They just really bug me.
Anyone know of a fix or alternate?
sure, remove them!
don't expect most healing to work right since it revolves around the surges. what about them bothers you?
Not really, or at least not without a rules re-design that would be a lot of effort. So much so, you are bascially deciding between playing 4E or another system. So how much do you dislike them, and can you explain why?
Surges are inmportant part of 4E. You can probably work something out, but you will have substitute this for set HP amounts healing or something.
Lemme see, you could remove the counting of healing surges mechanic. Any power that heals "1 healing surge" heals an amount equal to one quarter hit points plus whatever bonuses acrue, and not make people track surges. This will be a boost to everybody but defenders.
I assume you want to get rid of the Second Wind mechanic as well. It'll make the game a little harder, and will make having a leader in the party essential, but I doubt it will kill your game. Not really sure what to do about Wardens, and that will be one less reason to play dwarves (not really a problem, there are plenty of other incentives to play a dwarf).
I'm not sure you'd get anything back in terms of fun, but it won't kill the game not to count them.
Sure add up the total amount of healing provided by surges to everyones HP.
Not to sound critical, but have you played using them? HS may sound kind of weird at first glance, but the mechanic actually works reasonably well.
No...
...and why would you?
There's no fix. It's a very popular, and widely used mechanic in 4th. If you're taking them out, then you're going to be making more work for you. Leaders need surges to buff the party up, by activating healing surges.
We've gotten into the habit of referring to them as 'heroic surges' and to hit points as 'hero points'. Anything referred to in the rules as 'healing' we often refer instead to as 'recovery' (unless its obviously magical, like clerical healing).
So, my 1st level fighter has 29 hero points (15+14 Con), and that means he can spend 11 heroic surges per day and 'recover' 7 hero points. In D&D, 'healing' has always sorta implied magical ability. My fighter is the most mundane fella on the planet though, so when he spends a heroic surge, he recovers some of his oomph and he presses on; there's nothing magical about it.
It's a more abstract approach but after a while, we stopped thinking about the physical damage of each blow and started thinking of our PCs as having a resevoir of heroic power, mental and physical, both entwined. Heroic surges let us replenish that resevoir to an extent. Hit points on the other hand, often imply pure physicality. There's more to being a hero than that I think.
It really does depend on why you see them as a problem. Sure, there's ways to take them out, but the "best way" depends on that nasty "why" question. Your least-disruptive method would be Salamandyr2000's suggestion: just stop counting them. This makes everyone a lot more durable (in my opinion, counter to Salamandyr2000's, it's the biggest buff to Defenders who are the most likely to run out of surges in many cases) and it also overpowers a few powers and items that are normally kept in check by surge consumption. Potions skyrocket in value.
You could add 50% to everyone's HP and just handwave "okay, you're at full" between fights, taking out healing powers.
You could also strip the entire system right out of the game, healing, potions, surges, and anything related to them, by having starting hitpoints equal to the following clunky formula:
[(Surge value)*(number of surges)]+(starting HP)
So you'd figure out everything like normal, then multiply the surge value by the number of surges per day, then add that value to the character's starting HP and that becomes the character's Hit Points Per Day. The direct side effect of this is that characters will be impossible to kill until later in the day, and anything that relies on the Bloodied condition starts to act weird. Like a level 2 Dragonborn Barbarian is milking his Bloodied damage bonus but still has 40+ HP left.
As others have said, I don't know of any clean and totally sound way of removing healing surges.
I also don't really understand why you might want to. They don't represent anything in in-game terms. They're just a metagame way of limiting the amount of healing a given character can receive in a day, and of making certain healing abilities special (those that don't consume surges). And surges serve those two functions really well. So, do you not want healing to be limited per day? Or do you want all healing abilities to be limited per day, not just the normal ones that consume surges?
I don't really understand.
If you don't want surges, you may want to play an earlier edition.
"No Surges" basically means total rewrite of 4th to be more like the previous editions, or just playing the previous editions directly.
