Are hit points meat? Does the answer to that question even matter? Hit points are an old mechanic, ported into RPGs at the beginning from wargames, where they made the assessment of unit health more granular than ‘alive’ or ‘dead’. D&D took the concept and applied it to player-characters and monsters alike, and from there it became profoundly common. Measuring damage taken and time until expiration is one of those things where the simplest approach is often the most fun, even if it’s hardly the most realistic.

Hit points as a mechanic are not a monolith. Not even D&D still uses the original mechanic where you have a number and when it’s reduced to zero, you’re dead. Death saves, critical wounds, damage thresholds and any other number of modifiers to the hit point schema make the act of bleeding out after being stabbed a lot more complex than it necessarily has to be, but sometimes more fun, too. Of course, a lot of the relationship that a game has to how its characters get shot and die has to do with genre.