Yahtzee Croshaw said:
No, health systems are probably never going to be realistic, because in a truly realistic game you wouldn't be able to continue after getting shot once, and any game that doesn't let you make any mistakes isn't going to be much fun for anyone except insane obsessive no-hit-runners.
Someone who has been shot in the leg, foot, or arm would most likely be able to continue but with considerable difficulty, such as decreased agility or loss of the ability to aim properly. Games that come close to simulating the actual effects of bodily damage in combat are few and far between, excepting the "get shot in the head, you are dead" rule. But realistically, not all head-shots are immediately fatal.
As for realism: yes, games will never perfectly depict absolute realism when it comes to health systems, and games aren't stopping to ask to directions to get to that destination. Games shouldn't be absolutely realistic, and most of them don't want to be.
Yahtzee Croshaw said:
I do not know how anyone could have thought that regenerating health would enrich that experience. When your health can regenerate, all you need to do is, as ever, hide behind a wall and wait for a bit.
Regenerating health was a measure enacted by developers to meet players halfway in terms of game difficulty. Before 1996, I had never completed a Doom game while the difficulty was above "I'm too young to die", the lowest difficulty level, without cheating. All other times (on "Not too rough" up to "Ultra-Violence") I enabled [iddqd] from the start, and occasionally [idkfa] when hunting for keys in monster-less corridors became incredibly boring. I assume developers used regenerating health to discourage this kind of play, which is exactly the wrong way to play a game. It wasn't until the summer of 1996 that I had seriously attempted to complete the three episodes of Doom on UV without cheating. Two years after the sequel had been released. Call me risk-averse.
My complaint with regenerating health is that it regenerates far too quickly in most games: hide behind cover for a moment and half of your total vitality it restored. It's as if god-mode was built into the lowest difficulty levels of most modern first-person shooting games.
Health by station games tend to become slightly less boring than playing a game in god-mode due to the backtracking. When it was released it played Half-Life for the interesting level environments and horrible voice-acting (in the tesssst chamberrrrrrrrrrr), not the difficulty level, because interesting level environments and horrible voice-acting were things that the original Quake did not have.
Health by murder is interesting in that it encourages players to actually play the game and proceed forward rather than hunt for health packs that haven't been collected in the far corners of the current map.
Health by environment is mechanically identical to health by station, except there would be more health stations, and the health stations would become random terrain objects. Less boring, in a way, but eventually it comes down to players drawing health from whatever power lines/soda machines/lightbulbs are nearby. Too many or too few would break the game, and balance testing would be paramount in that kind of game.
Health by collecting second-chance flags (Sonic's rings) could be explored by first person shooter games, in a way. But really it would boil down into a combination of the regenerating health and health pack item pickup systems mechanically; start with health at 2, getting damaged reduces the health counter by 1, collect a health item or wait (run away) until the counter regenerates to 2, and when health reaches zero you're dead. This kind of system might encourage smarter play, such as not running in the open or between cover in directly front of enemies armed with automatic weapons, since "two strikes and you're out" will force players to take fewer risks.
Health by moving around isn't far from regenerating health by sitting still. Another aspect of regenerating health that isn't always taken into account by the player: why are you losing so much health? Are you running right up to the enemy instead of sneaking up on them? Not using cover effectively? Using the wrong weapon? Not using tactical retreat or grenades to lure enemies away from entrenched positions? Are you running into and through your teammates' lines of fire? Are you playing the game wrong (Commando-style*, instead of Rambo-style*)? Regenerating health time, the time players spend sitting still while they're health is restored magically, is almost never used by the player to reflect on why they were absorbing so many bullets/rockets/fireballs. Game instruction booklets have never contained basic infantry tactics. I see a few reasons for this, but will present only a three.
One: players don't read instruction manuals. That's a whole lot of trees gone to waste, and the paper is too rigid to be used as toilet tissue.
Two: learning movement and engagement tactics can become boring after a while. Who wants to study before playing a game? No one. They want the game and/or online opponents to teach them how to not die. And that's why modern games are composed of 10%-25% tutorial missions: because players don't want to read, and they expect games to hold their hands while they riding on training wheels that don't come off until the climax of the story.
Three: movement and engagement tactics that increase the likelihood of survival may make the game boring in the ways that cover-based shooters are boring.
In closing, I'll be playing some Metal Slug X after writing this junk, and dying a lot.
*Commando-style: reference to 1985 film Commando; running around shooting everything like an idiot.
*Rambo-style: reference to 1982 film Rambo: First Blood; using guerrilla warfare tactics.