(Rather than subjecting yourselves to D20 or the abomination that is 2E, though, might I suggest Savage Worlds as an alternate instead? The core book is $10 and it's an excellent system. D&D4 handles pure heroic team-based high-magic high-fantasy kill-the-orcs-to-save-the-villagers wargaming better than it does. New World Of Darkness handles low-fantasy horror better than it does. For everything else, it's the best I've ever seen.)
I can't see any easy way to do it. Healing surges are pretty central for the design of 4e.
For the life of me I don't see why anyone would hate them...I personally think they are one of the best things about 4e.
another obstacle is the fact that more than healing requires surge expenditure - such as the warlock's well of death (surge = bonus damage on attack)
Why on earth would you do that?
Are you the type of Dm that likes to kill his players?
The way encounters are built in 4e pretty much assume that the Pc's have access to healing surges, without them you would have to redesign how encounters are made.
I think we all know why he wants to strip them out. It's just a discussion that's been chewed through about a dozen times or more across the RPG boards in the past year.
for those of us who are newer to the community: what might that be?
Yes have you played 4e? Because Heroic Surges 'look' odd and wierd but they 'Play' wonderfully.
4e Hitpoints aren't really like traditional hitpoints. Like others have said they are really more 'Heroe Points'. It's more akin to Moral then actual health. When you get hit you don't get a big gaping wound as your moral drops, it takes a little out of you and by the time you hit zero hitpoints your exausted and have several small wounds and simply cannot go any father and you fall unconcious from that final blow. Then, once you take enough damage you reach your negative bloodied value or fail 3 saving throws, your dead. You've been beaten to death or slipped away while in a coma.
So if you consider health more as moral or minor to moderate damage, Healing Surges aren't some magical way you regain hitpoints, but a moral boost. You take a second to catch your breath and regain your balance and drive before rejoining the fight once more. It's why your Second Wind takes a Standard Action and gives you a +2 bonus to defenses. Your basically holding back, catching your breath and being on the defensive while you regain your ground and moral. You also have a limited number of surges you can use between a long rest because there are only so many times you can take a breather and pump yourself up again each day before your simply exausted.
Now you can think the same thing with magic that uses your healing surges. When a Cleric casts Healing Word on you they aren't just closing up your wounds with magic they are giving you a surge of moral so that you feel more capable of defeating your foe.
Once you think of things in that respect, Healing Surges become much more palitable to those who simply feel the system is unrealistic or is to different from previous systems.
The usual explanation is that people take a look at the system and expect it to work basically exactly like 3.x or earlier editions did. When they see the greater PC hit point totals and add up all the potential healing you can get from surges they get the impression that 4e characters are going to be practically unkillable and that the game was somehow designed to coddle players.
This is a false impression. One has to actually play 4e to see that this isn't so. On first reading of the rules I had reservations about this as well, but actual play quickly dispels this notion. For one thing HS are not easily translatable directly into hit points during an encounter. Even at high levels characters don't have free access to burning surges. A party can certainly pile on healing powers to the point where they can access a lot of hit points, but the opportunity cost for doing so is quite high and you will quickly discover that such a party is quite suboptimal in actual play.
For another thing you cannot compare hit points from earlier editions with hit points in 4e. 40 hit points in 1e or 2e is a pretty good number which will generally be more than adequate for an average character in a level appropriate setting, especially when you consider that healing is overall more easily obtained and has no upper bounds. A 40 hit point 4e character on the other hand is a low level fighter or perhaps a mid-heroic "squishy". Ordinary monsters they will be facing will have 2x the PCs hit points and tougher monsters can easily have 10x that. A 400 hit point creature in earlier editions would be a very high level monster and probably far out of the league of a 40 HP character. In 4e it is a significant boss monster which you would probably expect to fight. For example an adult White Dragon is a level 9 Solo with 408 hit points and would be a good match against a 5th to 7th level party (60-80 hit point characters roughly).
