The medusa is the figurehead monster for the Good Ship Argument About Save-or-Die Effects. Some people don’t want their character killed by a single failed saving throw, and others argue that if a medusa doesn’t turn onlookers into stone, it’s not a medusa.
The 5e playtest includes a medusa in its bestiary. In this version, gazing upon a medusa is a save-or-die effect, but an optional one; you can always choose to avert your eyes as you fight.
I found this quote in Greg Keyes’ The Charnel Prince: it’s about the gaze of another monster, a basilisk, but it’s worded in such a way that it’s practically game rules.
“They have two blind men with them,” he said. “They serve as its handlers. The rest walk behind. The cage is like an aenan lamp, closed on all sides but one. It makes a light, this thing, and once you have seen it, you can resist only through the greatest contest of will.”
A contest of will? Like a will save? That’s actually a kind of unique mechanic for a turn-you-to-stone monster, which usually attacks fortitude. Say on, Dungeon Master Greg Keyes: how does a basilisk’s gaze force a Will save?
And he saw a light suffusing the landing. It was beautiful, golden, the most perfect light he had ever seen. A promise of absolute peace filled him, and he knew that he could not live without seeing the source of that light.
This is a fun variation on the basilisk/medusa: you see something out of the corner of your eye that’s you know you shouldn’t look at, but you want to. It’s a good excuse to give people two saving throws: a will(/wisdom) save to let them tear away their gaze, followed by a fortitude(/petrification/constitution) save to resist petrification. Personally, I don’t like save-or-die effects, but I don’t actually mind save-or-save-or-die effects.
This effect not only makes the old-school save-or-die medusa less deadly, it could be used to make the 5e medusa more deadly. While you’re fighting that medusa with your eyes averted, you can’t help seeing little glimpses of something – a beautiful light, perhaps, or an angelic face. For some characters, maybe medusa cleavage is all it takes. Every round that you fight with your eyes averted, you need to make an easy will/wisdom save. If you fail, you gaze upon the medusa.
Greg Keyes’ quote also contains another cool idea: an army of blind men who carry a basilisk’s eye (or medusa’s head, or ark of the covenant) before them as a totem. A mercenary company of blind warriors with such a weapon would be quite powerful, although they wouldn’t work very well with allied troops.
Have I seen this idea somewhere else – maybe an Elric book or something? No matter, it’s worth stealing anyway.