The Secret World Fist Healing Guide

The Secret World Fist Healing Guide by Escalith

Well, I started AR originally, never touched blood and had some Fist abilities; eventually I transitioned to a full fist healing build because it at least appear to work best as it is.

[Early Game – 69 Points] – Able to heal Polaris


1. (Fist Tier 1) – Nurture
2. (Fist Tier 2) – Surgical Steel
3. (Fist Tier 2) – Empathy
4 ?
5 ?
6 ?
7 ?


1. (Fist Tier 1) – Nurturing Gift
2. (Fist Tier 1) – Out of the Woods {E}
3. (Hammer Tier 1) – Brawler
4 ?
5 ?
6 ?
7 ?

Very basic; that’s all you really need to keep your team alive in the first Dungeon.

[Mid Game – 192 Points] – Able to heal through any Normal instance.

1. (Fist Tier 2) – Cauterize
2. (Fist Tier 2) – Surgical Steel
3. (Fist Tier 2) – Empathy
4. (Fist Tier 2) – Creature Comfort
5. (Fist Tier 2) – Vigour
6 ?
7 ?Passives

1. (Fist Tier 2) – Hot Iron
2. (Fist Tier 1) – Out of the Woods {E}
3. (Fist Tier 2) – Making Amends
4. (Fist Tier 2) – Healing Sparks
5. (Hammer Tier 1) – Brawler
6 ?
7 ?

Your finisher should be Surgical Steel at all times. While Creature Comfort heals less, it is more pleasant to tank heal with – If your tank does not require the /slightly/ higher healing value of Surgical Steel. I do still prefer Creature Comfort, solely because I prefer high mitigation low spiking tanks where I can use a similar non spiking, everpresent healing style. By raw numbers however – as explained below – Surgical Steel is better.

[Lategame – 402 Points] – Able to heal through Elite & (Nightmare)


1. (Fist Tier 2) – Cauterize
2. (Fist Tier 2) – Surgical Steel
3. (Fist Tier 2) – Empathy
4. (Fist Tier 2) – Creature Comfort
5. (Fist Tier 2) – Vigour
6. (Fist Tier 2) – Radiance {E}
7 ?


1. (Fist Tier 2) – Hot Iron
2. (Fist Tier 2) – Making Amends
3. (Fist Tier 2) – Healing Sparks
4. (Fist Tier 2) – Empowerment {E}
5. (Subversion) – Subtlety
6. (Hammer Tier 1) – Brawler
7 ?

[Endgame – 592 Points] – Recommended Nightmare Build


1. (Fist Tier 2) – Cauterize
2. (Fist Tier 2) – Surgical Steel
3. (Fist Tier 2) – Empathy
4. (Fist Tier 2) – Fired Up! {E} (Radiance {E} – Explained in the notes)
5. (Fist Tier 2) – Vigour
6. ((((Fist Tier 2) – Creature Comfort *See Notes*)))
7 ?


1. (Fist Tier 2) – Hot Iron
2. (Fist Tier 2) – Making Amends
3. (Fist Tier 2) – Healing Sparks
4. (Fist Tier 2) – Empowerment {E}
5. (Rifle Tier 2) – Shadow Medic
6. (Hammer Tier 1) – Brawler
7 ?

This version dropped Creature Comfort, not because you could not find use for it; but solely for the fact that it offers more flexibility in terms of freed spots and what to use. If you like the spell, feel free to continue to use it – but as Surgical Steel IS the better finisher, this build focuses on maximizing your healing output with as little skills as possible, yet staying true to the ‘Fist Only’ part of the build.

This offers 2 open Actives and 1(2) open passives, if you replace Brawler with for example Subtlety.

You are now able to bring Deadly Aim + Hair Trigger (With it’s Ready for More passive) – allowing you to Cleanse and Buff.
Or you could bring Flak Jacket + Breaching Shot – allowing you to have a minor tank cooldown and buff the damage.
You could also go for a different route and use Elemental – to bring Short Fuse & an AoE CC, when you expect having to kite monsters.

This build is the most powerful Fist Only in terms of raw healing power, but it does not make Creature Comfort moot. It still has it’s uses, if only for having a constant instead of burst heal. Comfortablity, due to Creature Comfort.

While there are many healers that swear on the power of ‘Fired Up!’ – due to it being a very potent AoE heal on a very short CD, I personally felt that using Radiance offers you greater flexibility and costs alot less in terms of AP, allowing you to spend those in others trees. Radiance works as a strong tank heal to get him quick up to speed, but can also work as an AoE heal if used with Cauterize – since Cauterize applies a HoT and through Empowerment and Radiance every tick will crit and trigger it’s passive heal. (This requires you to tab through every group member individually and cast Cauterize on them before or while using Radiance, so every tick of it’s HoT will trigger Empowerment on every affected target)

Eventually however you will need Fired Up! due to it’s very easy to handle use. In an ideal situation where the DPS does not take alot of damage, (Preferably a TS/Vent group with skilled players) – Radiance is the better skill to use. In a PuG Situation; Fired Up! and it’s easy to use group healing will make your life easier.