The whole point of surges really was to make attrition a meaningful concept in 4e. Two basic options would exist to remove them, either simply making them unlimited or making them non-existent. Making them unlimited means any encounter not worthy of a daily is basically meaningless. This effectively means you can't use encounters of less than hard difficulty because the party WILL defeat anything less than that eventually without using daily resources of any kind and they have no incentive to hasten the encounter by trading a daily for less damage since they'll be fully healed at the end of the encounter anyway as long as they don't actually die.
Removing surges entirely just puts you back in the silliness of earlier editions where healing is all concentrated in the "healer" character, which now becomes an absolute necessity for the party to have one of, and which is too valuable to risk in actual combat. Thus some poor sorry sap has to play the support-only character. The alternative is the equally pathetic "giant-bag-o-healing-items" which just transmogrifies "no-surges" into the exact equivalent of "limitless surges" with the additional tacky fluff of hauling around the bag of holding with the 900 wands of cure light wounds in it. Even worse you are now absolutely dependent on having these items in the game, as well as divine magic to support them. If you just have NO availability of healing in the party, then again you can't use attrition because even the slightest amount of damage to a character is so serious a problem that it will practically guarantee the party will hole up if they take even slight damage.
Admittedly surges carry their own burden of flavor, which may not be perfectly compatible with some genre of play, but there simply is no one perfect system. It would be nice if there were, but sometimes D&D isn't the best system to use for a particular genre of setting. It works really great for heroic action adventure and does most other similar genre reasonably well.
Going further afield from the sort of game 4e is aimed at is one potentially good reason for house ruling the system though. Maybe removing HS could be a good idea in some of these cases. I can see how it might facilitate playing a really grim horror theme for example where healing simply doesn't exist and characters wander around desperately trying to avoid getting ganked by the boogy man. In that case though I think you'd probably be best off just not worrying about the consequences of removing HS. Nobody is going to be healing anyone and the few powers, items, and class features that depend on surges can simply be left out of the game. You'll still have a lot of material to work with. I suspect you'll also be building monsters and NPCs in a considerably different way as well, so its kind of hard to say exactly how it will play out or what the best way to house rule everything is.
for those of us who are newer to the community: what might that be?
Realism. The argument usually starts with "You mean, I can be stabbed through the heart and then use a second wind and be just dandy! That's stupid!" along with "So my character can be at deaths door, but a good nights sleep and he's perfectly healthy?" and then followed up with "So a warlord can give a pep talk and heal decapitation? That's ridiculous!"
This is of course based on the false assumption that hit points represent actual physical vitality, something that has not been the case at all in any edition of D&D ever written. Hit Points have always been an abstract representation of an adventurer's ability to "fight on". The problem in old editions was that the actual rules weren't really consistent on that point, like for instance, why it took so long to heal what was otherwise non-physical wounds absent cleric magic. And why Cure Light Wounds could bring back a 1st level character from the brink of death (it's not like that's actually "light"). In the old days we made jokes about the unrealistic nature of hit points and rolled on.
4th edition actually embraces the abstraction, giving adventurer's the option to "catch their breath" and regain hit points, and a nonmagic morale boosting speech can renew flagging spirits and refocus the will to live (and regain hit points). I think where some players from old editions have trouble is they are used to the DM describing the large number rolls as gruesome wounds in clinical, grand guignol fashion. For a player is who brought to zero hp by, say a charging minotaur, the DM might say "your limp body is flung through the air with two gaping wounds in your chest from his horns. Viscera and lung tissue litter the ground around you."
Of course, it doesn't really make sense, if that just happened, that a warlord could say "Buck up soldier!" and you get up and start trucking again. So that implies that perhaps that should imply that being brought to zero hit points doesn't gruesomely wound you. Perhaps it only throws you aside, knocking you unconscious, and possibly dead, unless someone checks on you. Mike Mearls actually mentioned this in a podcast, that if the primary mode of healing in the game is nonmagic, you should modify your descriptions to things that could "Inspiring Words" could generally help you overcome.
