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I really like the way it's handled in Matryoshka (a homebrew variant of Powered By The Apocalypse). There is a harm mechanic and there is a lot of leeway in how the DM dishes it out both to NPCs and PCs.
I generally prefer its focus on collaborative storytelling over straight up tactics and minutia of stats and attack ranges etc.
Check out the Red Game Table podcast if you're interested in a ttrpg that is basically cosmic horror x-files in the eastern bloc during the cold war.
I like Fate. You have a small quickly restoring pool of stress to soak up harm, but anything more becomes a Consequence. Players agree on what an appropriate consequence is and the narrative follows. You don't really have the "he's at 1/483 HP but still fighting strong!" thing.
That sounds really similar to the harm system in Matryoshka actually.
Like there are 7 points of harm anyone can take and as they pass certain thresholds they can receive wounds both physical and otherwise that may cause negative modifiers to subsequent rolls on certain stats or even just in general.
Like in the campaign I am in my character almost got themselves killed in a monomaniacal attempt to communicate and study a psychic entity and wound up just letting them literally live rent free in his head.
Yes, was going to bring up Fate! I really like systems that split damage into 'heroic near misses or light damageless scrapes' and 'actual wounds', without getting too bogged down in random tables and lookup charts.