Just some ruminations I've been having about health in games, and how damage is interpreted and illustrated in videogames. I've been having some thoughts lately, nothing too specific or focused on any one game, and thought it might make an interesting discussion. So a little bit of background:

I came into videogames from tabletop games. When I was growing up videogames could do some cool stuff but it was some time before they could start doing the sorts of things that I could with a tabletop game, and there was even a time where it looked like we might start seeing most of our favorite games translated into a digital format (seeing as some of my favorites involved a lot of math calculations and finnicking with tiny little figures - having a computer handle all of that usually saved a lot of time.) So for a while we saw games like Twilight:2000, Space:1889, Interceptor, etc all get videogame releases.

Since then (and I actually think this is a good thing) videogames have grown into it's own thing. You can still trace the ancestry, but it's a divergent evolutionary line at this point from it's grounding in more "old-school" games. There's a lot of mechanics that are pretty standard to videogames that have a foundation in old-school games, but which now are based on previous videogame standards than their old-school roots. I don't find that at all problematic, mind you - but I still think there's merit in looking back to the origins of their mechanics to possibly improve upon games as they are now.

One of those things, I think, is health. Or more specifically, hit points. And just what they represent and simulate. And I'm also going to preface this with the caveat that this is my own interpretation and not necessarily something that's unanimously agreed upon, even in the table-top gaming world. There are sources that back up my viewpoint, but it's also something I have had and continue to have debates about with other gamers (kind of like how we've never quite solved the "is Strength or Dexterity more important for a to-hit roll in melee combat" question.) I'm going to state these as absolutes, but that doesn't mean there's no wiggle room or other interpretations aren't possible.

So, to my mind, the most important factor is that hit points don't represent just structural integrity. It also covers stamina, frame of mind, morale, and even just your overall health and fitness. Take D&D for example - pretty much your archetype for every RPG out there (and videogame RPGs in general.) Typically-speaking, you gain HP as you level up, and the higher your Constitution (or Endurance or whatever attributes you have for whatever system you use) the more you'll end up with as well.

This doesn't mean that you're gaining muscle mass that somehow absorbs damage better, or that your skin is growing rock-solid and able to withstand damage better. It's supposed to represent experience and strengthening of will. As you gain in levels you're not just more used to shrugging off wounds, but better able to keep a cool head, roll with the punches, etc. This is especially important because:

A loss of HP does not necessarily indicate a wound, a successful to-hit roll does not necessarily mean that HP loss indicates physical damage to the person (and I'm not just talking about say, the difference between bludgeoning, piercing, or... necrotic damage.)

In table-top gaming, you make your die rolls and the GM interprets those results. A "miss" can mean anything from just simply a badly-aimed blow, the character dodging out of the way, your armor absorbing the impact, or any combination of those (or any number of other possibilities.) A "hit" can mean a physical wound, sure. But it can also mean a blow that you blocked fully, but takes the wind out of you, a staggering series of blows that drives you back as your opponent mentally dominates, a near miss that rattles you, and so on.

A useful rule-of-thumb that's often used is that a character with full HP is rested, alert, confident, and of course healthy. At about 3/4 HP you have some cuts and bruises, and are somewhat exerted. 1/2 HP is usually referred to as "bloodied." This is the turning point (obviously.) You have a flesh wound, most likely; you're bleeding, breathing heavily, and starting to get a bit rattled. (In the movies this is where the hero takes a hit that drops them to their knees where they have to catch their breath before getting back into the fight, and about the point where you adopt the classic "hand over my gut" pose.) Generally, this is the point where you're wounded enough that you'll need some real medical treatment after the fight.

1/4 HP and you're on your last legs. Every attack staggers you, you're fighting for breath, and you've received multiple wounds - at least one of which is pretty serious. And of course at 0 HP you're at least unconscious (depending on the system of course,) if not dead.

There are of course other rulesets out there. (I'm just going with the most typical one.) In Warhammer Fantasy you're doing pretty good until 0 HP at which time you make a roll on the critical hit chart to decide your fate/ serious wound. Which can be anything from "your head flies off 1d6 meters using the deviation rules" to "your opponent slices off your ring finger, -1 to all attacks with that hand," depending on how high the damage roll was. (Or something like that, I don't have the book at hand right now.)