But rather than modify the fluff descriptions of the wounds, they complain the system is "unrealistic".
xaielao quoth:
4e hitpoints aren't really like traditional hitpoints. like others have said they are really more 'hero points'. it's more akin to moral then actual health.
wrong. i've been playing D&D ever since the basic red box. even in AD&D1, gygax himself said that hit points didn't merely reflect physical trauma (AD&D1 DMG). in that same section, gygax describes hit points as at most representing 1/4 of the picture re: hit points. when hit points/level was uncapped in 3.0, that clearly diluted the physical basis of hit points even further.
salamandyr quoth:
this is of course based on the false assumption that hit points represent actual physical vitality, something that has not been the case at all in any edition of D&D ever written. ht pints have always been an abstract representation of an adventurer's ability to "fight on". the problem in old editions was that the actual rules weren't really consistent on that point, like for instance, why it took so long to heal what was otherwise non-physical wounds absent cleric magic. and why cure light wounds could bring back a 1st level character from the brink of death (it's not like that's actually "light"). in the old days we made jokes about the unrealistic nature of hit points and rolled on.
well said. and yeah, i was afraid "realism" was going to be the problem. thanks, salamandyr!
If you want to have more "realistic" wounds you can easily house rule something without removing or reworking the healing surge system. The DM could rule that in certain instance the PC sustains an injury that needs bed rest, medical attention, clerical magic or whatever to heal. Thus the wounded character could regain hp but take a penality to certain actions until the injury has fully healed. For example wounded arm means they can only use one arm, wounded leg minus to movement, or broken ribs -2 to all attacks etc.
in theory, one could graft on the SW saga condition track system, but using surge value in place of damage threshold.
Realism. The argument usually starts with "You mean, I can be stabbed through the heart and then use a second wind and be just dandy! That's stupid!" along with "So my character can be at deaths door, but a good nights sleep and he's perfectly healthy?" and then followed up with "So a warlord can give a pep talk and heal decapitation? That's ridiculous!"
In addition to what Salamandyr2000said about the hit points realism complaint, there's an even simpler defense for healing surges: even if someone still isn't comfortable with nonmagical healing doing what it does in 4th edition, healing surges still aren't really at fault.
A good night's sleep curing everything? That's not the healing surge mechanics' fault, that rule could exist without healing surges. A warlord's being able to bring someone back to consciousness with the nonmagical Inspiring Word power? That isn't healing surges' fault either.
EDIT: Ok, can someone explain to me how I keep screwing up the formatting of my posts like that?
4th Edition actually has the until now best possibility to represent lasting damage, if you take a wee bit of time to remodel a system slightly: Disease Tracks.
Arm broken? Take your "Injury Track" and lookup the broken arm injury and what it yields you. Heal checks and magical healing may help these injuries ("Heal Injuries"-Ritual).
Best system ever to represent this kinda stuff. Sadly it's not "IN TEHZ RAW!" and thus gets discounted with in a few seconds probably. Still, those who want a more gritty D&D4E experience should try to use this idea to boot.
I like this - THANK YOU!
Is it the healing surges you don't like or the second wind? Maybe you should look at removing second wind before healing surges.
They don't represent anything in in-game terms. They're just a metagame way
That's precisely why they need to get the boot.
Then you should look for a system that doesn't use hit points.
3e's hit points made even less sense than its predecessors, smiteasaur. your statement reveals ignorance of the history of the hit point concept.
Healing Surges represent something in-world; the ability of people to recover. If you exhaust yourself running, you don't remain exhausted for weeks. The problem is a misunderstanding of what hit points represent. Just because one loses hit points doesn't mean you've taken physical damage. A shot slamming into a shield or stopped by armor? Loss of hit points. A last-instant dodge? Loss of hit points.
Combat in D&D isn't just abstract, it's narrative. If one player wants to describe the loss of 20HP as the attack clattering off his shield, he can. If one wants to describe it as a nimble evasion, he can. If he wants to describe it as taking a wallop to the head and coming back for more, he can. It's freedom for the players to narrate their characters.
