Right now there is nothing aside from story to represent a player getting hurt. Maybe add in damage cards that randomly replace cards in the player's pool. So if a player gets shot, the narrator gives them a "Gunshot Wound" card (wound cards should be customizable too), that will replace, at random, one of their strength or weakness cards. They now have to use that card just as they would have to use a weakness card to get a refresh. When they refresh, if the wound card is still active, it again replaces one of their chosen strength/weakness cards at random. If the story moves in such a way as to "heal" the damage, the narrator can remove it from the player.