Garthanos
Arcadian Knight
The Dragon Masters of my game world tend to have somewhat poor self defense because they are regenerators with a berserkergang issue (they have monster like hit pts)... when they get hit it very often not skill induced fatigue/luck turning the blow or similar but that internalized healing turns the wound into fatigue and most healing is about refreshing that fatigue and other nebulous resource expenditure that heroes have ie divine favor / luck etc etc.My biggest gripe about HP is related to Healing. Heroes getting battered about for little impact is fine...just watch a marvel movie. My problem is when somebody casts a "healing" spell on a guy who...well, isn't wounded.
One way of seeing it is that a healer can see you are spent and that includes those nebulous resources that are hit points even if others cannot. It's part of both the magical healing gift and the knack for leadership. So that Poets Priests and Politicians all do their thing (Bards, Clerics and Warlords)
Wound removal is (in 4e) in a remove affliction ritual (and the surgery practice can do it to) But its usually only valuable for NPCs. Actually I think afflictions would be one of those areas I would have like to seen better developed for 4e. For instance perhaps if death saves are failed a wound/affliction is incurred.