The Science of Video Game Healing – Extra Punctuation

All of which certainly helps with immersion, but sooner or later a real life simulator rubs up against the one aspect of video games that will never, ever, be truly realistic. And that is healing. You can traumatize your art team by making them render a photorealistic bullet wound in a character’s once handsome face, but then they regenerate like the T-1000 after they swallow an entire bottle of ibuprofen and suddenly the whole futility of the exercise is laid bare.

Oh, there have been plenty of video games that have tried to inject some verisimilitude into the process. Some games will have a suite of different healing items depending on the wound, such as Call of Cthulhu: Dark Corners of the Earth, or Metal Gear Solid 3, in which a lit cigar is great for cauterizing a bullet wound, not so good for splinting a broken limb. Or for treating pink eye. Some immersive RPGs like Deus Ex do that thing where different body parts have different health scores, so you can only cripple a dude from shooting them in the legs and never actually kill them. But the point is, there’s no realistic way for that dude to go back to sprinting at full speed later that same day no matter how many cold compresses they rub on their thighs.

And all these elaborate healing systems are just different language and complications layered on top of the process of eating a box of health and regenerating instantly. And we might as well accept that it’s never going to make sense. Might as well just lean into it like what Mortal Kombat does. Have special attacks that involve getting stabbed fifteen times and getting a stalactite through your eye socket, fall on the ground and stay there for all of three frames before popping back up for more.

The fact is, the quest for realism will always rub up against this because health and healing are a fundamental requirement to gameplay structure, before any notions of theming can even be considered. It’s essential at least in any game that has any kind of challenge. Or more specifically a failure state. Visual novels, walking sims and LucasArts adventure games can go back to sleep.

Because when you have a failure state, you also need a mechanism that shows the player how close they are to that failure state, to allow for human error, training, intuiting the mechanics and a certain amount of suspense. This goes back to the earliest imaginable days of video games. It’s the reason why Space Invaders gives you three lives. It predates video games, actually: pinball tables let you have three goes. You could argue that in chess, your remaining pieces constitute your health bar.

So health is really just a word for the fundamentally vital game design aspect of being able to signal to the player that they’re losing. Basically the same reason pain exists in everyday life. Follow that to its logical conclusion and you’ll realise that restoring it would also be useful for signalling that the player’s doing something right, and so was invented the extra life, and with it the mechanic of healing.
The concept of the health bar or health as a percentage was an evolution of lives because lives is a language that can only say one thing: you fucked up. Don’t do that. Health is a much more fluid concept, you can start playing with the idea that there are degrees of mistakes. You can remove a small amount of health for a mild error like dropping down a ledge that was slightly too high for comfort, and a larger amount of health for something like absent-mindedly sitting on a frag grenade.

And with that, the concept was just about perfected. Since then there’s been very little alteration in the fundamental premise of health as a stopgap between you and failure. Although I would like it noted that I’ve always admired Sonic the Hedgehog’s health system. It’s so unique, and works so perfectly for the intended feel of the game. You collect rings, and if you get hit all the rings fall out, and if you get hit with no rings you die. So simple, and yet so elegant, because it captures the purpose of health in a much more organic fashion. Having more rings makes you naturally safer because if you drop them all it’ll be much more likely you’ll be able to pick some of them back up before you get hit again.

Also, if you’re smart and quick enough to grab most of your rings back before they all fly away, you can get yourself back into a strong position, health-wise. Which works really well with the fast pace intended by the game. Never worked so well when Sonic moved to 3D graphics because the rings bouncing off in three dimensional space made grabbing them back again much more awkward, and it’s just one of the horrible things that happened after Sonic moved to 3D.

But it does illustrate how, while health as a failure buffer is a fairly universal concept, HEALING, regaining health, can be done in lots of different ways, and because it’s such a fundamental part of the core gameplay loop, the method you pick has a huge impact on the tone and feel of the game. So Sonic with the ring-regrabbing emphasises speed and getting stuck back into the action. I think the only healing mechanic I can think of that has a similar effect is the rally system from Bloodborne, where you can get some health back if you quickly hit your tormentor back, possibly while crying and gibbering in desperation.

But then you have Bloodborne’s forebear Dark Souls, with its Estus Flasks, a system wherein healing becomes more of an inexorable countdown to doomsday that constantly hangs over the player and incentivises them to seek the shelter of a bonfire. In something like Doom or Half-Life where the player has to find first aid kits lying around the level, low health is an incentive to focus on exploration and cautious advancement, force the player to think about their environment. And then of course there’s the auto-regeneration so popular in the meathead shooters of the 2010s, aimed at players who, and let’s try not to sound cruel, react poorly to being obliged to actually think.

In the age of gear grinding, health is frequently just another resource, another number for the crunching, to be strategically risked for equivalent gains and boosted by 5.64% percent by an artfully selected hat. Which does take some of the joy out of the process for me.

Here’s a fun idea – how about instead of bodily integrity, you refer to health as “luck,” and every time you’re about to get shot, the bullet just barely misses and you lose some of your “luck” bar. It runs out and you finally get hit for real. There, that could for work a realistic setting, disregarding the magical good fortune that’s somehow numerically quantifiable.

Or, if you’re in a war setting, have no healing at all but if your character dies or gets seriously wounded, you have to replace them with a virtually identical soldier who’s still healthy. Sort of like what ZombiU does. This would really fit something like a World War 1 setting because it would reinforce how relentlessly fucking bleak everything is.

Of course both of these ideas are just another changing of language, and isn’t doing anything new mechanically speaking. I suppose my overall point is that designing games is ultimately one long list of decisions between what would be realistic and immersive, and what would be necessary for the functioning of gameplay, and healing is going to be ground that the first side of that conflict is always going to have to cede. Still, it’s something I find fun to think about. Some people tell me I have strange ideas of what’s fun, but that’s between them and the FBI profiling unit.