All systems use "hit points." A rose by any other name and all that. Though 3e hit points made sense, using inspiring word to bring someone back to total consciousness and reasonable health is stupid.
And the ability to take an axe in the face, or be engulfed in flames and still have a pulse is equally stupid. No need to shout, Smite.
As an EMT, I'm keenly aware of just how delicate the human body is, when confronted with traumatic injury. I haven't yet seen any HP system in any game that I would call even vaguely realistic.
All systems use "hit points." A rose by any other name and all that.
Wrong. Many use conditions, damage saves, or add disadvantages instead. And even within hitpoints there are variants. D&D is in the "totally unrealistic" area.
Though 3e hit points made sense
It's totally reasonable for a 4 Con Wizard to heal faster then a 20 Con Barbarian! Wait....
using inspiring word to bring someone back to total consciousness and reasonable health is stupid.
Unless HP didn't represent physical wounds. In which case NOT being able to do that is unreasonable.
HP hasn't represented purely physical wounds since Gygax made the system.
All systems use "hit points." A rose by any other name and all that. Though 3e hit points made sense, using inspiring word to bring someone back to total consciousness and reasonable health is stupid.
Not all systems use hit points. And it's not stupid, it's a failure of imagination on your part. Consider the scene in Rocky (any of them really). Rock's been beaten half to death, he's punch drunk, he can barely hold it together. Burgess Meridith yells at him, slaps him in the face, tells him to "Get out there and kill that so and so!" and the bell rings and Rocky, renewed, goes out there and whips tail.
There you have it...Inspiring Word in a nutshell.
The problem, again, is describing the loss of hit points as massive wounds. No, a warlord can't heal decapitation, but if the party fighter was brought to 0 hit points, and the warlord restores him, then he must not have been decapitated!
You know, I've mentioned this before, but it bears repeating - we have always described hps as actual wounds. We also have no problem with those wounds being healed by a pep talk. The D&D world is not ours, so who is to say that a pep talk from a warlord would not be able to heal wounds?
As an EMT, I'm keenly aware of just how delicate the human body is, when confronted with traumatic injury. I haven't yet seen any HP system in any game that I would call even vaguely realistic.
I would say simply "HârnMaster", but strictly speaking that doesn't use 'hit points' and so is not a 'HP system', per se. It is, however, vaguely realistic (for what that is worth) and gives a very different feel to getting hurt than D&D (any version) does.
All systems use "hit points." A rose by any other name and all that. Though 3e hit points made sense, using inspiring word to bring someone back to total consciousness and reasonable health is stupid.
Not all systems use hit points. And it's not stupid, it's a failure of imagination on your part. Consider the scene in Rocky (any of them really). Rock's been beaten half to death, he's punch drunk, he can barely hold it together. Burgess Meridith yells at him, slaps him in the face, tells him to "Get out there and kill that so and so!" and the bell rings and Rocky, renewed, goes out there and whips tail.
There you have it...Inspiring Word in a nutshell.
The problem, again, is describing the loss of hit points as massive wounds. No, a warlord can't heal decapitation, but if the party fighter was brought to 0 hit points, and the warlord restores him, then he must not have been decapitated!
That is perfect...I have herd Gibbs from NCIS (When tony has the plauge), Karate kid, die hard (any movie by 30 mins in), and even war movie drill sargents...but rocky I think is the best example yet of inspireing word/healing surge...
He isn't better...he is still bleeding and in some cases still have broken parts...but he pushes past it.... heck in some cases he is dazed, and maybe he had other condtions, but he was back in fighting state anyway...
He isn't better...he is still bleeding and in some cases still have broken parts...but he pushes past it.... heck in some cases he is dazed, and maybe he had other condtions, but he was back in fighting state anyway...
The most recent film I've seen that really gave me the same effect was Pineapple Express (of all things). Getting Red to help, after the poor bastard had had his head smashed through a wall and been shot (several times), just by giving him a pep talk.
The DM narrates things, kthx. A hit is a hit.
Can you point to where in the rules it says that?
