuries but more (or a greater damaged surface.)

Cure Light Wound -> Cure Injury I or Cure One Injury

Cure Moderate Wounds -> Cure Injury II or Cure Two Injuries

Cure Severe Wounds -> Cure Injury III or Cure a Shitload of Wounds


Why “one” or “two” injuries? Well, because on average that’s what you are healing. Most normal people can die from a single hit that sends them to 0 or negative hit points, and that’s what the spell is healing. It could be a broken skull, a perforated lung, a missing limb, or a severed artery, what matters is that it’s one deadly wound that, if left untreated, will kill the person.

That also applies to high-level characters who are on the brink of death – the first wound you are going to heal is the critical one no matter how the spell is named, and it’s the injury that any medic would try to heal first. The difference? That high-level characters also have many other lesser wounds on top of that, injuries whose severity diminishes as they move away from the last wound. In other words, not only does he have a broken skull, but also many lacerations, a contusion, a few nasty hematomas, three broken ribs, and a luxated joint. Apparently, polytrauma is the reward of being a high-level character.

That means that when a cleric is healing a high-level character, a Cure Critical Wounds spell isn’t necessarily healing critical damage or wounds that are objectively worse (as in, they look worse,) it’s just healing MORE wounds. The problem with the healing spells’ names is that they were named by someone who knew how the game works and was thinking in terms of hit points, forgetting that hit points are an abstraction of something else.

Using my interpretation, healing spells work like a repeated use of Laying Hands (literally since I imagine the cleric laying his hand on the wound) – first, heal this severed artery before the guy bleeds to death (the first 1d8 of damage,) then the broken leg (the second 1d8,) then two broken ribs (the third 1d8,) and finally these minor lacerations here and there (the last 1d8.)

And this is why a Cure Light Wounds will heal a common peasant (since the injury that almost killed him is probably just one plus minor stuff that will heal in a day from natural resting) but cannot bring a superhero to top-notch condition. Example: at the end of the Indiana Jones and The Last Crusade, Henry Jones is miraculously healed because he only had ONE important injury (a bullet wound,) but if he had looked like Anakin Skywalker after falling into the lava, he would have needed more than just a small cup of holy water to heal all that. Probably an entire bathtub.

Aaand that’s pretty much it for this post. In the next one I will give you more examples and a handy guide to applying this logic not only to humans but all sort of creatures, and I will also explain when this logic may not work (which, in any event, still makes it better than believing Hit Points mean how many stabbing wounds your character can survive.) If you understand what I wrote here, you are already good to go, though.


7 thoughts on “You are not doing it wrong, but change it anyway: injuries and healing spells in D&D

  1. Pingback: You are (probably) doing it wrong: Hit points, literature, and D&D. – Emperor's Notepad

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  4. As usual, great thoughts. Even though it’s been a long time since I’ve been in a pen and paper game, I enjoy these analyses of yours.

    I’ve always thought of D&D HP in similar terms to what you describe, but it just never seemed worth trying to revamp when it actually came time to game. I felt like most of my filthy casual players wouldn’t appreciate the extra complication. I never even really considering the problem of healing. Something to consider if I DM again down the line.

    Liked by 1 person

    1. emperorponders

      It’s not really relevant to playing; it’s just that it’s nice to know what something “means,” or if you are one of those people who writes or imagines stories and tries to apply D&D logic to that – a risky logic, but it can be done.

      Liked by 1 person

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