It wasn’t until Dungeon World that I finally started noticing this. I played D&D almost exclusively for almost a decade and normally when you take a hit, you lose X number of HP and when you hit 0 you finally fall down. Some monsters were able to put conditions on you, like confusion or ongoing damage, but that was usually a separate attack or a special trigger. Most times you just lose your few HP and move on. Nothing changed fiction wise except maybe you are more tired or your armor is starting to break. Then once you hit that magic 0 HP threshold you suddenly actually take a hit that will knock you out/down. So what makes that last HP more special than all the others?
Dungeon World taught me to use tags to make the attacks more evocative. If the monster’s attack has the forceful tag, then whoever gets hit is going flying. If the messy tag comes up, then someone is losing a limb or something else important. These were always in addition to whatever number of HP were lost. Then I started applying this to “normal” attacks. If the goblin hits you for 2 HP, you end up stumbling on the body of one of the goblins and are now fighting from a prone position. If you get hit by the orc for 6 HP he also knocks your axe out of your hand. There is nothing in the rules that says that anything else should happen when you take damage, but adding these bits of flavor to the damage really helped to make the battle come alive.
Recently someone else in my group has taken up the GM mantle and is running DW. I noticed that when he would hit me for what HP damage I took, I needed to know what exactly happened. Did I get hit in the eye, the arm, or did I take it square in the chest? Did I drop something? Did I give up an important advantage? It felt like something was missing. I talked to him about it afterwards and made sure to ask a few leading questions during the next session like “Ok, I take 4 damage, and what else happens to me?” or “Ouch, that hurt. Do I end up surrounded by his friends after reeling from that hit?” Then the battle started picking up and felt more alive. When someone experience damage in an RPG and the damage is in a vacuum, apart from the fiction, the battle ends up feeling even more artificial.
This philosophy can be applied to most RPGs without any real problems, but make sure it goes both ways. If you make damage more than a number in, say, 13th Age and the paladin hits an owlbear for 15 damage, tell them that the owlbear is knocked over and is scrambling to recover, but then when the paladin takes a hit not only does the owlbear do 21 points of damage, it also rips the shield free from the paladin. As long as you are giving the players a little extra with their successful attack, they probably won’t mind when the bad guys get a little extra as well.
Thanks for reading.