Too bad Rocky can't hear Burgess when he's unconscious.
Actually, you can hear things when you're unconscious. You can also feel things. Which is why yelling at people and slapping them can rouse them.
That's real life.
I'm not the DM.
So because your DM plays with house rules that hit points are actual physical vitality, and that attacks always do physical damage, you say heroic surges are unrealistic.
Isn't it more fair to say that your DM's house rules don't fit with the spirit of D&D?
The DM is in charge.
Yes, but the DM's house rules that contradict the rules of the game don't make the game rules stupid.
How often can you wake people up by yelling at them? Not very.
OK, at this point I think you're trolling.
I've removed content from this thread per the Code of Conduct, which can be found here. Please keep your posts polite, respectful, and on-topic, and refrain from making personal attacks.
The DM narrates things, kthx. A hit is a hit.
But what is a "hit" (other than "a hit" - circular definitions aren't cool)?
The DM narrates a lot of things, in a lot of groups, but that isn't necessarily how people want to run with it. Letting players dictate what happens with their character (with DM oversight) seems to be fairly common - it lets everyone be involved in the narrative.
Too bad Rocky can't hear Burgess when he's unconscious.
DISCLAIMER: I've not seen Rocky since I was a kid, and have no familiarity with it, so if you're speaking to a specific instance in the film (like, say, them pointing out in some scene that Rocky is unable to hear anything while he's unconscious), I can't really touch on that.
So, that said, being unconscious doesn't seem to bar (passive) senses. Common sense can be applied however the GM/players see fit, but given that the prior edition and the monster readiness section of this edition both provide a penalty (rather than a prohibition) on checks to hear while sleeping (which I know isn't the same thing - we're going for closest fit), I think your assertion lacks textual backing.
EDIT: Eh, others have covered this better than me in the other posts.
Look, the warlord can't inspire someone to action if the person he's trying to inspire is unconscious. It just doesn't work. If the person is weak or wounded, he can. But not if the person is out like a light.
proof?
So how about, hypothetically, not narrating it as actually unconscious, but rather "I'm done for, go on without me!"
Too bad Rocky can't hear Burgess when he's unconscious.
Unconscious is not the same as comatose. All unconscious means as a game mechanic is prone, helpless and unable to take any actions. A character who is descriptively so weakened and/or shaken that they collapse to their hands and knees unable to move could be mechanically unconscious.
Furthermore heroes aren't normal people. I can't even count the number of movies where at the climax of the fight with the BBEG the hero falls, seemingly dead, but while the BBEG laughs manically over his victory, the damsel or sidekick unwilling shouts to the hero "get up, I believe in you!" and then the seemingly finished hero's eyes snap open and he staggers back to his feat to finish the fight. Is it realistic, probably not, but it's damn heroic.
but it's damn heroic.
And that's what's important.
...No. Do I have to break out the dictionary?
Can you provide medical conditions for the following? Or at least an explaination beyond that they are just metagame names for conditions?
Slowed
Bloodied
immobilized?
...No. Do I have to break out the dictionary?
Dictionary definitions aren't really relevant when discussing the meanings of game mechanics. RPGs tend to use a language all their own.
Movies are dumb, and they're criticized for what you just described.
Seriously? Because it's exactly those kinds of movies that D&D is designed to emulate. Not stories about ordinary schmoes, but stories about BIG DAMN HEROES. Anyone who doesn't like that should probably go find a different game
So words in 4e don't actually mean what they mean.
Perhaps a better way to phrase it would be that terms with defined effects in a game have the effects they are defined as having.
I'll save you the trouble:
un·con·scious html_removed (
n-k
n
sh
s) adj. 1. Lacking awareness and the capacity for sensory perception; not conscious.
However, The game redefined the term (and if you take issue with that, you should hate microsoft as "closing the windows" now has a different meaning to many)
From the PHB:
When you're asleep, you're unconscious (see "Conditions," page 277)
On page 277, the condition is fully defined
It goes on to state (as recorded below) a -5 penalty to passive perception. So, they SPECIFICALLY define the term for you for playing THIS game. And - by RAW - you can be woken using sound. QED
edited: typo
Again, words in 4e don't mean what they mean.
