lets talk about ludonarrative dissonance
ludonarrative dissonance is the conflict between a game's narrative told through the story and the narrative told through the gameplay. now this might seem like an odd thing to consider when discussing rules, however the rules of D&D are representations of a narrative that exists within playing the game, which is why you say, as the rules specify that hitpoints is an abstraction of a characters effort of taking a damaging blow and turning it into a near miss. that is the narrative the game is telling you, but is it the narrative that the mechanics of the game actually express? lets take a look
hitpoints
we've described what hitpoints are narratively, but mechanically hitpoints are a number of points that characters gain through the classes they take and the level they achieve in those classes plus a characters bonus from constitution, an ability statistic that is representative of endurance, which also applies itself to holding ones breath, march or labor for hours, go without sleep, survive without food or water, or handle alcohol. additionally though constitution applies itself to resisting poison. all in all constitution stacks up as a stat that represents endurance and fortitude, not necessarily health, which reinforces the narrative of hitpoints. the classes that gain hitpoints more than other classes are those that emphasize martial talents and surviving combat, those who are most likely to fight at the front line have higher hitpoints gained every level than those who do not, additionally characters who gain experience gain more hitponts as well, a measure of their ability to fight is represented by their increasing gains in hitpoints. this all still reinforces the idea of hitpoints being a measure of ones battle hardiness rather than survival of direct damage.
physical damage
so now we've addressed what hitpoints are and where they come from, lets discuss what they oppose, damage. damage is an expression of lethality by attacks or effects in the world of D&D, the environment can be damaging, elemental damage can be damaging, poison can be damaging, disease can be damaging, and most commonly experienced, attacks from physical weapons natural or created can be damaging. damage is expressed by weapons based on a few trends that can be observed, typically heavier weapons deal more damage, lighter weapons deal less, and damage from these weapons come in 3 different forms implying that the way these weapons effect the body will hurt the body in different ways, additionally implying some forms of body take less damage from some sources than they do of others, in fact physical damage can be resisted by a creature separately from elemental damage.
strength likewise increases damage by physical attacks, strength is a measure of physical power, it effects the skills of athletics where it gives them a bonus to climb and hold onto a vertical surface, jump propelling their body further from the ground and over horizontal distance, and swim. other applications of strength include force open stuck, locked, or barred doors, break bonds, push yourself through thin spaces against friction, hang onto a wagon while being dragged behind it, trip over a statue (this one is odd to me), or hold a boulder from rolling down a hill. additionally besides increasing damage strength also increases your attack roll with a melee attack or some throwing weapons. it effects how much you can carry on your body while acting normally, how much weight you can lift, push or drag, and larger creatures have more strength. this describes strength as being the ability to apply more power behind motion, that power translates into damage as kinetic energy which not only makes the attack faster as expressed in strengths bonus to attack rolls, but makes the weapon impact harder.
the qualities of how physical attacks deal damage imply that damage is a measure of a weapons impact on a body rather than a weapon's ability to push a person to expend endurance to avoid it, the more damage a weapon would deal if it hit, is the expression that damage takes in D&D with the way strength adds speed to a weapon, the way weight imparts mass to speed to create force, and how different types of weapons damage differently based on how they are used. if the damage from physical attacks was just an expression of the endurance taken to avoid a telling blow, weapons would do no different damage from each other as the amount and type of damage is not relevant, the endurance used is simply avoidance.
elemental damage
elemental damage is expressed in a few different ways, the main forms of elemental damage are acid, cold, fire, force, lightning, necrotic, poison, psychic, radiant, and thunder damage. that's a lot of damage, but i think i am going to divide these a bit more, acid, cold, fire, lightning, necrotic, radiant, and thunder damage seem to be damages that most reflect elemental nature, while force is a kind of physical damage which is expressed by an invisible energy that expresses itself by hitting its opponents like...well a force. psychic damage seems to be damage to ones mind or brain which reflects the idea of hitpoints being reduced as a matter of endurance, however instead of psychic damage causing a character to exert endurance to resist it, it is a direct attack on the mental endurance a character has. poison is a kind of damage i would like to get back to later.
how do sources of acid, cold, fire, lightning, necrotic, radiant, and thunder deal damage? typically expressions of these energies are from spells and special abilities of creatures or characters. acid is a splash of a liquid that dissolves materials on contact. cold is low temperatures that negatively effect creatures with liquid circulation systems or a dependence on heat to maintain their existence. fire likewise negatively effects creatures with a liquid circulation system but also creatures with bodies made of compounds that break apart easy at high temperatures, and creatures that require cold to maintain their existence. lightning is like fire but gets inside you frying up your nervous system and burning everything its in contact with while also breaking apart the bonds between hydrogen and oxygen. necrotic energy is a form of spiritual decay which often manifests as physical decay, it snuffs out the spirit that clings to the material world. radiant energy is much like fire, searing flesh and blustering the spirit until it can not be contained in material form. thunder damage is a concussive burst of sound, a shock-wave through an atmosphere that rips and shakes atoms apart breaking down complex structures in bodies and can even snuff out flames.
so do energy sources express themselves as endurance a character must expend to avoid a deadly blow? all of the damage expressed by these forms of damage effect the way the body reacts to them, and one could say something like cold, necrotic, radiant, and sonic damage even if they struck the character can still be expressed as direct endurance reduction by the effect of the damage itself but i could also call that health as well. other forms of damage are more telling though, acid that dissolves flesh, fire burning that flesh and boiling blood, lightning frying nerves and scaring flesh, radiance burning tissue, and thunder ripping flesh from bone as it shakes a body apart are clear expression of body damage if they hit, and even cold at extreme temperatures crystallizing blood and cutting the body up from the inside out. can all these damages be avoided or minimized by an exertion of endurance in order to avoid a deadly blow? of course and thus that interpretation stats, but then we run into a different problem, how can different creatures be resistant, vulnerable or even immune to these damages? are they just good/bad at avoiding them? or is it some property of their body that resists it or is effected by it worse than other bodies. when including resistance to elemental damage, elemental damage seem less like a toll on endurance and more a toll on ones body
poison
poison is an interesting form of damage because it can be delivered in a few ways, some spells, but often direct attacks. the damage from poison requires the poison somehow getting into the body of a character and then slowly hurting the body in some way until it dies, endurance can be expressed in resisting the damage via a constitution check or as an expression of the damage it does, but its clear that poison damage is happening to your body, its not something to lose hit points to avoid, but you do lose hit points to avoid death from it. how poison enters the body is also telling, there are 4 methods of poison entering the body besides magic, contact, inhalation, ingestion, and injury. injury is most interesting because the type of damage you take effects weather you take that poison damage or not, and this reflects weapons not damaging as a measure of endurance to avoid taking a telling blow, but instead weapons actually harming the body of a character.
conclusions
very little about the mechanics of damage in D&D reinforce the idea of hitpoints in the game being an expression of avoiding death by avoiding body harm but rather expressions of the body avoiding death by being harmed less as hitpoints of a character increase. this creates a ludonarrative dissonance between what the game is telling players hitpoints represent and how they actually lose those hitpoints. furthermore reinforcing this ludonarrative dissonance is the system of avoiding damage all together in the armor class system and dexterity's impact on the game which implies a statistic that exists to avoid damage all together. the game does not require multiple narrative explanations for how a character avoids taking damage, especially where damage itself runs contrary to the narrative that the body is undamaged until its dead.
