What does a fish know of water? Avoiding design patterns?

I think that the main reason for designers to use health is that it gives so many more possibilities in the design of a game.
It has also many balancing advantages over 'not' using health tracking.

The main disadvantage of health tracking, is the health tracking itself.
That's it, I don't know of any other disadvantage.

I do know of a replacement though in the form of using dice only. But I bet that this is the second most used mechanic after health tracking.

If you really want to refrain from health. Perhaps design a game, then remove health and see what can replace it. Maybe the game works without health?

Not quite sure... The game I was thinking about (or had previously seen) was that a Deck was being used and you needed to worry "about your deck running out of cards"...

Seems like it would be something different than "Falling".

But for the life of me, I can't remember any details concerning the name of the game.

What I can CLEARLY remember is that either there was one deck or each player had their own deck and cards were uses as life points. When you run out of cards, you run out of life points and are "dead". "Falling" doesn't seem to have that kind of mechanic... I also don't remember the need for a player to have to draw cards, I think players did this by themselves...

I highly think it's ANOTHER "Card Game"...

Update: From what I can remember is that the game was NOT "real-time", it was turn-based ... It might have been a NEW design too... Because it just doesn't seem like "Falling". That seems to be the only game out there where you are "falling from the sky" ... but the reality, it could have been another design...

It had to be "turn-based" because otherwise it would be very difficult to avoid cheating or "not losing" in a "real-time" game...

Quite a few games have used decks as health. One group of examples is WotC's "Arc System" games from the late 90's (including the Xena and Hercules CCGs), which played in a broadly similar way to Magic: The Gathering, but instead of having separate life points, you discarded cards from your deck when you took damage. I rather liked these games for their speed and simplicity.

I had a somewhat similar card based health tracking system. It was a dungeon crawling romp with a health track that you'd put your damage cards on to.
When your turn came, you'd read the whole tracker from left to right to see the effects of damage you had, and when you got to the first empty spot on it, it would tell how enemies reacted to your condition and you'd move them accordingly.
It was one of the few aspects of the project that actually worked right out of the gate.

I think these weirder systems and just plain HP both have their places of course. I feel that binary HP has much more heroic feel to it as your character can act as normal to the bitter end. While the other has some debilitating effects to it, more suited for grim and depressing survival style games.

I had a method that used dice instead of cards on your character sheet for an experimental RPG some years ago. It's been shelved since I felt it was too clunky even for an RPG.

Your character's ability to do combat and cast magic was based how much dice is put into their sheet. The more dice, the less they can do. The object is you want less dice on the sheet and more in your hand to roll.

Your D6s are your least capability, D8s are basic capability and D10s are your best capability with the few D20s as your critical capability that can do permanent or lingering effects.

Fatigue starts to draw from your D20s and you work your way down barring some feats and abilities that can offset by letting you keep at least one die of a certain side. Where this gets interesting is injuries. If you're injured you're less likely to defend and attack versus being uninjured.

The difference is, you get your dice back when your character takes a reprieve and rests a little where as injuries the dice does not come back until you're healed. I even made it where if you can lose a limb if a nat 20 is rolled on your character which can more or less take your character out of the story or limit their full potential.

You put the appropriate number of dice as well as the certain sides onto the sheet to modifier things such as movement speed, attack, defense and other strenuous actions. Some of your stats dictated how much dice you get back and so on.

It worked well in theory but in execution, it needed a lot of work.

That's how I handled my own variation of hit points and damage.

It's tempting to try and avoid design patterns and make something completely unique, but unless I have a really good reason to or think of a really good alternative I just don't. Usually, if I go away from the accepted standard it's because it naturally developed that way and it just makes sense in the context of the game. Modifying things just to avoid these mechanics often leads to awkward, confusing, contrived gameplay.

Just remember, these patterns are there for a reason. They work. People like them. They are general enough that they do not really decrease the uniqueness of your game (nobody can really say you made a knock off of magic because you used health points). They are familiar and players instantly understand how they fit into the framework of the game.

Just my two cents