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I'm interested to know what the experience of others has been on this. I've been running three noobs through some basic 1st and 2nd level stuff. Here's my observations:

1. Second Wind works like its name. PCs find a reserve of strength and energy to overcome their scratches, scrapes and fatigue to get back up to some strength during an encounter. It's only 25% of their hit point total though, so it's not a tremendous boost. The feel of it is good. The PCs don't use it willy nilly either, since it's a standard action (for everyone but dwarves), and since it doesn't give you as good a return for your effort as Healing Word does. But PCs still want healing potions because they want to be able to get themselves back up to some strength if they've already used Second Wind.
Players like having their own cushion in combat. Don't forget the defense increase for the round after you use your surge. ---Good point. I left that out and it's a nice feature.
2. The cleric's Healing Word is interesting. It can be used twice per encounter, and it took even me a little while to get out of 3E mode and realize that it's a Minor action (this should have been subcoded, like in alternate font or something, so it stands out), which means the cleric can use it and move and fight all in the same round, which is neat. In a hard fight, the cleric is out of these quickly of course. I did notice that if PCs have the time, and they have a cleric, they shouldn't ever burn healing surges on their own outside a fight, but should instead use Healing Word for the extra hit points. Since Healing Word resets every 5 minutes or so after a rest, you can get back to speed inside an hour easily. The noobs were confused at first because they thought encounter powers could only be used inside an encounter. Easy enough to be confused, with WotC's unclear writing at times.
The cleric also has attacks that can grant temp hit points or additional saving throws. ---Yep. A few even grant actual hit point recovery. The Warlord also has many powers that can activate healing surges. One of the more interesting forms of healing is the Paladin, who uses his own surges to heal others. Combat does tend to have healing flying back and forth, which makes for long, complicated, and much more interesting encounters. ---- It sure is complicated. So far it's manageable. I'm wondering how it'll be later though. And I've only been running three players!
3. With so many healing powers (including Healing Word) using surges as the base, the surges go quicker than you'd think. If the fights are at all hard, it pretty well matches the resource expenditure (healing wise at least) rate of 3E, and the need to take an extended rest. Three or four encounters max, and that doesn't even count the PCs' desire to get their daily powers back. After most of the group have used their daily powers, they are really calculating on whether they can afford to stop and take an extended rest, because they really want to at that point, even if their number of healing surges left is still okay.

4. If a PC gets in a pickle and hits 0 hit points or less, and no one can help him or her, things get tense. The death saving throw is essentially a slightly better than 50/50 luck throw, so level doesn't have anything to do with it. It's "three strikes and you're out," so even if you only went to 0 hit points, if you fail three saves, you're dead (could happen in 3 rounds). And even if a character can get to you, if that person is not trained in the Heal skill, and/or has a high WIS, things are grim at low level. At higher levels of course, this will increasingly be a slam dunk regardless, but until then, no so much.
The coolest thing about going below 0 is that when the character gets healed he is first brought up to 0 before the healing is counted. This fixes one of the most frustrating things about 3E, that someone dropped down to below 0 can be healed and still be unconscious. Players get to play more, and that's always fun. ---- I was always ambivalent about that. It stunk to be out of the game essentially, but it didn't bruise my suspension of disbelief.
5. The "till bloodied value expressed as a negative number" provision is usually enough of a cushion for a PC to avoid outright death from a blow that sends him or her under. But not always! Feels about right.

6. What still feels artificial is when a PC who has been kicked to crap and maybe even gone way under 0 hit points, gets stabilized, uses healing surges, and is back up to speed in 10 minutes. It also feels artificial when the same thing happens and the PC is out of surges, but then 6 hours later is in perfect health and no drawbacks.
Another example of 4E's ethos that players should be allowed to play. ----- A usual good thing, but if suspension of disbelief is impacted too much and too often, the game degenerates, players don't take it seriously and get attached to it, and more and more of the campaign becomes about PCs trying wild crap over and over again because there's no connection.
By James Treu


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