D&D damage is, and always has been abstract.
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Gritty realism and medical detail are fine in theory but tend to bog down in play.
Sure. But how does this show that being critted by a lance in D&D means you've been impaled through the lung? That doesn't sound very abstract for me. That sounds like just the sort of gritty realism that D&D (as you say) avoids.
The consequence of damage being abstract is that it's abstract. Not that it's concrete, but we ignore its concreteness when we come to matters like healing, impairment, etc.
What does abstract damage look like in the fiction? I think Conan in the REH stories (much blood, much exhaustion, no serious injury) and Frodo after being speared by the cave troll.
Or perhaps it follows that off screen wound care involves prayer based healing rituals that are too slow and disruptable to be used in combat, but which allow for the healing of grevious injuries. Or maybe everyone in D&D knows magical/psionic disciplines that allow flawless wound recovery. But again, not combat usable and therefore not mentioned by the system. Fluff can be written as desired. It does not require chucking out the concept of grevious but sub-lethal damage.
This is the first time I've heard the theory that "natural healing" really isn't natural at all!
Have to disagree pemerton, taking a week to heal from a heavy blow or wound to the body may not be 100% realistic, but it is more realistic than healing in less than a day through non magical means.
In my view neither is remotely feasible - no one heals from a broken limb, a torn tendon or ligament, a ruptured lung, etc - in either a day or a week.
Which is why I say that
no hp loss from which a PC recovers, or can recover, naturally (in any edition of D&D) amounts to a wound like that.
Which is why I further say that all hit point recovery is (i) recovering from bruises, scrapes, etc - like those narrated by REH in the Conan stories (Conan's lips are bloody, he has cuts all over him, but no soft tissue is torn, no bones broken, no major vessels severed); and (ii) is restoration of the mojo necessary to fight on despite such wounds.
And as I said, whether mojo recovery takes a day or a week is a matter of taste and pacing. (In Conan it seems to vary quite a bit, depending on the narrative needs of the author.)
I am not asking for impaling rules or hit location, but i am asking that my guy who got trashed with an orc's axe can't just walk it off in minutes to a day. I agree that blow isn't all physical damage, but you cant just ignore the physical damage aspect of HP like 4E does and expect everyone to be happy
Anyone who thinks that their PC gets trashed by an axe, and then is all better in a week, is (as far as I can see) envisaging a PC with regeneration powers far beyond anything human, or even action-movie-heroic.
All that you can recover from in a week is cuts (that don't hit major vessels) and bruises. And the difference between a week and a day, in respect of recovering sufficiently from such injuries that they are just a cosmetic features rather than debilitation, is as I say purely a matter of taste.
No one is suggesring older editions penalized you for wounds (aside from walking around with fewer HP) or dealt with specific types of blows, but it did accomodate the notion that damage was physical and this is why mundane healing took so long (up to a week or more may not accurately model all physical wounds--though it spdoes model many--but it certainoy doesn't model being winded or tired from battle).
But one week of healing IS NOT LONG AT ALL! And for those who think that it can't be modelling recovering being tired from battle, I wonder how often they engage in serious exertion! Admittedly I'm not the fittest guy around, but a month or so ago I jogged home from a roleplaying session. The distance is somewhere around 12 km. I was carrying my backpack of books and stuff - I'm going to call it around 10 kg. I was pushing a twin pram carrying around 35 kg of kids. And the temperature was somewhere around or a bit above 30 degrees C.
It wasn't the first time I'd done the trip, but never before with more than 2 of the 3 adverse factors (heavy backpack, pram, and high temperature). I was feeling the effects of the exertion - especially in my shoulders - for at least a week afterwards.
Obviously our fictional PCs are fitter than me, but they also push themselves a lot harder than I do. And (absent magical healing) they don't get all the care and attention that contemporary professional sportspeople and athletes get (who still require multiple days to recover from a game - at least in Australian football, it is considered a marked disadvantage to have to play on a Friday after having played the previous Sunday).
I see people assert over and over "no previous edition..." as if 4E healing is exactly in line with what came before.
Well I'm not such a person. 4e has dramatically different pacing rules for both incombat and out-of-combat healing. That's why I play it rather than AD&D or Basic. (Playing 3E is not even on my personal radar.)
Even in 4E, leader is (imo) the toughest role to go without.
Interesting. The group I GM went for 6 or so levels without a leader, but did have two cleric, one warlord and one bard multi-class, and one paladin PC and one dwarf fighter with Comeback Strike.
When PHB3 came out, the ranger (multi-class cleric) was rebuilt as a hybrid ranger-cleric, and since then two of the other three leader multi-class feast have been retrained away.
I have to push the party pretty hard for healing to become an issue as far as quantity is concerned (managing the timing of access to it continues to be an important part of play).
