@Oofta @Hussar
I wondering about what would be needed to be added to the rules to make HP more clearly tie into the story (e.g. not carry 0 information to some) and still be easy to use and D&Dish. What about something like:
"Each character's hit point total represents both capacity to take actual damage (roughly 3/4 of their starting hitpoint total at 1st level rounded up) and ability to avoid taking actual damage from attacks due to skill, stamina, luck, etc.. (the rest of them).
So, each "hit" to a character could be thought of as doing a (roughly for higher level characters) 1/(2*level) fraction of the total of damage of the appropriate type (burns for fire, frost-bite for cold, cuts for slashing, bruises for bludgeoning, etc...) and the rest as a reduction in capability to avoid damage.
To smooth gameplay, the amounts are not tracked separately, and the default is to give no penalty for different amounts of damage taken, but the character will certainly have a rough idea how close they are to death and act accordingly.
The allocation of damage doesn't typically result in integer amounts. For narrative purposes, any "hit" at all involves a minor singe, tingle, scratch, or soreness as appropriate. A single hit for twice the characters level or more is definitely a noteworthy burn or cut.
A "simple gritty" version gives a -2 on all rolls if the characters is 'significantly bloodied' (that is significantly injured and at half hp or below) and gives a scar for any significant wound (single blow that causes 2*level of damage).
The optional rules also allow for the two types of hit points to be tracked separately as "wounds and vigor" with different healing options, healing rates, and penalties for each type of damage. This is facilitated by using an app or online tool (and is an option in DnDBeyond, for example)."