4e's model works PERFECTLY well for something like 'Seven Deadly Sins' style epic conflict where the PCs are literally invoking and being hammered by epic level magic that blasts the land almost on a scale equivalent to nuclear weapons. Arthur comes back to Camelot in a sequence at the very end of the series, after 5 demon lords and 6 or 8 ultra-powerful characters duked it out there. The whole place is literally melted slag. Every character (on both sides) walked away from that fight, albeit some of them were 'bloodied' a bit. Even the healing powers that some of the characters employ are very well modeled by 4e; at several points major characters are 'out of gas' and reduced to either outright unconsciousness or ineffectiveness, and then one of the healers comes in and charges them up again, and they rejoin the fight, albeit they're often still somewhat worn down.
I mean, I agree with you, NO VERSION of D&D emulates anything realistic very well AT ALL. High level AD&D is not really all that different in character from 4e in terms of how it is best interpreted. Hit points are basically 'plot armor' and can be equated with luck, fatigue, minor injury, etc. Sure, you can imagine a PC as having some limited degree of significant injury (broken ribs, cuts, piercing wounds, maybe a severed minor body part perhaps). Still, clearly their limbs, torso, head, etc. is entirely intact, or they'd be suffering critical debilities.
And it isn't that hard to make a more realistic system. If EGG intended any level of realism, any level of 'your body is actually being ripped apart' then it would have been trivial to implement, and many RPGs have done it. I mean, my own game has the possibility, you can accept an 'affliction' of the type 'wound' in place of critical damage. It's just a fun way of introducing another dimension of stakes into combat. Players can entirely ignore that and play 4e style, or they can trade an HS worth of damage for 'broken arm' and whatever conditions that imposes. Honestly I'm not sure how well that plays, it's an element of play that hasn't been used much up to now.