Sir_Darien said:
If someone comes around and beats you to inches from unconsiousness, you can't take 20 minutes to use 4 healing surges and a few short rests to be back to feeling fine. No one can. Characters in 4e can no longer be hurt, only killed. They can be knocked out, but provided someone can wake them up and they still have healing surges they'll be fine in 20 minutes, tops.
I had a discussion about it with my long time friend who is a 3e DM and we came up with following explanation for ourselves:
For sake of argument, you have 24hp and 8 healing surges (6hp each). What it means is that your 'body' is able to withstand 72 points of damage before giving up (and another 12 to be dead). Your mind on the other hand, will give up after 24 points of damage received in short period of time. If you can take a short break, you can calm down/rest/whatever and regain some points - but you still cannot improve you overall status. If you receive too much damage in short period of time (one encounter, which will be probably 1-2 minutes of in-game time), you pass out from shock. If you cross -bloodied, your heart gives up. Only if you used all your healing surges, then you are really at the edge of your physical resources.
Not 'real-world'? Think about torturers. They work on the subject hard, but they have to make a break sometimes. If you do too much, too fast, person will die. If you allow him to catch some breath once per some time, you can continue for days. D&D encounter = torture routine, short rest = break in torture.
We were very happy with our explanation - fitting the rules, pleasing our simulationist devil inside, just great. Then we have recalled that overnight you fully heal your damage and recover healing surges. And THIS is something which at the moment puzzles me, as far as non-metagame solutions are concerned. Because I just don't subscribe to the fact that after bathing in acid/fire for 60 hp of damage, only your luck/morale/agility is damaged. Hp is majorly an abstraction, but this abstraction DOES contain part of real wounds.
Current solution is just to assume everybody/everything in world regenerates perfectly overnight, unless hit by some kind of disease. It is not that world-shattering as you may think - it will not really change the way society works (what is the benefit of peasant having to heal from knife cut for 4 days instead of 1 day?). You know, people are drinking clean water, not using preservatives in their food, so they are more healthy then us
If we are at this subject, we also considered another idea - that healing surges are real healing. Real visible healing. PC can get hired in circus, cut himself with a knife and close the wound with the crowd watching ("Watch the Ameba Men Regenerating His Appendages"). As only PCs (and maybe very, very few NPCs) are getting healing surges, it would lead to quite interesting results. For sure, there would be a major hunt for anybody showing such powers, and high-level mages would catch healing-surge-capable people, put them in captivity and perform horrible experiments trying to find out the limits of this power. For sure, many power-hungry NPCs would try a lot of creative ways to extract healing-surgeness from PCs, by consuming their brains/blood/souls/whatever. PCs could differentiate themselves from the rest of the world in very real manner. At this point, full heal overnight is not any issue of course. Same goes for resurrections -no more 'destiny' crap, just raise dead works only on healing-surge positives.
This route is probably bit far - suddenly, healing surge would change it's role from small game balancing element, to most defining factor of entire campaign. It could be explained by some kind of god spark in PCs, correct gene combination, being cursed at birth by faerie, etc. It would also explain a lot of other special abilities PCs may have.