But that's the point isn't it? Neither is realistic, but at least with magic we can say "oh, it's magic to that's okay". Without magic, people just get better overnight... and that doesn't suit a lot of people because it makes NO SENSE. Magic allows us to bypass sense, but 4E says to bypass sense without magic.There's nothing inherent in magical-or-long-term-healing that is more realistic than a quick recovery system.
A lot of the complaints are along the lines of, "it is more/too abstract now". And the responses are along the lines of, "But it was always abstract".
The fact it is abstract isn't the problem. The degree to which that abstraction is taken is the problem. For many gaming groups the change in the degree of abstraction is just fine, to others it is not.
The complaint is that the degree of abstraction changed, but the response is that abstraction is okay. Which rather misses the point of the complaint.
I'll now present a slightly alternative way of handling the Healing Surge mechanic. From a game results standpoint it is identical - there is no alteration in how much damage you can take etc. The difference is in how it is tracked, and it MAY help with people trying to understand how healing surges work.
A 1st Level Fighter with 14 Con has 29 HP and 11 surges. A surge heals 7 HP.
So per RAW that's written as HP: 29/29 and Surges: 11/11.
My alternate way of writing that is:
HP: 106/106 Danger Point: 77 HP.
It works as follows: Your character's total hit points is their orignal hit points value plus # of surges * surge value.
The Danger Point is the point where you fall unconscious/dying.
Each time a surge is triggered, the Danger Point moves down by the surge value, thereby giving the character more breathing room, but not 'healing' the character.
The only healing he/she receives is from special powers, not the surges themselves.
Example:
After spending 2 surges already our character is at 70/106 HP, and Danger Point 63. The party cleric casts Healing Word, causing the fighter to lower his danger point to 56, and heal 1d6 + Cleric's Wisdom HP.
From a narration point of view, this makes a little more sense - you can map the amount of narrated damage received against the total of 106 HP, instead of mapping it against 29 HP. Each time a blow takes the character close to, or even below the Danger Point, you narrate a blow that is questionable - it looks bad, there's lots of blood, but only time will tell if it's serious or not. This is the 'blood nose' of wounds - There's blood everywhere so it looks bad, but it won't kill you. You don't know that it won't kill you until you've had a few seconds (a round or two) to stem the flow and assess the real damage.
Mechanically this method would fail due to overcomplexity, as you'd have to ensure you never receive too much healing because that would leave you with a greater range of HP than you should ever have at a time. Also your bloodied value would continually move. But narrating it would make a great deal more sense to some players.
Each time you reach your danger point, it's a telling blow, the kind that make you wince and wonder just how bad it is... but when you're not near that point, the blows just glance off, or the character rolls with it etc. Healing surges don't appear as healing, because they don't restore your HP, they just give you access to a lower section of your HP reserve.
When you get right down to it, part of the problem is the choice of words. If "healing surge" was replaced with "Hit point reserve" it would fit the logic a little better. Being given encouragement from the warlord makes sense in that it allows you to 'dig into your reserve', but doesn't make sense if it 'heals' you.
The term badass keeps coming up also. 4E present badass differently to earlier editions. A 4E character takes damage, sucks up healing surges and continues on his badass way with full HP. A 1/2/3E character takes damage, and continues fighting, despite the fact he's a lot closer to death. Both are badass, but in different ways. I prefer the earlier representation. 4E assumes all characters are badass. Earlier editions presented it as a choice - you can keep fighting even though your wounded (be badass), or you can take the better part of valor and return another day (play a character that isn't badass). Running away after using some healing surges makes less sense because it appears as though the character is fully healed, although in fact he isn't.