Playing with hardcore switched on, you can switch it off at anytime but you can't switch it back on.|
It makes the game much more strategic, scary how often you get a limb crippled and have to fight on until you can get to a doctor, stimpaks are definitely rarer but doctor's bags are even rarer again and only they can fix your limb. When you meet multiple enemies you really have to plan your attacks, right now I'm throwing sticks of dynamite at them, hiding until they come into range and bludgeon them with a sledge hammer, it's just easier to deal with enemies until I can get my gun/energy weapons to a higher skill rating.
Having to drink and feed yourself was kinda annoying at first but now I'm used to it and it adds to the game as you have to judge the value of food now and think about where you're drinking water. Before food was almost meaningless in fallout 3, at the stage where I have to decide what to drop, particularly in terms of ammo and guns, and when you add keeping miscellaneous items for workbenches and what not decisions become tough, overall though I'd recommend it. Hoping to stick with it to the end.