This module isn't bad. It's a much better example of tier 4 play than the season 8 modules and has a great background to it that will probably make it memorable. Hwever there are several short comings that result in the 3 star review.
Firstly, the opening. While it's jarring, shocking, and scary to open with a major combat in the Call to Action. The exploding head ability feels downright cheap to the players. One of my players, when targetted using the rolling system as written, had to then sit on the sidelines for the rest of the battle while the party fought off the foes. This sucks, especially in the rare tier 4 game. I honestly would reduce the hit point threshold to half of what it is currently, then at least the majority of characters would have at least two turns to act before being no-save killed.
The priests offering raise dead is kind of a slap in the face when you read the spell and realise that it wouldn't work. Is this a bug or a feature?
Combat in tier 4 is typically difficult to balance, with the winner generally being dependant upon who rolled initiative first and does anyone have surprise. I would say that the combats within this module are genrally balanced, but strong, well played characters will probably render the majority of them trivial. There's no getting around that tier 4 characters simplly have too many resources for 4 hour modules.
The graphic descriptions of gore are presented without content warning, something that in 2020 we should really be doing by now. This is especially pertinent considering the current discourse about what is appropriate to be on the DM's guild. Should an appropriate content warning be put into the module's description I would be happier to grade this adventure at 4 stars.
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