Thinking about Hit Points in 5e

February 21, 2022

Hit Points (HP) do not track physical damage in Dungeons & Dragons 5th Edition, with blood and scars. If you track debilitating wounds and organ damage, or corruption and insanity in your game, then I would think those affect the character's actual stats, in the reduction of Strength, Intelligence, Charisma, etc. Your stats and corresponding ability modifiers represent your character's somewhat permanent capabilities—how much you know, how much force you can put into that axe swing. 

Your hit points, on the other hand, represent the luck, stamina, flexibility, fortitude, and ingrained fighting skill you can bring to bear to evade that final killing blow. HP is a resource that can go up and down a thousand times in the course of a long campaign. You can regain some after a short rest. But you only have ten fingers (humanoids anyway) and the loss of more than few can permanently limit your ability to fight with most weapons.

HP is obviously tied to character death in the rules, but that final killing strike only comes after you've exhausted all your hit points. Up to that point, even with a single hit point left, you're still in the game, with your full capabilities—your +6 Strength. This is also why a dragon can have hundreds of hit points. They are just that difficult to break, that difficult to bring to the point where they give up physically and mentally. A dragon reduced to zero hit points or lower might be "dead", but more importantly, they are broken in spirit. This obviously goes for your player characters too, and it's why they are not beyond reviving in some cases. 

Sure, there are physical aspects of the hit point mechanic in 5e, but I think most of it is comprised of less tangible components, like fortitude, the confidence of years of training and combat experience, even arrogance—just how badass you think you are, even if you're not as dextrous or charismatic in reality. How much of a high-level bard's hit points is pompousness? In some it's quite a bit—same goes for that dragon. And during combat it is your foe's fortitude and well of confidence after years of training you are eroding when your Sword of Uprightness lands hard and you do 42 hit points of damage. In the fiction of the game you may have only twisted past their defenses and given them a good scratch across the cheek, but the point is that it's so devastating a blow to the faith in their fighting abilities that their hit points just took a nose dive. Mechanically, you and your sword cut their hit points in half. In the fiction, you can see them step back from the fray, raise a hand to touch their cheek and come away with blood on their fingers—and then that sudden look of horror in their eyes when they realize this isn't going to end as easily as they thought it would.

Sources:
Tim Kask - The Curmudgeon in the Cellar YT1 https://youtu.be/jhFjo_mFuIo?t=31
Matt Colville - Let's Kill A PC! https://youtu.be/xZdS8lP-Sdo 

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