I dont need 100% realism or a healing and damage simulator but I do want a modicum of believability and for HP to represent actual physical damage.
The question is - what sort of physical damage are you talking about? Bruises, cuts and scrapes? Or being punctured through the lung by a lance?
so the solution is to be even less realistic and hand wave mundane healing?
It's not an issue of more or less realism. No edition of D&D (not even first-ed AD&D, although it has the strictest rules for recovery from negative hp, and for natural healing) requires mundane healing to take anything like a realistic amount of time, nor impose anything like a reaslistic amount of impairment,
if that natural healing meant natural recovery from massive physical injury like being impaled through the lung by a spear.
It therefore follows that no edition of D&D has had mechanics that result in PCs suffering such injuries in combat (some magic swords being an exception).
It therefore follows that natural healing has always been recovering one's stamina/mojo, plus recovering from bruises, minor blood loss, grazes, and rather modest cuts and scrapes.
How long should that sort of recovery take? In my view that's mere taste and adventure pacing. (4e says "overnight". BW says mulitple hours, up to a day. 3E says a week or so. Rolemaster generally says a day or two. In BW and RM good CON reduces the time. In 3E it increases it - because you'll have more hp/level with a good CON. In 4e CON is irrelevant.)
A modular set of rules (as D&Dnext apparently aspires to be) will set a dial and explain what are some of the factors that one might have regard to in setting it.
There was a damage treshold for massive damage in 3.x.
In 2nd ed AD&D also, I believe.
A lance that does 20 damage does not impale the 10th level fighter. The 1st level one is dead. If you have some massive damage rule that says: a lance from a charging knight against a charging knight reduces the massive damage treshold to 20 will usually never occur. But those people wanting "realism" in their game are happy.
You could also rule that both knights are coup de cracing each other.
But what does a "massive damage episode" or "coup de grace" represent in the fiction?
If the PC dies, it is clear enough - the PC was skewered, decapitated, throttled, whatever.
But if the PC survives, then it must be the case that the blow missed, or grazed, or merely stunned, or something of that sort. That is, the in-game intepreration of the hp damage can't be settled without knowing the result of the saving throw against massive damage, or without knowing how many hp the PC has left after the damage is applied.
It will still be the case that no PC who is not dead has ever been skewered by a lance.
I believe there is a middle ground, that leaves both grogna4rds happy/unhappy.
Whereas I am more doubtful about this, because at least some of the "grognards" in this thread want it to be the case that both (i) some hit point loss represents massive wounding and yet (ii) that same hit point loss neither kills nor impairs. Which is to say, they want a game that has all the lack of verisimilitude that drove many RPGers in the 80s to games like RQ, RM, HERO, etc that don't have any such issue.
D&D assumes cinematic wounding. It doesn't matter how hospitalized John McClane should be, he keeps fighting without impairment because it's an action film. All D&D characters are that tough.
It's a while since I've seen Diehard, but I don't think JMcC gets impaled through the lung with a steel rod.
I have recently reread a number of Conan stories. Conan gets in many fights, but he is never run through. He suffers cuts, abrasions, bruises etc. Not impales or severings or disembowellings.
That does not mean wounds are morale, or luck, or any other such crap.
I don't think anyone in this thread is saying that "wounds are morale". That doesn't even really make sense.
Some people (including me) are saying that a lot of hit point recovery is morale - that is, drawing on one's mojo so as to push one despite the bruises, cuts, minor blood loss etc.
TL;DR: There are two ways of explaining the absence of a death spiral. One is that when PC's lose hit points, they are not taking severe wounds until they die - until then, they are pushing on despite superficial/modest injuries.
The other is that they are being run through, disembowelled, maimed and the like, yet nevertheless suffer no impairment in their performance, and are able to recover from these wounds in a few weeks at most.
Being a fan of verisimilitude in my RPGs, I go for the first approach when I play D&D. And when I want a game with real wounds, I play one. The idea that a person might be disembowelled and yet fight on without impairment, and then walk back home and recover in a week of bedrest, strikes me as too silly for words. And I can't believe that this sort of bizarrely comic theory of hit point loss as being put forward under the banner of "more realistic".