Hit points do not represent actual physical damage. They represent your ability to avoid actual physical damage. Sometimes your suspension of disbelief will run up against the concept of hit points. In which case I suggest making them match.
Your example was a person falling out of a four story building. Realistically, you cannot survive that fall. Game terms, yes you could easy. I cannot abide by that myself, so if I put my characters in a position where they where in that much peril, I would make a save or die (yes, even in fourth I will have it; but I like the concept of drawing it with multiple saves) fall. Now am I going to do that from a story standpoint with my characters? Probably not. I am going to have some fluff their so reality can match the fantasy. The character falls off, manages to grab several ledges, slowing him down, and falls onto an awning and then trash heap, etc. If their is multiple chances for all characters to fall off, I will have to make some other fluff for reality to match fantasy.
Realistically, if a person receives a bad cut to the gut, they are out for 1-8 weeks. In my campaign unless their is a story reason for that, I am not going to have them receive that kind of wound. The hit points they take that day do a good job of tiring them out, taking away their luck, and they have plenty of scatches, but nothing a night of healing won't fix. I only decribe killing blows. If a character hits a monster for 50 hp of damage, and the monster has 100 hit points, I describe it like this "Normally your well timed blow would have felled a normal beast and all you managed to do was put a scratch on it." Same with Characters.