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Message: <blockquote data-quote="DreamChaser" data-source="post: 4791226" data-attributes="member: 1190">First, healing surges are a system that creates a mechanic for the restoration of health, energy, vitality, and capacity to battle on to the character. They are not a "thing" any more than a strength bonus, a half level modifier, or an action point is a "thing." So first off, any attempt to say that an explanation fails to describe the process but not the "thing" is inherently fallacious. One may as well say that there is no reason that chance comes into an experienced character's attack and ask for an "explanation" to describe the presence of the d20 in the game. The character is not aware of the d20. The character is not aware of action points. The character is not aware of healing surges. The character might be aware of his ability to rally resources represented to the player with these ideas but at no point could I imagine a character, in game, saying "I spend and Action Point to make another attack...my d20 came up 19...woo hoo I hit!"Second, I have ready many many books where the price of some magic is the user's vitality so while the magical item may not be bloody, he well look more tired the he otherwise would have and he would be aware on some level that he is less able to face physical and mental demands until he has a chance to restore himself.This does not strike me as complicated. No verbal gymnastics. No hand waving. Just a simple, agreed upon (within my group) explanation that I think works. YMMV. Your group can decide that each healing surge reflects a fairy trapped in a bottle, a bottle of red potion, the will of the gods forcing their servants back to work, the power of nanites in their system healing them, a stupid system that needs to be thrown out (which would probably lead to another game system), or the nasty side effect of having been raised by gremlins. It doesn't matter. What matters is that healing surges are not an in game "thing" (for a reason) and we can describe the causes and effects of the system as we choose.With regards to the power and the items that power it, this is a circular argument that goes on in each edition:When I take (apparently balanced) power/item/spell/feat/skill X and pair it with new/existing/modified power/items/spell/feat/skill Y, Z, A, B, and/or C, it can do [insert god destroying, balance wrecking, time unraveling consequence]. This is not a problem with the item it is something inherent in complex systems: the more elements are added to a complex system, the faster the number of potential interactions grows. The strictures of 4e slow but do not stop this trend. Eventually, it becomes the job of the DM and / or players to say "Yes that could happen. It could work that way. But do we want it to work that way in our game?" There is no way for the designers (no matter how good, bad, or geeky they are) to account for every possible interaction between a new power and 3-5 items.I'm not worried about the power on its own and I'm not going to stress about the combinations because  I (as the DM) will cross that bridge **should** I come it it.DC</blockquote>

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