Darkest Damage

The least funny part of D&D is getting taken out of a fight early, and then waiting around for ages until you are either healed, or the fight is over, or you die. Boring. So we changed it.

New Conditions

Ripping something straight from a popular computer game, we introduce two new conditions; At Death's Door, and Downed. Only player characters and certain important NPCs can suffer from these conditions.

At Death's Door

When a character is reduced to 0 hit points or below, they are At Death's Door. A character At Death's Door has 0 hit points, ignoring any superfluous damage.

They are still conscious and can take actions, but if they take another hit while At Death's Door, they receive a lingering injury and become Downed.

Healing a character At Death's Door to above 0 hit points removes the condition.

Downed

A Downed character becomes Stunned and Prone, until the beginning of their next turn. On their next turn, and any subsequent turns, the player can choose whether the character will recover from being Downed, ending the condition.

When a character is Downed, enemies will typically ignore them in favor of active foes, believing them to be incapacitated or dead.

A Downed character can be healed but only if the player agrees to end the condition. If the player does not choose to end the Downed condition, no healing takes place. If the Downed character was the only intended recipient of the healing, no resources are spent and the healer may take a different action.

Lingering Injuries

For lingering injuries you can use the table in the Dungeon Master's Guide (p. 272). I suggest rolling a d30 instead of a d20, counting results above 20 as 20. This makes potentially character-ending injuries less common.

Another option is to instead simply give the character a level of exhaustion whenever they would take a lingering injury.

We can also recommend the "Lingering Injuries by Damage Type" tables by B.A. Morrier, which can be found here: http://www.dmsguild.com/product/175403/Lingering-Injuries-By-Damage-Type

Spell Alterations

Some spells require alterations to work with this system, especially if you, like us, prefer to not allow Raise Dead or Resurrection and similar spells, in order to preserve the severity of death.

Revivify (Alternative Version)

3rd-level necromancy

Casting Time: 1 action

1 action Range: Touch

Touch Components: V, S, M (diamonds worth 300 gp, which the spell consumes)

V, S, M (diamonds worth 300 gp, which the spell consumes) Duration: Instantaneous

You touch a creature that has suffered a lingering injury within the last minute. The lingering injury and all its effects disappears. If the creature has suffered multiple lingering injuries within the last minute, you choose which lingering injury is removed by this spell.

Greater Revivify (Alternative Raise Dead)

5th-Level necromancy

Casting Time: 1 hour

1 hour Range: Touch

Touch Components: V, S, M (a diamond worth at least 500 gp, which the spells consumes)

V, S, M (a diamond worth at least 500 gp, which the spells consumes) Duration: Instantaneous

You touch a living creature and remove one of its lingering injuries, along with all its effects, provided that the injury is no older than 10 days. If the creature suffers from multiple lingering injuries, you choose which injury is removed. If the creature is at Death's Door, it regains 1 hit point.

This spell also neutralizes any poisons and cures nonmagical diseases that affected the creature. This spell doesn't, however, remove magical diseases, curses, or similar effects.

Regaining full functionality of lost limbs or other bodyparts takes some getting used to. The target takes a -4 penalty to all attack rolls, saving throws, and ability checks. Every time the target finishes a long rest, the penalty is reduced by 1 until it disappears.