If you describe any combat result as a specific result ("gut wound, slashed arm", etc.), you open yourself up to absurd results.
Not IME.
For example, if a 50hp fighter is brought down to 1hp, you could describe the blow as a "brutal slash across your chest, opening a bloody gash".
Said fighter could then eliminate his foe. With no penalty to his abilities.
Charging straight on with no rest, said fighter could then lift a portcullis (if he made his check). With no penalty to his abilities.
Said fighter (to paraphrase Hypersmurf) could wander the Underdark for days, evading or fighting monstrous foes. With no penalty to his abilities.
Not in 1e.
When the fighter completed his combat, rest is automatically assumed.
Moreover, while it is possible that said fighter "could wander the Underdark for days, evading or fighting monstrous foes" IME this never happens when Mr. 50 hp is reduced to 1 hp. The nature of the game system itself enforces role-playing of wounded status on the player in order to achieve success.
Moreover, in no edition of D&D does the fighter have "no penalty to his abilities" unless the DM decides that this is so. 4e rightly goes back to the idea that DM fiat should overrule absurd results -- this being the reason why the DM can rule that NPCS Intimidated to 0 hps faint rather than drop dead.
Of course, a game can make it easier or harder to deal with absurd results. In 4e, for example, you could simply say, "Sorry, that was designated as a wound, a healing surge will not work" and remove much of the absurdity (along, unfortunately, with much of the game balance). That game balance is tied into absurd results in 4e is unfortunate.
It was also avoidable. Previous discussion on this topic brought forth a plethora of ideas that, had they been part of the 4e rules, would have eliminated (or at least greatly reduced) the Schrödinger's Wounding/Monty Pythonism of the edition.
And on semi-related point, what's with the "What would Gary say?"
IMHO, the opinion of the author of the previous paradigm is the most relevant opinion as to whether or not the new paradigm is the same as the old.
RC