To paraphrase Winston Churchhil: it has been said that hitpoints are the worst form of tracking health except all those other forms that have been tried from time to time.

Hitpoints have always struggled with their reflection of both physical health (how much of a beating you can take) as well as skill, fatigue, blood loss, luck, and other ineffable elements of health. There has always been the question of why, if hitpoints represent avoiding a hit as much as soaking up a hit, doesn’t bonuses or penalties to AC affect your hp? Why do all forms of hitpoints heal at the same rate? Etc.

Much of the underlying unease of hitpoints came to a head in 4th Edition, when hitpoints went from kinda sorta representing physical health to maybe representing physical health. No matter how badly hurt someone was, they could take a short rest (or be shouted at by a warlord) and recover. Which was fine when the damage is as abstracted as hitpoints (damage from a monster’s weapon could narratively be a deadly cut or a ugly scratch) but things like falling, taking a swim in acid, being critically hit by a breath weapon, or taking ongoing fire damage are hard to dismiss as just being tiring a character out.

After hard fights, where characters have failed multiple death saves and hit the ground more often than narcoleptic toddler in a boxing ring I keep expecting them to pick up stray body-parts and exclaim “Don’t worry, that will buff out.”