Dropping to 0 and Falling Unconcious
When a PC drops to 0 that PC falls unconscious. In base 5e this is only concerning at very low levels or among parties with no healing capability. If the party has any healing capability or even a PC proficient in medicine what should be a tense and impactful moment becomes an easily managed after-thought.
Additionally, the current system invites meta-gaming. In this case, the PCs are almost always better off using healing methods only after an ally reaches 0. In the context of the game, this does not make sense. It is absurd to prefer an ally to be knocked unconscious and near death before healing that ally. So, we have damaging meta-gaming that cannot be justified and does not add much to the game.
To address this, we have an alternative system to dropping to 0. When a PC drops to 0 the DM will roll on one or more tables and determine an additional consequence to accompany falling unconscious. These range from lingering injuries (injuries that impact performance for a certain length of time) to fears (negative reactions to the monster or monsters that reduced the PC to 0) and more. Most effects are temporary, and none standing alone are debilitating. A character will not lose a hand or arm or be permanently blinded by dropping to 0.
This system adds consequences to dropping to 0 beyond the possibility of death. Embrace those consequences, they add variety to the game and PCs. Maybe a PC has been scarred, or developed a fear, or broken their hand, how the PC responds to these is where the interesting parts of the game occur. The story of the hero who persists through adversity is the most interesting. Whether it's Luke losing his hand, Harry, Ron, and Hermoine struggling with the Horcruxes, or Superman struggling while exposed to kryptonite, the interesting bits occur when our heroes are beaten, battered, and bruised, not when they are at 100%. In the words of Brandon Sanderson "limitations are more interesting than powers." Use consequences and limitations to elevate a PC from a character you remember to a character others remember.
