Hitpoints don't represent physical damage. But when you are half your hitpoints, you're "bloodied".
In my games, I narrate the hit that produces bloody-ing as causing some sort of physical damage - a cut, a burn or (if it is psychic damage, which is fairly common in my game) bleeding from the ears in classic X-Men style! I personally haven't found this to be a problem.
What would be trickier would be if the bloody-ing was the result of inflicting hit point damage by way of sheer demoralisation (eg as in the final encounter of the Winter King module in the Monster Vault). I'm sure I'd find a way to handle it, though - after all, there's always the possibility that blood starts welling from an earlier blow that appeared at the time to have been a mere touch or graze.
I find it difficult to narrate a serious wound if there is a significant chance that it can be practically "ignored" within the time it takes to have an extended rest (less than 24 hours and assuming no magical healing).
I can agree with this, but personally don't feel that the 3E healing times make a significant difference here - especially because the ignoring of the wound can begin right away (ie lost hit points don't impede performance) and the only way that the ignored wound impedes performance is the rather abstract one that later blows have a better chance of being killing blows.
Obviously in this discussion I'm closer to [MENTION=22779]Hussar[/MENTION] - I'm a little curious about the narrative space in which exist wounds that (i) don't really impede performance at all, but (ii) in some sense (which is a bit obscure, given that they don't impede performance) take days or weeks to recover from, and which (iii) would strain verisimilitude or genre to be recovered from in the same obscure sense within several hours instead.
I'm not denying that the narrative space exists, but I'm not sure what its occupants are. What is particularly unclear to me is (ii) above: ie, what does "recovery" mean in AD&D or 3E, when at any time the "wounded" person can get out of bed and perform unimpeded. (I know that dropping below 0 hp in AD&D is an exception to this, but as Pentius stipulated upthread I'm interested here in wounds that don't cause unconsciousness.) Until I have a clearer handle on that, I don't have a handle on why (iii) narrows the narrative space for those who are OK with (ii).
I know people upthread have mentioned concussion, brusising etc, but either those things impede performance - in which case hit point loss in AD&D or 3E cannot be those things, any more than hit point and surge loss in 4e can be those things - or those things do not impede performance, in which case they can be narrated or not independently of the healing mechanics: I can describe my guy as being at full hp but covered in bruises, or at low hp but physically hale (all that I've used up is my luck!) or any other mixture that takes my fancy. Just as the scuffing and polishing of boots and armour is treated purely as a matter of free roleplaying, so can the scuffing and polishing of bodies!
Looked at in this way, with full regard being given to the non-impedence point, in any edition it seems that what is being "recovered" when hit points heal is luck or fate or verve or heroic capacity, and I don't see why several days is OK for that but several hours not.
This doesn't address my problem with PCs getting up every day with wounds they can always completely brush off without external healing.
Like I've said earlier in this post, in 3E I can completely brush off those wounds too - the only effect they have is they make it harder for me to ignore wounds in the future (ie because my hp reserve is lower) - which means that rather than actual impeding wounds they are more like a loss of heroic verve. And I don't feel any particular loss of verisimilitude in verve returning over hours rather than days.
For others, it is just one of a long line of "gamist" issues with 4e that makes houseruling all of them difficult. Far easier to stick to a previous edition and highlight surges as one of the main issues I suppose.
My thinking is this: suppose I liked the way 4e combat plays, but for reasons of pacing or verisimilitude or whatever found the extended rest mechanics a bit over the top, I could trivially houserule the recovery times with no other adverse effects on the system. Whereas suppose I found the role of healing surges in 4e's combat dynamics irritating, then I would probably have to find another game, as they are pretty central. At which point the fact that the extended rest mechanics irritated me too might be icing on the cake of my decision, but hardly a determinative or even a significant factor.
Or you could get rid of the healing surge since that is what is causing issues for people.
But at this point you're bascially committed to rebuilding and rebalancing the game - the healing surge mechanic is pretty inherent to the balance between classes, the balance of the action economy, the design of many powers, and the dynamics of combat.
The easier path - but one which narrows the story space quite a bit - would be to ban the warlord class, to abolish the Second Wind action, and to have each of the PCs bear a magical tatoo with a 1x/enc standard action healing power as a Second Wind substitute. (The dwarves, being masters of tatooing magic, would of course have tatoos that permit this healing as a minor action!)
But if you can't handle non-magical surges, and you don't want to do something like the above, then I think you have to seriously think about dropping 4e, given the work involved in stripping out the surge mechanics.
That's kind of boxing in character options a little if they are all so "heroic". Variety, spice, life and all that.
you're losing a lot of potential narrative paths by that always happening.
D&D isn't generic, it emulates a specific type of fantasy. Arguably, different editions of D&D are better at emulating different sub-genres and their related "narrative paths" than others.
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complaining about healing surges here is a bit of a red herring; healing surges are simply one symptom of a greater issue--you want to play a different kind of fantasy than (4e) D&D fantasy. Naturally, it's making you feel artificially constrained and hampered in your efforts. In all fairness, though, that should be expected.
Here I agree with Hobo. And I made a similar point to JamesonCourage upthread. If I want semi-gritty fantasy, 4e won't deliver it. But if I want gonzo heroic fantasy, 3E won't deliver it without a cleric or bard (because of its natural healing times). Each supports certain "narrative paths" but undercuts others.
I have played a lot of Rolemaster, which is a game where recovering from wounds takes significant ingame time, typically even after magical healing has been received. I personally don't think this works all that well for Rolemaster, which in many other respects is closer to D&D in its gonzo-ish orientation - so the gritty recovery can get in the way of "save the world" scenarios. Burning Wheel is also a game which builds extensive recovery times into the system, and does so I think in a more integrated way than Rolemaster.
But what both RM and BW have in common is that wounds actually play like wounds - they impede performance - and so when a recovering character hops out of bed because heroism demands it, the burden of the wound is still felt. Given that in any edition of D&D this is not the case - performance is unimpeded - I think that D&D copes fine with wounds, and recovery from them, being simply a matter of free narration.