But why Vigour AND Fired Up! you might ask. It is simple. Vigour not only offers a nice second AoE heal, it also can dub as a minor emergency heal if placed beneath the tank, as it heals for twice the amount of a Cauterize and you can continue to heal while it is in effect. That and it is a very strong, albeit placed AoE heal.

I re-added Creature Comfort to the build list. I have calculated that the highest healing rotation is achieved my interweaving SS and CC. The actual values can be found in the maths section.
The rotation however as following:

1x Cauterize – 1x Creature Comfort – 3x Cauterize – 1x Surgical Steel – Repeat

[Possible Secondary Options]

Since all the builds so far focus on nothing but Fist and Fist abilities – the second weapon becomes nothing but a support. Whether for defensive or offensive support is entirely up to you; the team you are in and the way you distributed your AP.

– Assault Rifles –

They offer ‘Platoon’ as a good AoE Heal that ignored LoS (Line of Sight), but also Shadow Medic to increase Direct Healing by 7.5%.

– Pistols –

Pistols offer no direct healing per say; but they offer nice and situationed actives; for example Deadly Aim, offering a 40% crit chance for your group AND in synergy with your Empowerment passive. They also have Greater Good (+15% all healing for up to 15 seconds) and Backup Drone – +30% Healing on a single target.

– Shotguns –

Shotguns can get you Flak Jacket, a groupwide damage reduction buff (15%) and Penetrating Shot 40% Penetration for the group. It is situational but they also offer you ‘Cleanup’ – a groupwide Debuff and Buff purger. They are my personal favorite cause I like the animation of Flak Jacket and it allows me as the healer to have control over a little ‘defensive cooldown’ for the tank when I feel or know that an amptle amount of damage is going to hit him, or the group.

– Blades –

Blades are a less support and more of a survivability option. Your own choices are very limited in terms of what is really useful; but ‘Martial Discipline’ + ‘Regeneration’ – offers you at 2k+ healing power a very potent self heal for ~2700 health over 6 seconds and 50% glance chance, helpful when you expect a punishment or the tank looses aggro frequently. Surging Blades can be used as a second dodge.

– Elemental –

What, Elemental as a support on a healer? Is Escalith crazy now? – No. Well, sort of. Elemental offers you to bring along Short-Fuse. It’s not as required as many, if not every competitive DPS has Elemental in their Build, but it is an option when they can’t bring it due to bringing a purge instead. You can also load up on crowd control spells such as Coldwave – or even go for more mobility with Flicker. Your combination possibilities are endless, although other than Short-Fuse the other abilities, just like blade, serve your own survival more than anyone elses.


Of course, your first and foremost important stat is crit – especially once you have Empowerment due to the simple fact that – more crits, more procs, more heals. You should aim to get it as high as possible, preferably at least 900 in blue gear. In reality you will get higher values, but that’s a pretty decent amount to enter Nightmares with.

Always useful – A lower Talisman with Health and +Magical Protection. You are unlikely to be hit by anything melee or physical, and most of not all AoE effects or chain spells that hit you are Magical, thus this offers alot of protection!

Dependant on your build Crit will overshadow Crit Power. Your general Rule should be:

Using Out of the Woods, a 80/20 or 70/30 spread in terms of Crit/Crit Power will receive the best values.
Using Empowerment, a 100% Crit YET using the Brawler Passive will always pull ahead. Crit Power should only be used past 1250’ish rating. But maths for that are still unknown.

[Maths & Calculations]

[Surgical Steel vs Creature Comfort]

Values taken from my current Healing Power.

Creature Comfort heals for 138 per second, 6 seconds, at a roughly 20% increase per resource.
138x2x6 = 1656 Health over 6 seconds. Disregarding crits for this calculation.

Coupled with Radiance and Empowerment, the math is as following.
138×1.5x2x6*1.7+(426×6) = 6778,8 Health over 6 seconds.
(70% crit power)

Surgical Steel heals for 144×3 + 72 per second, at also a roughly 20% increase per resource.
144x3x2+(72*5*2)+(4×62) = 1832 Health over 5 seconds. Disregarding crits for this calculation.

Coupled with Radiance and Empowerment
144x3x2+(72*1.5*5*2*1.7)+(426×6)+(4×62) = 5504 Health over 5 seconds.
(70% crit power)

So as you can see, in terms of healing power Surgical Steel pulls slightly ahead; however since it is a burst heal and not a constant HoT such as Creature Comfort you need to be far more on your toes to try not to overheal.

Once you add Radiance into the equation, Creature Comfort pulls ahead – but only during the 6 seconds of Radiance.

My suggestion, try both – settle for which you prefer; the difference while existant should not be a matter of why your tank dies, but if you want to go for ‘the most powerful’ – it’s Surgical Steel (Only with Healing Sparks)

[1 Resource vs 5 Resources]

Surgical Steel Calculation:

Over the course of 6 seconds you will be able to cast Cauterize 3 times, 3 times Surgical Steel.
Healing Sparks and Surgical Steels HoT will both tick 6 times.

