Obryn
Hero
I don't think it matters one way or the other. HPs are HPs, and Surges are your Reserve, and what that means is necessarily left vague. (And for the record, I don't think that the "Unconscious" status must necessarily mean unconsciousness in a real-world sense, either.) There's nothing wrong with describing someone as bruised and bloody, but 4e HPs shouldn't represent stuff like broken bones, concussions, severed limbs, etc.
If I want to model long-term injuries, I have other, better ways of doing it.
Clerics and Bards heal with divine and arcane magic. This doesn't automatically mean they're patching up wounds - a cleric of Kord could just as easily be doing something through divine power like a Warlord does with martial power - inspiring people to ignore the pain and power through. Ardents could be dominating your mind to make you forget your wounds, suppressing pain, or patching stuff up. So not only isn't there a 1:1 wounds:hp ratio, there's no necessary relationship between power sources and means of healing.
This level of abstraction bothers the crap out of some people. It doesn't bother me in the least, but they're not wrong for being bothered by it.
-O
If I want to model long-term injuries, I have other, better ways of doing it.
Clerics and Bards heal with divine and arcane magic. This doesn't automatically mean they're patching up wounds - a cleric of Kord could just as easily be doing something through divine power like a Warlord does with martial power - inspiring people to ignore the pain and power through. Ardents could be dominating your mind to make you forget your wounds, suppressing pain, or patching stuff up. So not only isn't there a 1:1 wounds:hp ratio, there's no necessary relationship between power sources and means of healing.
This level of abstraction bothers the crap out of some people. It doesn't bother me in the least, but they're not wrong for being bothered by it.
-O