Life bars, hit points, vitality, health or (if your Zelda fan) hearts...regardless of what you call them video games almost always use abstract numbers or HUD indicators to quantify how much physical punishment can be absorbed before suffering from a critical existence failure. It's a simple system that has roots in 30+ year old tabletop games like Dungeons and Dragons. I think the reason it has endured so long has to do with its simplicity. I can relate to that, but I also think the time has come for this particular game mechanic to receive a healthy dose of innovation.
Before I start offering suggestions though, I want to take a moment to review some attempts that have been made in the past to move beyond plain old HP counters. Call of Cthulhu: Dark Corners of the Earth had a surprisingly intricate method of keeping track of injuries; everything from claw marks by Deep Ones to twisted ankles from falls. All these injuries can and often do handicap the player, which is fitting for a horror game. However, there is one notable drawback to the way it was implemented. Whenever a player suffers cuts, bruises or sprains they must essentially pause the game, by going to the menu screen, and use the appropriate treatment from their medicine kit. After a short animation all debilitating injuries are instantly repaired.
Another game that tried to employ a similar concept was Metal Gear Solid 3: Snake Eater. Much like the above mentioned horror game protagonist, Solid Snake can (and does) get bullets embedded into his flesh, along with other aliments like burns, leeches and broken bones. Again it sounds neat on paper, but in practice Snake's max health reducing problems are more of a mild annoyance than a critical aspect of the game. Granted, in what is essentially a tribute to 1980s action flicks, this design choice might be for the best. I can't help wondering what a more detailed system might look like though...
Let me take a moment to emphasis the word "looks" from the previous sentence, because if you want to get technical Dwarf Fortress has an incredibly complex damage system which takes all kinds of factors into account, tracking location and the type of injury in disturbing detail. It's an unique take and has a few terrifying consequences like undead and golems being practically invincible (because they lack vitals). Needless to say it's a game where the construction of a molten lava sluice gate is one of the few effect ways to defend a fortress from attack by an irate herd of zombie mammoths.
Flip to the other side of the coin (metaphorically speaking) and you have Bushido Blade, a one-on-one fighting game in which the duelists wield edged weapons rather than relying on unarmed combat techniques typically seen in the genre. Appropriately, one hit kills are a common outcome of matches and even grazing hits will leave limbs immobilized. A more recent variant of this type of fighting game can also be seen with the Deadliest Warrior series of Xbox360 games.
So, there have been a few attempts to change things up over the years, but so far nothing has really stuck. Not a big deal except recent games attempting to capture a strong feeling of verisimilitude suffer from hit point based abstractions. Further compounding this problem is the overused rebounding health meter. Lara Croft's latest outing was one such example, prompting a suggestion in this quicklook that maybe a bullet avoidance luck meter would be more appropriate than a bog standard regeneration health bar. While another abstraction in its own right at least under the suggested mechanic the new more realistic(ally proportioned) Lara wouldn't be shrugging of gunshot wounds like insect bites.
Personally, my hope is that someone will decided to capitalize on the processing power of the next generation of console hardware to simulate physical trauma in innovative ways. While the idea of seeing your character suffer from shock, pain and blood loss might make you feel a bit queasy it could also bring a new (and much needed) dynamic to games trying to capture a realistic vibe. Of course having fun is important too, so some may find the concept of death spirals inherent frustrating. However, setting specific details such as magical healing in a fantasy setting or consciousness uploading into clone bodies in a sci-fi setting (The 6th Day in video game form?) could be used to balance between gameplay needs and story trappings. At the very least though, I hope players will wince when they see their poor onscreen character take a hit knowing that the consequences of injury are something that can't be resolved with a few seconds of rest.
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