I don’t think it would be desirable to put that sort of stuff in a pen and paper game. If you were making a hybrid system as more than a form of game-crippling DRM you could handle it better by letting the computer worry about calculating all your bonuses, penalties, derived bonuses and derived penalties, but for a pure pen and paper game, the less bookkeeping you need, the better.
As a note, there’s a difference between using a map and using a grid. Having a map with miniatures on it can resolve a lot of arguments about “Wait, I was standing on the other end of the room” and “But I thought the other guy was in between those two”. But that map doesn’t necessarily need grid marks on it. You can trade in the grid marks for other ways of measuring distances (for instance, bits of string or wire of appropriate lengths) to get the same benefits, without some of the peculiar artifacts of the grid. It’s a bit more work, of course, but some groups find it acceptable.
Yeah; Maps are often useful - even if they’re just quick sketches. Grids… result in a certain style of play. Though I personally feel that if you’re going to play the “is he in range or not? Let me measure!” game, then you might as well just bite the bullet and use a grid, artifacts be damned, because measuring distances is a pain in the ass.
Wait, you mean your gaming group doesn’t already handle the vast cornucopia of feats, buffs, debuffs, items, side-effects, conditions, negative levels and so forth of regular *Pathfinder *with handy iPad apps ? Oh, you poor bastards 
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Actually, I find it a little odd that you can, in the same breath, say “I fudge things when they don’t produce the results I want” and essentially, “I want my characters to be able to randomly lose an eye at any time.” These two concepts seem fairly fundamentally opposed.
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It’s not so much “I want my players to lose eyes randomly” and more “I want them to treat every encounter somewhat seriously / sometimes actually begrudge and *remember *a random mook”.
E.g. I think it would be interesting for a given character to develop an irrational hatred of goblins because “it’s because of fucking goblins and their pyromania that I look like *this *! Screw the dragon, I’m going to torch every last goblin village in the region *myself *!”. Fantasy litterature and their inspiring myths are certainly rife with demi-gods doing everything right all of the time, but being or becoming a demi-god always comes with a price of some sort, which in turn has an impact on their psyche. That price hardly ever materializes in D&D.
Dungeon World. 
See, this is why I don’t give a rat’s tail about 5E. D&D is, as far as I am concerned, a game whose time has passed, and it’s lingering on because people haven’t looked at the alternatives.
Swap “goblins” for “slavers” and that pretty much describes my favourite D&D character. It is unfortunate that she failed her Will save against the Apostle of Peace, because when a captured slaver started taunting her about her backstory, I was fully intending on having her try to knock his block off.
Airk: Maybe someday I will look into this Dungeon World you speak of. However, I assume you know that since most people started gaming via DND, although that’s less and less true, it is (was) easier to gather a group based on DND and then branch out from there, if everyone was open to it. (I prefer Alternity myself but lack of support makes that tough.)
In my case, I have some cheap buggers who game with me, so they would be wanting my copy of the game to use. It’s really tough to play a game, imo, when I have to totally worry about rules and the other guys have no idea about it and do the adventure on top of that!
I think the people who want characters to have that kind of depth tend to be DMs and not players. A system that tracks all of that is usually difficult that it’s not easily playable by new players and can get tough for veterans.
Don’t get me wrong! I like it when rules and role playing match up. In other words, a character does get badly hurt by an X and then the system has a way to reflect in game terms. We might still forget it late in the gaming session but at least it’s there compared to “pure” role playing, where the player remembers all the quirks like that about their character.
I say this because stacking all of those penalties (fear of goblins, fear of water, hatred of orcs, fear of trees) is like running a high level game in PF. Suddenly you have so much to track, that it’s tough to walk across a town without making some sort of check! It can be argued to hand wave that but if the character is afraid of something they might encounter, it shouldn’t be skipped.
(The point being that you can’t skip much anymore because it forces the “have a bad day” check and where they were going to work on a magic item, now they are pissed/scared/intimidated so much that they can’t work for that day. Still exaggeration but hopefully the point is taken. At what point does the reality of having little quirks and phobias become the game instead of enhancing it?)
Back on topic, at the end of the day, DND 5E seems to have some good ideas behind it but I’m not convinced the execution of it will appeal to me and my group. I will wait and see.
Most people learned to get around via walking first too, but that doesn’t mean there’s no place for cars. 
What kind of “support” do you feel a game company needs to give you?
Guess what! Dungeon World, unlike D&D, has basically every rule the players need to know on their character sheets. So NO, you really DON’T need multiple copies of the rules at the table, and if someone desperately wants to read up about it between sessions, it’s all online! Thinking “OMG! Everyone needs to have a copy of the rules, otherwise, how will they look things up?” is the exact kind of oldschool D&D-based logic that I don’t feel has a lot of place in tabletop RPGs these days.
There’s a difference between “a system that tracks stuff like that” and “a game in which things like that happen and make sense.” I am not attempting to assert that Dungeon World has RULES for this stuff. Quite the opposite. What it has is a system in which players will pay prices. It is inherent in how actions work. Those prices may be temporary (“Your grip on the ledge slips, your quiver tilts, and you lose half of your arrows.”) or long term (“The dragon tears your arm off.”) but they flow from the fiction, rather than “roll on the loss table.”
Now I think we’ve wandered needlessly far; Any game that does this would be functionally unplayable. DW attacks the situation from the other side - it encourages and supports these sorts of things WITHOUT needing special rules and restrictions.
Please share what some of those “good ideas” are, because right now, I haven’t really heard any.
That’s how it works in Warhammer 3rd Ed - any random mook can crit you, and some of the crits either are permanent or turn into permanent disabilities if you are already badly enough wounded. And if you happen to avoid getting any criticals in the fight itself, well if you were fighting ghouls or zombies or something that uses especially dirty blades, you just might catch a disease instead. Those are a pain to get rid of as well.
You can imagine the hilarity that ensued in our gaming group when in a certain battle our Knight took a Flesh Wound, then a Flesh Wound and finally a Crippled Leg which was pushed into a full-blown lost limb by the flesh wound criticals. He got a wooden leg later on and had a horse and was good with a pistol, so it didn’t even ruin his character concept.
Another thing that it does well is making it hard to avoid being hit so even rather feeble opponents end up whittling your hitpoints down rather quickly. Fights are short, brutal, exciting and scary.
Not sure how something like that would work in a D&D though, given how common combat usually is in it and how powerful healing magic is.
Disease charts are truly the stuff of heroic fable! 
I think I tried to play WHFRP once, and through the magic of totally random chargen, ended up with a gravedigger. I think he could play the lute. He didn’t really seem like adventuring material, somehow.
On the other hand, having THIS happen would have destroyed any attempt at coherence for the remainder of the game session.
Yeah; This stuff is 50% system assumptions and 50% ‘game table’ assumptions. Nothing stops you from playing D&D where there are no clerics or healing potions, but it results in a game with a feel that’s probably not going to be a lot like D&D, and that annoys a lot of people.
Sounds like newer editions of WHFRP might not be a bad choice for Kobal2 though.