I'm considering doing an unrealistic Halo-like health system. That is, if you take too much damage too quickly, you die, but your health recharges when you're not getting hit. I think this allows set pieces - "I've got these resources to get through this section" - which is exactly what I'm trying for in Pistol Slut.
I actually liked the riskiness and uncertainty of not having a health counter and not being sure if the next bullet would be the one that takes you down.
Maybe with a stronger indication of when you get hit it could work quite well without one.