In either case, HP is not just "how many times can I get shot before dying," and a damage value is not just "how many inches deep did my sword cut?" It all depends on the amount of damage applied, of course - but loss of HP can mean anything from your hero losing some stamina from a staggering blow he absorbed with his shield to even your opponent taunting you and psyching you out.

So what's this mean for videogames? Basically, that I think it's become a little simplified in this regard. There's only a couple of games that come to mind that interpret damage as anything else, off the top of my head. Fear Effect, I believe, specifically stated that HP represented nothing more than your state of mind - when you get to 0 you'd lost your cool (or luck, or whatever) and the next attack would essentially be fatal. In those interpretations, every "hit" until you reach zero HP is actually a "near miss." It's only when you lose all your health that a bullet actually physically "hits" your character.

Another that comes to my mind was The Getaway. One of those early racing/shooter hybrids from the PS2 days (I believe it was after Driver added shooting segments to the series a la GTA.) That was my first experience with "get into cover to regenerate health" mechanics. You didn't really have a UI that displayed HP but as you got shot up you'd appear more wounded and start to slow down and stagger - locking into cover for a few moments would regenerate your "health" while still leaving you in a damaged state. (You'd still appear bloody depending on your damage level and moved slower, but could take more damage again.)

Anyway, to the point -

I think a lot of games could benefit from a more nuanced approach to not only how health and damage was handled by the game mechanics, but how it is visually represented by the game.

When Fallout 3 came out, I saw a lot of people wondering how you could shoot a Raider in the face with a shotgun two or three times before they fell. In a table-top game that would be because they weren't actually taking those shotgun blasts straight to the face every time. In a videogame, though - you pull the trigger when the crosshairs are over their head, you see blood spray out of their face, and they keep coming at you anyway.

There's no dissonance with these results in a table-top game where the GM is able to interpret these results in a manner that makes sense. I think it'd be nice to see more videogames start to take this sort of approach as well. I think it could allow these mechanics to make a lot more sense to gamers, and even more importantly I think it could lead to more interesting gameplay.

If health were handled in a more nuanced manner, then it wouldn't feel like Stimpaks "magically" pulled bullets out of your body, sealed your wounds, and gave you a blood transfusion. And it wouldn't feel like regenerating health gave you Wolverine's healing factor.

Instead, Stimpaks could be seen as basic first-aid that stopped further bleeding and injected painkillers and stimulants to get you back on your feet, and regenerating health would represent your character taking a moment to catch their breath, shake off the pain, and regain their composure. As well, (and maybe to a lesser extent) eating food would restore HP not because it was stitching up that svcking chest wound but giving you an energy boost and improving your morale (who doesn't feel better after gulping down an entire roast chicken?)

The amount and type of damage you caused to a character could dictate their reaction and the feedback the player received in a way that made sense.

i think stalker, misery mod changed the health mechanic to something more like this, where getting hit could sometimes be fully absorbed by armor but you would have a stamina penalty as a result. id love to see something like this implemented in.... any game, really. would love it in fallout, COD, whatever.

DayZ is similar to what you are describing. You have to bandage wounds and splint broken bones. It has a few different types of painkillers that you can use and so on.

Would love to see that type of stuff in TES and FallOut. It isn't something that would go over well with mainstream gamers though from what I see. Thought FONV with it's hardcoe mode was a step in the right direction.

Some gamers seem to deem that kind of stuff as being too micro managey. To me just adds another layer of gameplay.

The thing that springs to my mind reading this is RoleMaster where you had criticals should you loose a lump of HP in one blow, the critical could be anything from nothing up to loss of limb or bleeders 5HP for 5 round followed by 4 for 4 rounds etc until it ran its course, many players lost their lives to bleeders.

Would still like to see something like that implemented in computer games.

Fallout is not the only game like that. While playing Skyrim, I have many times attacked opponents with an arrow stuck deep into my forehead or eyeball

Generally, I agree with your thoughts. I, too, started with Old D&D. Hit Points/Health, to me, is more than just physical damage a player can take. I'd like to see video game incorporate this attitude instead of bloody, "cinematic" damage dealing.

Also, when hit points get low, that is when heroes become heroic. That is when they reach down and find that "extra reserve" that helps them out of sticky situations. It is not "heroic" to blast someone when one is at full health. It is heroic to overcome bad situations, sometimes by sheer willpower.

Good read, nu_clear. Thanks for sharing something that crosses my own mind many times when playing video games