The goblins have surrounded you. You have one hit point left. What do you do?
If your answer is “collapse in a mangled heap with my measly one hit point,” then you and I aren’t playing the same game.
Hit points are a concept that is ubiquitous nowadays, being present in nearly all forms of gaming media. They serve as a handy metaphor for the vitality of a character. Run out of hit points, and it’s game over.
Despite being a handy gameplay mechanic, hit points are really weird when you look at them through a real-world lens. Whenever a character loses hit points, are they taking physical damage? Is your character in that video game really able to absorb hundreds of bad-guy bullets before dying, or endure multiple slashes of a samurai’s sword? In the make believe worlds of those games, maybe. But in reality, no one can take punishment like that.
Aside from being able to presumably take an insane amount of physical damage, the characters in games usually suffer no ill effects for enduring that damage. That is, until they run out of hit points.
This is the case in Dungeons & Dragons. In D&D, characters can have as little as four hit points when they start out, and upwards of one hundred or more at high levels. Just like in other games, your character is in serious trouble when they run out of hit points. No matter what level they are, however, your characters can fight just as well with a single hit point as they can with one hundred. There’s no concept of impairment within the game (lingering injuries aside). You’re either conscious and fully functional, or you’re unconscious and dying (or stabilized, but whatever). There’s no in-between.
I want to point out that I'm not arguing that there should be an "in-between" here. Imposing any sort of graded impairment on a character would only lead to a death spiral, and people not having fun. And, as we all know, fun is the entire point of the game!
Let’s pull back into the real world for a second: a single blow with a sword or a mace is enough to fell even the toughest of people. It doesn’t matter how big and strong you are—a caved-in skull or a sliced artery is the end of you. Extending that same real-world logic to the game world, it’s just not believable that a hero of any level would survive repeated stabbings. As such, I don’t think that characters take any significant physical harm when they lose hit points.
So if losing hit points doesn’t represent how much physical harm a character endures, what are they?
It is my considered opinion that hit points represent some sort of heroic force within each character, or some finite amount of luck, or even just plain ol’ skill that they use to avoid physical harm. A high level character, who is a more seasoned adventurer, has more of these resources than a character of a lower level. As such, they can survive in battle longer by simply not being hit, or blocking appropriately.
When the dungeon master rolls above a character’s armor class and deals 20 hit points of damage, that isn’t the character suffering a massive laceration. Instead, it’s a blade that narrowly misses them by a hair’s breadth, or a blow that painfully bounces off of their armor because they didn’t get their shield up in time.
It’s only when a character’s “hit points” drop to zero or below that real physical harm is dealt. That’s when the sword rends flesh. That’s when the mace strikes true. And that’s when blood begins to flow.
In this way, we also add a bit of realism to another game system in Dungeons & Dragons: death saving throws represent that the character is bleeding out.
So if a character isn’t being really hit until they lose their final hit point, is the name “hit points” still appropriate?
Yes and no; I could go either way. Alternative terms like “stamina”, “endurance”, or “vitality” all work well. But I see nothing wrong with keeping the name “hit points”. It’s familiar to nearly every person in the world at this point, and there’s no need to confuse anyone by inventing new terms.
Granted, we do run into a bit of an issue with this metaphor when we bring in the concept of healing damage. Healing spells and potions are all intended to reverse physical damage—close up wounds, mend bone, stop bleeding, etc. If hit points are just an abstraction for a nebulous force of luck or skill, then what in the heck are healing potions actually doing?
Like a lot of other things in Dungeons & Dragons, the metaphors aren’t perfect and not everything lines up in a satisfying manner—especially when you start trying to apply real world rules!