In GITAW, when things start to bad they typically begin to spiral into even worse scenarios. This is because a character's "health" using traditional terms plays a dynamic part in determining outcomes. An injury that a character has directly become an asset to their enemy that they can use in their dice pools to try to beat you. This is logical common sense, but can be surprising to people who migrate from other games and are used to jumping off a cliff and expecting to walk away carrying on with just 1 hp left like in D&D.
To start to understand the system of "health," think of every character or entity as having a maximum tolerance for certain kinds of damage. On PCs, this is your HP or MAX HP attribute. When they take "damage" they get what is called a complication Which is a new temporary dice trait added to their character that They cannot use, and only their opponents can use. These complications usually come in 8 forms: 7 elemental and 1 physical, but they can also represent other states of confusion or damage with custom complications from SFX or the GM's discretion. The easiest way to acquire complications is when an enemy successfully beats you in a dice contest and after you compare effect dice. If your effect dice is larger or equal sized to your opponents, you take a complication of the exact size of their effect dice. If instead your effect dice is smaller than theirs And the scene is "DIRE-STAKES", you are taken out of the scene and afflicted by a Trauma of the size of the effect dice that beat you.
Trauma is a more permanent complication dice that lasts on your character usually for the rest of a session or until you can get to a place that restores trauma. Some characters will have constellations or abilities that can heal trauma, return characters to the fight, or healing complications. Otherwise, you may need to find special places like Statues of the Seven that can partially heal complications and Traumas!
When you acquire another complication or trauma of the Same Type of an existing complication/trauma that you already have, one of two things happen. If the new dice size is larger, you use the larger dice size. If it is smaller than your existing dice size, then your current dice size is "stepped up" by one value. So if you have a d6 pyro complication and get hit with a d4 fire arrow effect, now you step up and acquire a d8 pyro complication.
If your character acquires a complication beyond their max hp, they become "fainted" and can no longer participate in a scene unless revived. If a character acquires any Trauma stepped up beyond a D12 value, their character instantly dies and their vision goes inactive until picked up by the right hands. The character cannot be revived and their story comes to an unfortunate conclusion.