I love my Death and Dismemberment table. I spent a lot of time making it, even though the idea comes from someone else originally.
But when I made it, I was primarily playing games in my Sea of Stars setting, which is Sci-Fi and low magic. Specifically, there was no magical healing and technology was more limited, so there weren't many healing options, as unrealistic as that might be.
So it wasn't a problem. But when I started playing my current game, the players quickly gained access to Healing Magic and suddenly, Horrible Wounds became trivialized as the long time it took to heal could be erased with a single casting of 'Cure Wounds'. Now that might be fine in less intense or more light-hearted games, but in any game that is trying to make violence meaningful or dangerous or scary, that simply won't do.
So I thought and thought and eventually, came up with a fix.
Healing in the Wheel of Time series:
A brief digression. In the Wheel of Time, Aes Sedai can magically heal wounds using magic. However, this ability is not unlimited. Not only does using this ability slowly wear down a caster's stamina, but healing also involves accelerating the wounded person's normal regenerative abilities.
Simply put, it requires energy from the person who is being healed. This means that sometimes, if someone is too badly injured, magical healing is just as likely to hurt them as it is to heal them, as it will drain them of strength they need to heal and could kill them if they are healed too much.
Additionally, even those who are healed are still weakened and require rest to regain their strength. It's not a magical fix-all.
When a character drops below 0 HP, they must roll on the Horrible Wounds table that corresponds to what kind of damage they took.
They will remain at 0 HP, with their Horrible Wound existing independently of HP.
When affected by healing magic, the healer can choose to heal someone's HP or try to remove their Horrible Wound.
If the first, then the ability restores HP equal to whatever amount it does. Leftover HP rolls over into Fighting Spirit (FS). Note that some abilities only restore FS.
If the latter, then consult the Horrible Wound. Depending on the result of the table, each Horrible Wound has a number that indicates it is at the result. When suffering a Horrible Wound, players should mark this next to their HP. For example: HP: 3/10 Wound -6.
When removing a Horrible Wound, the healer's ability can remove up to X points off the Wound, where X is the amount it would normally heal. If the Wound's number is reduced to 0, then it goes away. But for each point that is removed from the Wound, that reduces the CON of the creature being healed by 1. These lost points of CON come back after 1 day of rest.
If this would reduce a creature's CON to 0, it instead kills the creature. This is a commonly known fact by anyone instructed in healing magic.
Robert Bloodcursed is stabbed through the stomach and takes a Horrible Wound of -5.
Jennet Brightstar uses 'Cure Wounds' and is able to cure 6 HP. She opts to remove Robert's Horrible Wound instead.
Her ability lets her do so, but this reduces Robert's CON from 13 to 7. It will take him 5 days for his CON to come back and his HP to be restored to normal.