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1. Sadly, if you don't get some good items along the way, it's kinda hard to reach Hush. Not IMPOSSIBLE, but hard. Try to go for Item rooms/boss fights/devil deals and shops, and just skip the rest of the floor as much as you can, I guess. And be blessed by the Isaac gods.
2. Yup, classic Isaac problems. Just ♥♥♥♥ RNG. Although, I think people said for Hush it's not that important to have 20 dmg if you have like 8-10 firerate. He has the armor thingy and it's better if you have like 7-10 dmg, but high as possible fire rate. I may be wrong here, tho. Also items that deal damage over time are amazing with him. Like Sinus Infection and such.
3. Get lucky for some heart generating books along the run like Book of Rev/Satanic Bible or The Nail etc. Having orbitals to block his attacks also help. And lastly, you may just have to learn his shooting patterns and such to easily avoid them. After you fight him some times, he won't be a problem anymore :). Unless you play with the Lost or Keeper.
Ehwaz is kinda meh, imo. Use it if you already have a decent build, maybe you skip some kewl item rooms c: . Best character, there ain't one. But he sucks with Azazel/the Lost/ Keeper.
GL boiiiiii. Please correct me if I said something stoopid, people.
Good strategy. Forget shops entirely if you don't have more than 15c and 4 keys though (1 for the current or next treasure room, 3 for Hush's floor treasures and shop - any extra goes to the chests).
You're right, pure damage isn't really effective against Hush because of his damage resistance. Overall, he's more vulnerable to higher tear rates.
Learning monsters' attacks and how to dodge them is definitely a big part of the game, especially against Hush which is more of an "endurance" boss than anything. If you only rely on RNG and items to carry you, you won't do much in that game, unless you enjoy taking years to do anything.
Agreed. If you end up using it, try to get the treasure first at least. Missing only the Deal room is better than missing a whole floor, and finding the treasure shouldn't take too much time. Anyway, runes are pretty rare, so relying on that to get to Hush consistantly is pretty much nonsensical (again, "unless you enjoy taking years to do anything").
Some things that I've noticed:
Items that can give you health from enemies are good against hush because he mass-spawns hush flies and hush gapers. Things like lilith's kiss, gimpy, and the leech are surprisingly effective, and when I have one of those I often find that I leave the fight with more leath than I entered with.
Any form of projectile defense is great against the hush. Orbiting familiars that block shots are great, but be careful, as not all orbitals and familiars block shots. Many do, but not all.
Abilities that permanently slow him down are dubious, as they sometimes cause his attacks to cluster together, making it hard to pass through them, but overall I find that his fight is easier when he's slowed down.
Good items for helping get to the hush fight include high damage/spectral/piercing to kill enemies more quickly, speed boosts, and map-based items that help you find your way through areas more quickly(especially the compass). You shouldn't be fully exploring areas most of the time if you are going for either hush or boss rush, though I find hush is often the easier of the two to reach within the time limit.
Also, be careful with trinity shield. It's great for this fight, but some of hush's shots curve, so it isn't going to be a perfect defense if you aren't paying attention.
Stuff like Knife/Tech X + Triple/Quad shots melt Hush. Brim+Sad Bombs with enough damage does it too. You see it more often with booger tears, how many, many sources of damage at once damage him faster than most other possible runs.