We are playing FFG's "End of the World" and having a great time but are having difficulty with one rule are that we feel needs to be house ruled for our group.

In brief - when a character receives damage it comes in the form of Stress. This has no immediate effect other than tallying towards a total what will kill you eventually. (Think HP for the purposes of this thread)

Now the only way to heal Stress is to covert it to Trauma, something more limiting, once a break is taken, a little rest etc. This leaves the character with a hindrance, a wound or condition basically which can then be healed normally but immediately frees up the Stress track again.

So for example a character takes a fall and suffers some Stress. Later when he gets a chance to look himself over (and after assumedly running unimpeded on adrenaline in the mean time) he converts part or all of the Stress over into a "Hurt Knee" Trauma, which levies a modifier against tasks involving his leg etc. This can then be treated medically, heal on its own etc. but the Stress is gone, his Stress Track clear and ready for more damage.

If one doesn't convert Stress and keeps going, it totals out at some point and you die, so its a gamble? Keep going and risk death or succumb and accept limitations to your performance.

Its a cool little mechanic, metagaming wise, but is kind of weird when roleplaying with characters and NPCs often ignoring seemingly nasty wounds or effects until later all the time. ("Oh gee, damn my spleen was ruptured back there, that's sucks - I hardly noticed till now!")

We would like to change it, allowing for more immediate and more realistic results but don't want to scrub the entire idea. What do you guys think?

My impulse is to levy modifiers for Stress as it is accumulated, then transfer it to the Traumas later. You would lose part of the effect of the exchange.. the "Getting nearer to death v.s. modifier" thing and it is definitely a shift towards making the character's lives more hectic (causing negative Stress modifiers where they weren't before) but Im not sure what else to try.

Perhaps Stress modifiers are all encompassing while Trauma modifiers are more selective? The logic being that when first injured you are affected by the overall effects of shock etc. and coupled with adrenaline results in a lesser yet more widespread hindrance while later, when time is taken to settle down, examine wounds, rest etc. the effects are more localized to the actual injury?

Falling and screwing up your leg causes a -1 on everything for a while but later, after the shock wears off... its just a sore leg, impeding movement etc, but not affecting your thinking, use of arms, shooting your gun or whatever. So in this case its a -1 only to the appropriate endeavors.

Makes sense but is still far more severe to the characters than RAW in the short term.

I think the mechanic as is does in a weird way kind of model how many people seem to react to certain types of damage. They will keep going for a time after the harm. But during rest and when possibly shock or adrenaline have worn off. BOOM!

But it doesnt seem to map to more severe traumas? EG: falling from a height, being shot, and so on? I assume that this is a feature and not a bug somehow?

Sounds like you could plug in original Albedo's wound system which factored fatigue much like stress. And had thresholds where things started going wrong. Wounds were immediate problems. Possibly instantly fatal. Some could be held back with willpower for a little bit. But the bad stuff tended to lay you out flat on the spot.

Id have to break out the rules for the exact progression and what they say on falls, breaks, etc.

Hmm...

I suppose an immediate threshold of some kind could be inserted wherein smaller incremental damage can be taken as stress - and handled as RAW but there would be a point where the damage immediately transfers to a trauma - perhaps anything after 2 points etc.

or, it could be left to chance. When you take damage it is considered Stress unless some mechanic (additional die roll, specific die result causing damage etc.) declares it as immediate Trauma instead.

Something to think about... Thanks.

In Albedo it worked thus. Fatigue was a factor of the characters Stamina score. Halve the stamina score and each incriment of that in fatigue points was a level of fatigue and incurred various setbacks.

So with a STAM 10 for example 5 points of fatigue was level 1. Each level causes a -1 penalty to all checks. At level 4 (2x STAM) the character was into severe exhaustion or shock and had to make a willpower type check to do much of anything. At level 5 the characters unconcious and at level 6 is dead.

Wounds were trauma from whatever and accumulated more fatigue, possible, limb/stat impairment, and the severety of the wound impacted treatment. Internal damage, broken bones, etc.

Falling had you roll a number of locations damaged based on the height fallen for example and then checking the effect table on the appropriate column. Say the PC falls 4 meters. Thats 1d3 locations damaged at a +2 fatigue for each if harm was taken. So say rolled 6, thats a stun result. 4 damage +2 and is halved actions for 2 rounds then can make a check to shake it off. No woulnds so effectively just knocked the wind out of them.

But had the roll been a 12 then that is a knockdown which does 6+2 wounds and KOs the character for 6 phases and then stunned as above. And they suffered a light wound, which puts a -2 on strength and dexterity equivalent checks if say was the arm, and takes another point of fatigue if moving or jolting the limb. If they damaged more than once that could potentially kill the character right there. A really high fall was 1d6 locations with a +5 wound each.  

So you could apply that to your games Stress levels that also act as trauma, wounds, etc. Depending on the amount characters have.
Albedo stats ranged 3-16. So 9-48 fatigue. Though Albedos PCs range alot in size. The average though was 7-13 so 21-39 as a frame of refference.