Knowing when to heal during combat is an under appreciated ability in Dungeons & Dragons. Too many players think that their characters are invincible, able to take whatever the DM throws their way. This refusal by the players to accept the reality of the situation can be detrimental, not only to their PC, but also to the rest of the party. Refusing to heal in favour of a combat action is a calculated risk that every player is forced to make. The question is what is the right decisions to make? While hindsight is always 20/20 we’d like to think we are making the right choices for our PCs.

In a recent home game two PCs went below zero hit points and started making death saves. In both cases neither PC had used their second wind in the same round. It should also be noted that the party doesn’t have a leader to provide healing. Now I’m not second-guessing the decision of those two players, I don’t know what their hit point count was at the end of their turn and it’s not my place to tell someone else how to play their PC. Of course I can understand the desire to attack instead of using the second wind option. As a player I prefer dishing out high damage as a striker, so taking a turn away from that to heal isn’t high on my priority list either.

However, eventually the question needs to be asked when do you heal yourself? Some players have a set time for using their second wind, like when they are first bloodied or when they’ve taken damage equal to their surge value. Healing surges and the second wind encounter option are one of the major changes that were introduced with 4e D&D. When this ability isn’t used, players aren’t using all their resources effectively. Some leader’s won’t heal a party member that hasn’t already used their second wind. You can read more about that debate in our article, I’m Your Cleric, Not Your Bitch.

When a PC becomes injured in combat three options are available to them. The severity of these decisions will depend on how much damage has been taken and the overall state of the party.

Should I Fight?

Fighting is the default decision for 99.9% of PCs on most rounds of combat. While there are other options that can be taken, most often we decide to use an attack power to eliminate the enemy. It makes sense, the more damage that is dealt the quicker the enemies fall. The fewer enemies on the map, the less damage the PCs need to worry about taking. If the enemy is already bloodied and the PC has a good damage roll it could mean one less opponent to deal with immediately.

Don’t discount the strategy of focusing fire. If every PC is attacking the same monster there is a strong argument towards taking an attack option versus healing. If on the other hand you are going to be a rebel and attack a fresh target when there is one already injured within range, well then perhaps you should heal since you already aren’t making the best decision.

The PC may decide that moving tactically is another alternative to healing that makes sense. Terrain features on the map, such as climbing a cliff to reach ranged attackers could take precedence over healing. It’s a risky move, but if it pays off it’s a risk that’s well worth it. Other conditions such as being dazed could limit what the PC does and make the risk of attacking versus healing appear attractive.

Should I Heal?

Knowing when to heal is an art. You are attempting to maximize your damage output and be an effective member of a team. You don’t want to take yourself out of the fight for a round as that could have repercussions for your companions. An enemy might notice you taking a defensive stance and decide to attack a weaker party member, possibly knocking them out of the fight early or forcing a chain reaction of PCs using their second wind.

However, if you decide not to heal your PC and in a subsequent round you are attacked and knocked unconscious the consequences to the party could be devastating. When you heal will also depend on the resources that you have on hand. Do you have a leader in the party? Have they already used their Healing Word (or equivalent)? If these powers are available is the character in range or able to get in range? Do you have utility or item powers that will let you heal based on certain conditions?

All of these questions will factor into the decision of when you will heal your PC. They will also determine how quickly you will use your second wind. For example my current PC has a utility power that allows him to use a healing surge as an immediate action when he becomes bloodied. As it is an encounter power I always opt to use it before using my second wind as I don’t want to give up my attack on my turn.

Another question to consider when determining whether to use your second wind or not is how much damage am I taking on average and what are my current hit points? If you have less than 20 hit points and the monsters are typically doing an average of 20 damage you should attack. The possibility of removing the threat of the monster from battle outweighs any advantage that healing might offer.

Should I Flee?

Flight is the option of last resort, but this doesn’t mean it shouldn’t be given serious consideration. There are several reasons for fleeing, the dice just aren’t rolling your way, you misjudged an encounter or poor tactics have resulted in the party taking excessive damage. Normally fleeing is a party decision, however it doesn’t always need to be so.

There are instances where a PC might flee for a round or two in order to regroup and heal. Depending on what consumables a PC has on hand there is also the option of buffing up slightly before returning to the fray. The PC may also be able to return to combat from a different angle, causing confusion to the enemy.

Of course leaving the battle for a round or two does have serious implications that need to be considered. The PC may be followed by one or more enemies, leaving them alone, wounded and facing a very lonely death. The flip side is now the remaining members of the party are facing the enemy without your assistance. This puts additional strain on the resources of the other party members.

No matter how you slice it healing needs to happen. It is a question of when to heal and what powers should be used. Balancing offensive output with restraint to keep the party alive. What experiences have you had with healing in your encounters? Has a leader ever held out on healing to perform another action? Does one of the players at your table constantly attack instead of heal?

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