Natural healing is slow and difficult. After a short rest, characters may heal using Hit Dice, as usual. But after a long rest, characters do not gain back all their hit points, and instead must use Hit Dice to heal. As per usual, after a long rest, characters regain the use of a number of hit dice equal to half their level, rounded down.
This is mean, there's no way around that. And it takes away, somewhat, from the heroic nature of the game. But I've always chafed at the "full reset" quality of eight hours of rest. So, you take 30 points of damage. Magical healing from your cleric's god will heal what, 10 of those? But sleep it off for a night, and presto! You're back to full health.
So I'm using one of the healing variants from the DMG: Slow Natural Healing.
Your natural healing (Hit Dice)—which scales with your heroic nature (more with higher levels)—is all you get. Grievously wounded? Rest an hour, have someone patch you up, and you're feeling a bit better. If you can rest overnight, you can probably find it within you to go on one more day. Take a couple of days, and you're right as rain. (Even that seems unrealistic, but you'll be happy to hear I don't like the Gritty Realism rest variant that makes short rests eight hours and long rests a week.)
How does Hit Dice use after a long rest interact with regaining Hit Dice after the same long rest? Simple, you heal first, and expend the required Hit Dice. Then you regain Hit Dice. The opposite, regaining Hit Dice and then spending them, would be generous, I guess. I suppose I'm not against it, really. Maybe we can try it, but only if the first system proves too onerous.
What does this do to a game? Well, magical healing becomes more valuable. It removes the "full reset" in the middle of an adventure, but doesn't do anything to short rest healing. For long rests, it does change things (though healers will get their spells back). I imagine it would make parties be more cautious about running headlong into combat, which is something I approve of.
Note: I originally was also requiring a Healer's Kit to heal Hit Dice, but in practice, parties would just load up on Healer's Kits, and then it was just an inventory make-work system, and that isn't fun for anyone. So instead, I'm just going to role-play the bandaging. Maybe in dire circumstances where there are no bandages of any sort, I'll prevent people from using Hit Dice to heal. Yeah, that makes me feel better. :)
About the only argument I imagine carrying any weight is "I don't wanna!" which I guess makes sense. This is a game after all, and if you don't wanna, then you shouldn't hafta. In one game I ran, I realized halfway through that I wanted to use this rule, but it felt unfair to pull the long rest healing carpet out from under them. So I let the players vote, and they overwhelmingly wanted to keep the RAW healing rules. That makes me suspect that 1) they were more scared of dying than I thought they were, and 2) players like the reset. I can see that in an IRL game, where you're trying to do at least one encounter/fun thing per session, you'd like to start fresh each time. I guess I'd have to see how that goes. But in a less episodic game (like asynchronous online), I think it wouldn't matter.
Anyway, this is my rule. Go ahead and @ me. I'll listen.
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