I've written up "visceral/descriptive" harm rules for AW and Dungeon World, and now I can't stop. Since I'm playing Monsterhearts in a couple of days, it gets the same treatment.
It's basically a first draft; I expect many revisions. But I think Monsterhearts needs a more interesting take on harm than good old hit points, so here's a basic adaptation of my AW harm rules to Monsterhearts.
The basic gist is: you hurt someone to make them lose control over their destiny.
When you suffer bodily harm, roll. For each statement that is true (below), take +1 to your roll.
* "It's not serious: they're not really trying to cause me lasting harm."
* "It's not frightening: they're not bigger, heavily armed, or more numerous than me."
-If you're not sure if "they" are trying to cause you lasting harm, ask them.
-"It" could be an object or a place, if, say, you've just crashed your car.
On a 10+, choose one from the list below.
On a 7-9, choose two, or ask your opponent to choose one.
On a miss, you choose one, and your opponent chooses one.
Mark your choices. You can only choose each option once. If you come back from apparent death, clear them all.
The MC or other players can narrow your choice. Don't choose an option which doesn't follow believably from your actions or the situation. If "you're dead" was chosen, the second choice might come into play before, during, or after your death: for instance, you might flee, only to bleed out and die in the woods.
O You are scared and shaken - give a String to your attacker.
O You look weak - lose a String on your attacker, and take a Condition.
O You're a bloody mess. This will probably leave serious scars.
O You freeze up or you panic and flee (your choice).
O You're knocked flat on your face: dazed, senseless, you hardly know where you are.
O It's bad: you're going to need medical help.
O Afterwards, you have no clear memory of what happened or misremember important details.
O You're dead.
At the beginning of a new session, clear any and all choices which don't seem to be still relevant.
Otherwise, spending time with someone in an intimate context (being vulnerable to them) can allow you to clear one. Ask them what they're doing for you, and which choice that might allow you to clear. (Again, follow fictional logic here: if they have some weird way of restoring your memory or bringing you back to life, then that's an option. Otherwise, probably all they can do is remove a Condition or get you cleaned up so you don't look like hell anymore. A medical professional can supply medical help, of course, in the same way.)