144x3x3+(72+62)x6+(3×296)+(27×6) = 3150 Health healed with 1 Resource + 1 Finisher, 3 times
144x2x3+(72x2x5)+62×4+(5×296)+(27×15) = 3717 Health healed with 5 Resources + 1 Finisher.

In terms of actual power of the heal itself; Surgical Steel – using it 3 times with no resources pulls ahead; HOWEVER since you are only able to use Cauterize 3 times instead of 5 and your HoT won’t stack fully till you cast it the third time, using 5 resources and 1 finisher is the stronger combination!

This calculation is useless for Creature Comfort as it does not stack and without 5 resources the HoT is too weak and will simply be refreshed.

[Crit Rating&Power – Out of the Woods vs Empowerment]

This calculation is based upon my current healing stats. Since I did the maths in Excel and only wrote a single base formula in the Editor, I will solely post this but the values for every calculation I have done.

I know that you can have more than 1250 Stats in total, but I used those to test with as it’s the approx number you can have in full blue gear.

Out of the Woods – 20% Crit Rating (~750) + 70% Crit Power (~500)
(324×80+324x20x1,7 + 157x2x3x16+157x2x3x4x1,7)x1,275 + 28×285 +28x72x1,7 + (78x2x5x16 + 78x2x5x4x1,7)*1,275 + 61x4x16 + 61x4x4x1,7

Total Healing Value =106022

Out of the Woods – 25% Crit Rating (~1000) + 60% Crit Power (~250)

Total Healing Value = 106952

Out of the Woods – 30% Crit Rating (~1250) + 40% Crit Power (~0)

Total Healing Value = 104162

Empowerment – 20% Crit Rating (~750) + 70% Crit Power (~500) (3 HoTs roughly 52 Procs per 2 minutes)

Total Healing Value = 107609,6

Empowerment – 25% Crit Rating (~1000) + 60% Crit Power (~250) (3 HoTs roughly 63 Procs per 2 minutes)

Total Healing Value = 113071,75

Empowerment – 30% Crit Rating (~1250) + 40% Crit Power (~0) (3 Hots roughly 73 Procs per 2 minutes)

Total Healing Value = 115265,6

– What does this mean? –

Quite simple. Empowerment grows stronger the more crit you have, despite your Crit Power dropping.
Also, the more HoTs you have on your Target, the higher the chance that you will heal for more. However – since Crit is RNG your healing will spike dependant on your Crits. Out of The Woods has overall lesser healing but it shows that you will need some Crit Power to make it more effective.
Also, your healing will not spike and is more reliable, albeit healing for less. Also unlike Empowerment Out of the Woods needs a roughly 70/30 stat ratio to be most effective.

– The Breakpoint of OotW vs Empowerment –

Thanks to Shadai I revised my calculating formulas and noticed that he stated that the HoT part of Surgical Steel also is affected by OotW, which shifted the calculated breakpoint from 13% crit to 18% crit. Having 17% or less crit will make Out of the Woods the more potent healing passive. In terms of Crit Numbers that is achieved at around ~ 550-600 Crit Rating.

– The Highest Healing Rotation –

After numerous tests and calculating, the current highest possible rotation for HPS using Fists (Healing Per Second) is the following:
1x Cauterize + 1x Creature Comfort + 3x Cauterize + 1x Surgical Steel

Using Empowerment, thus your Crit Rating superceeds your Crit power Immensely. The more Crit Rating, the Better. Even at 30%/40% it is majorly ahead.

I will post the results of the calculation; as using the calculated formula isn’t possible. I use Cell-Links instead of Numbers to calculate.

OotWSS 20/70 = 883 HPS
OotWSS 25/60 = 891 HPS
OotWSS 30/40 = 868 HPS

EmpSS 20/70 = 896 HPS
EmpSS 25/60 = 942 HPS
EmpSS 30/40 = 960 HPS

OotWCC 20/70 = 803 HPS
OotWCC 25/60 = 815 HPS
OotWCC 30/40 = 796 HPS

EmpCC 20/70 = 796 HPS
EmpCC 25/60 = 863 HPS
EmpCC 30/40 = 880 HPS

OotWSSCC 20/70 = 985 HPS
OotWSSCC 25/60 = 994 HPS
OotWSSCC 30/40 = 968 HPS

EmpSSCC 20/70 = 1048 HPS
EmpSSCC 25/60 = 1108 HPS
EmpSSCC 30/40 = 1137 HPS

The upside, it offers you 177 more Healing per Second; at the downside of having to use 2 Finishers.

[Final Words]

I am sure there are more possible combinations, more possible builds, but I found this to work the most effective for me while still being a cheapskate and not investing too much into other healing trees. This shows that Fist on it’s own can be a very strong in terms of healing and does not need to rely on AR or Blood to be effective. This build is tested in Normals, Elites and Nightmares by myself on a QL10 Blue tank; thus there was no ‘overgearing’ or similar involved.

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