Lanefan
Victoria Rules
Depends.It seems to me like you're pushing hard for realism here, and that... isn't going to work with hit points.
If the hit point numbers are kept vaguely rational and either a) all hit points are viewed as at least part 'meat' or b) some sort of wound-vitality or body-fatigue system is introduced, it can end up being realistic enough for rock and roll; though of course far from perfect.
Where realism flies completely out the window IMO, at least in 4e-5e, is the ridiculously fast recovery times. So, for added realism (and to make magical healing relevant again) you'd slow down recovery gained via simple rest and introduce some sort of long-term injury system.
None of this, however, solves the most difficult problem: the near-binary difference between fully-functional at 1 h.p. and down-and-out at 0 h.p. This one takes more work, including some sort of potential death spiral when close to 0 but still above along with putting death at -10 (or some other negative number) and having a series of less-functional conditions applied at stages between 0 and -9.
Modern D&D might not be equipped to deliver such a game (though I think it can if enough massaging gets done) but the pre-3e versions to a much greater extent are; in any case the pre-3e systems don't put up nearly as much resistance to making the necessary modifications.But in this case, it really does seem like you're looking for a kind of game that D&D is not equipped to deliver. With enough work, you might be able to force it, but the system will fight you tooth and nail.