And therein lies the problem. That "greater narrative range" never really existed. Outside of some fairly corner case examples (the 1hp fighter running marathons - more on that later) being at 1 hp or being at full hit points made no mechanical difference.
Again, and outside of concussions, name me a potentially lethal wound that I can completely recover from in a week of bedrest. As soon as you start actually narrating wounds in D&D, you have departed from what the mechanics actually represent.
If I take a heavily bleeding leg wound, for example, I could possibly die. But, since I can heal from this in a week of bedrest, it is impossible that that wound did any ligament damage, broke any bones or did any serious injury. And, even a deep cut will take a heck of a lot longer than a week to get better.
I feel like the fantasy genre is being applied sometimes but not others in this conversation.
"It's fantasy, and you're a hero, so your character can use a second wind to push himself when others would falter."
"No, you can't model long term wounds without significant impairment and permanent injuries, because that's not realistic."
Okay, I get the first one. The second one baffles me. Why not have it, "it's fantasy, and you're a hero, so your character can push himself when others would falter after a wound heals"? I mean, if 5e kept PC stats separate from NPC stats like 4e does, it's not like all NPCs would have to heal that quickly -you just say they don't!
I just don't get why the fantasy genre is suddenly overrun by a realism simulation as soon as the want of long term wounds is asked for. You can have a mechanic that handles long term wounds without crippling the characters or bogging the game down in conditions. HP can do that well enough. You're a hero, so you're getting out of bed after a week instead of the normal month it'd take other people. This happens in fantasy. Having no wounds that take a long time to heal happens in some fantasy, I'm guessing, but it's certainly going to be only a portion of fantasy. Wounds have been used as a plot point for years.
Now, when you cloud the issue with genre conventions, I'd point out that by and large, genre books don't allow the hero to recover from potentially lethal wounds in a matter of days without magical intervention because to do so breaks the believability of the narrative. When Conan gets nailed to a cross, he takes months to heal. How long does Frodo take to recover in Rivendell, even with magical healing?
And, with sufficient mechanics, you could have an option of long recoveries or short recoveries -it'd just be left to the dice. For example, take Tony Vargas' suggestion to me in this thread: a character who "dies" can be permanently crippled instead.
If you had a system that made "dying" a little easier than 4e, but had a roll to change the outcome of death, that could be really interesting. When you would "die" due to failing death saves, you can make a check or save. If successful, you live for now, but the wound is bad: it takes a long time to heal (say, 1d6 weeks). You keep making saves against death, and if you would "die", make another save or check, with success indicating that you live for now, but now you're permanently crippled. That is, that bad gash on your leg has apparently permanently damaged you -you have a limp. Now, you keep making checks to see if you bleed out. If you "die" again, you can save yourself with another successful check, meaning the leg is now worthless. You keep making saves, and no saves or checks can prevent death, now; you bled out.
Now, I'm sure you can clean this up, and have an easy way to determine what's disabled. It allows for the narrative where your character recovers quickly (he never "died" to death saves), recovers slowly but presses on sooner than others (he "died" once but made his save), is permanently crippled (he "died" twice but made both saves), or permanently loses a limb (he "died" three times but made three saves), or, of course, just bleeds out (he "died" once and failed a "bad wound" save, or he "died" seven times [too many in my opinion!]).
This opens up narrative options, and that's a good thing to me. I'd still separate physical HP and "other" HP, as I think that'd be necessary for the narratives to be coherent without retconning.
Personally, I'm fine with just deciding how bad the wound is when you're hit, even if that leads to bleeding out with 100 hit points left. I'm okay with that, but I know most people don't want that in their D&D. Having a system in place (even if it's a more complex "dial" that's included in the core books) that allows for long term wounds isn't a bad thing, in my opinion. As always, play what you like
