I will always favor internal consistency and causality over verisimilitude. I can believe in a world which follows different laws of physics, but I cannot (seriously) buy into a world that is internally inconsistent or that isn't restricted to purely in-game causality.
If that means someone can take fifteen arrows to the face before falling down (as an extreme example), then that is infinitely preferable to most of those arrows missing because we chose to narrate it that way.
How do you know that a character took fifteen arrows to the face except that you
choose to narrate it that way. Nothing in the resolution mechanics tells you that the arrows hit the face, the arm or indeed caused tiring ducking and weaving - indeed, that is the whole crux of the discussion!
When you played D&D and HP did indeed equal meat how did you handle wounds?
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I think I might could buy hit points as meat if we talk about some of the subsystems you guys used to make that actually mean something.
D&d models, and always has modeled, physical injury using a separate set of mechanics (penalties in the proliferation of optional crit mechanics and specific traps in modules, ability damage in 3e) than hp.
I personally find that if damage mechanics are meant to correlate to particular injuries, they need to impose penalties, or send some other mechanical signal that a particular part of the body has been struck and hurt.
In Rolemaster, crit results tell you what part of the body is injured (eg "slash to side cuts deep, -10 to all actions"). The healing times for these penalties tend to be days, weeks or months, depending on severity. Magical healing, exept at very high levels, speeds healing but is not generally instantaneous.
Bleeding is measured in concussion hit loss (generally from 1 per round to 5 per round, depending on severity). Bleeding also inficts a penalty until staunched (generally -10 per point/rd of bleeding). These bleeding rates tend to be unrealistically rapid, but do generate a sense of urgency around blood loss.
When concussion hits have been lost equal to 25%, 50%, 75% or 100% of the Body Development bonus, then a -10, -20 or -30 penalty is suffered, or unconsciousnes results. When further hits equal to CON have been suffered dying commences, death from concussion hit loss then takes place in a further CON-determined number of rounds. Fatal crits genrally specify their own time until death. Concussion hits heal at one per 3 hours, or 1 per hour when resting.
As well as the sense of particular body parts being hurt - generated by penalties - and the sense of being badly beaten up - generated by penalties for concussion hit loss - there is also a sense of urgency around healing, because of bleeding, time-until-death rules, etc.
I don't know of any hit-points-only system that has this sort of mechanical detail attached to it. But the first version of wounds/vitaity that I know, which is Roger Musson's "How to Lose Hit Points and Suvive" in an early-80s White Dwarf, did have this sort of stuff. As wounds are taken equal to 25%, 50% or 75% of CON a penalty to fighting etc is suffered of -1, -2 or -3 and there is a 5%, 10% or 15% chance to suffer a mortal wound. A mortal wound kills in 1d4 rounds (minutes) if active/fighting, or 1d12 rounds otherwise, and can be cured by a Cure Serious Wounds spell or similar.
It's not as detailed as RM - he doesn't have a hit location system, for instance, but suggests one as a possibility - but it still has the elements of penalty and the possibility of urgency via mortal wounds.
If the GM is telling me that my PC has 15 arrows in the face, but nothing in the mechanics suggests that s/he is having any trouble seeing, talking, lifting up a visor, etc, that is pretty jarring!
