As I've established pretty thoroughly in this blog, I'm interested in 4e rules hacks, tweaks, and general brainstorming. This is because I believe the most essential part of 4e is the way information is presented in the form of powers; everything else is worth examining for other applications. The 3e Unearthed Arcana was one of my favorite books released in the entire edition, just for the kitbashing and genre-bending fuel it provided. Since I don't think WotC will release a 4e version (though the DMG 2 was a nod in that direction), I'm interested in compiling as many rules variants as possible as another Harbinger project.
One of the most interesting variations I've heard about is a change in how players recover healing surges. The problem with healing surges as we have them right now is that short of unusual rules (perhaps modeled as a disease track), PCs cannot suffer injuries that take longer than one extended rest to heal. The game wants to get players back into the action as soon as possible, rather than running the risk of requiring downtime and interrupting the flow of the game. For the high-octane game that 4e wants to be, this is a reasonable choice, but there are other ways it could work that might create a grittier feel.
I like the core idea behind healing surges, because they are a solution to 3e's issue with a wand of cure light wounds: for a relatively trivial investment of cash, characters always start every fight at full health, and this does not cost any spell slots or any other resource that can really suffer attrition. (At even mid-levels, 15 gold per 1d8+1 healed is not enough to count as attrition.) There are other fixes to 3e's problem that are worth discussing, but they're a matter for some future post. With a lot of these ideas, characters may be at full hit points the next day, but getting there cost them some or all of the surges they got for that day; you'll need more time before you're ready to go back into the field.
1. PCs recover one (1) healing surge per extended rest, and cannot benefit from more than one such extended rest at a time. This does mean that at most, you'll need about four days to go from negative hit points to full health. The problem that I have with it is that a paladin or warden will take up to a week longer to return to their full complement of healing surges than, say, a wizard.
2. PCs recover a class-linked number of healing surges per day, typically 1-3 (with a possible +1 for paragon tier and +2 for epic tier). This means that very tough classes will take about as long to get to the maximum number of healing surges as a more fragile character, give or take.
3. PCs recover healing surges from an extended rest equal to their Constitution bonus, minimum 1. This is probably more benefit than Constitution needs, so I don't recommend this.
4. PCs recover a number of healing surges based on a level-scaling Endurance check, or another character's Heal check on them.
Easy DC - 1 surge
Moderate DC - 2 surges
Hard DC - 3 surges
Hard DC + 5 - 4 surges
5. PCs recover healing surges from an extended rest if and only if they are resting in an inn (or equivalent), or are receiving extended-care medical attention in someplace that is not a dungeon. This focuses the effect on attrition over the course of a wilderness adventure, and would be a good first step toward making 4e work in a hexcrawl.
6. PCs have specific conditions, chosen at character creation or available as class features, that replenish healing surges. (This would need to be combined with at least one of the above ideas.) Here I'm imagining something like nWoD's Virtues and Vices that replenish Willpower, or Spirit of the Century's Compels that replenish Fate points. One game I know of rewarded the emotional high of quest goals with healing surges, which is really where I'm coming from with this idea.
7. For a sufficiently episodic game: PCs can only recover healing surges at the definite end of an adventure. This is the most like a TV show or series of action movies, where the characters are (almost) always back to full health by the next episode; particularly serious injuries might be plot complications for the next episode, but only if the writers feel like it.
I think this #7 pretty close to how the designers intend for players to approach 4e anyway. One of the toughest lessons I had to learn over the course of my two-year 4e campaign is how to run adventures that demand the players take on 3-5 encounters in a day, rather than running 1-2 larger encounters in a day. Incidentally, this is one of my problems with 4e; it needs to be run in its own patterns, and deviating from those patterns causes headaches or challenge-scaling issues. Which brings me back to why I'm writing this in the first place: breaking those unbreakable patterns.
1. Any of these would hugely increase the usefulness of daily healing powers that restore hit points "as if" the target had spent a healing surge. (I can live with this; my players have not tended to see those powers as particularly useful under current rules.)
2. A paladin's ability to heal by laying on hands is heavily nerfed by reducing the paladin's supply of healing surges. (Obviously this only matters if someone plays a paladin. Even then, the point was to reduce the availability of healing somewhat, and the game is still fair.)
3. Monsters or effects that drain healing surges are really awful. I would have to think carefully before ever using any kind of wight, and then only as a small part of the overall encounter - or treat standard wights as elites and elite wights as solos, in that their hits represent so much that cannot be healed that day.
4. The new Vampire class that WotC has released doesn't work with this at all, because its supply of healing surges is central to the class's mechanic. (This is a non-issue in my gaming group.)