More general than that - Terms defined in ANY game, take precedent over their dictionary counterpart, if one exists.
Chance means one thing in a dictionary, another in a monopoly game.
Rook means one thing in a dictionary, another in a chess game.
Even "IT" has a very specific meaning in many games, than the dictionary standard.
Again, words in 4e don't mean what they mean.
Like i said in my last post, Show me a definition for immobilized that will work for any and all situations. Immobilized can come from fear, restrainment, intimidation... It can come from a rogue stabbing a enemys cloak to a wizard casting a force spell.
You know, I've mentioned this before, but it bears repeating - we have always described hps as actual wounds. We also have no problem with those wounds being healed by a pep talk. The D&D world is not ours, so who is to say that a pep talk from a warlord would not be able to heal wounds?
If you have no problem with it, good for you. I know my group, for one, would barely bat an eyelash at it.
However, some players/groups, as evidenced by this thread, seem to not be able to swallow such large suspension of disbelief. It's understandable, in a way; previous editions have created the mindset that "Mundane/Melee/Martial = Nonmagical,"* and the default assumption on "Nonmagical" seems to be something that is perfectly in line with reality. Thus Inspiring Word (a Martial ability) isn't allowed to defy the laws/rules/observations of our reality, which means some uplifting words can't reattach your severed head.
* I think this is where the disconnect starts. In 4e, Martial does not necessarily mean mundane or nonmagical.
* I think this is where the disconnect starts. In 4e, Martial does not necessarily mean mundane or nonmagical.
Well, definitely not mundane - these are heroes after all.
However, I'd count myself amongst people who expect Martial power source to work more like an action movie with no concept of magic involved (plenty of fantasy of course but that's a different matter). That includes a warlord's Inspiring Words being a "pep talk" that indeed cannot re-attach severed parts or splint a broken leg. I think this is still workable, there is no absolute need to invoke Martial Magic. It means I personally focus on concepts such hit points as morale and it's just a flesh wound.
Again, words in 4e don't mean what they mean.
That is correct. They mean exactly what they are defined to mean in the rules mechanics and nothing else. Others have already recapitulated what the mechanical definition of the unconscious state is in 4e so I won't bother. Note that at no point does it state that healing powers don't work on characters in this state, nor that certain power sources can't heal an unconscious character, etc. Thus unconscious in 4e does not mean "cannot be healed by X". If you interpret it to mean that, then you are using variant rules (which is OK if you want to do that).
As others have also pointed out, there is no intention in 4e (and you can research this, the designers of the game have flatly said so) that a particular game mechanic is fixed to any particular narrative description. When your character is beaned in the head by that orc (IE hit and reduced to 0 hit points) he falls to his hands and knees (goes prone) and has the mechanical restrictions of the dying state put on him. The game never intended that to mean absolutely that the character IS unconscious, just that he has certain penalties (in this case he can pretty much not do anything except make death saves generally). The warlord sees him rolling around on the floor and inspires him to get up again. What's unbelievable about that? How is that narrative not consistent and sensible?
Another thing that you seem to be failing to absorb is that narrative control of the game is not in the hands of the DM alone. Again other people have mentioned this, but I'll put it more strongly. Every action taking by a PC is a point in the game where that player has narrative control. If they use a power then that control extends to explaining certain mechanical effects granted by the power. The DM certainly has an editorial function as well as acting as a referee, but when your warlord uses Inspiring Word and makes the fighter stand back up you have narrative control and given that the actions you take are within the rules its entirely your place in the game to describe that the fighter, lying stunned on the floor, hears your inspiring words and gets up again. You could describe it as you saying "In the name of Bane I command you to get up and FIGHT!" and you're just so awesome that it happens. Granted the fluff of the game suggests that's more in line with the way clerics work, but nothing demands that the gods don't ever pay attention to warlords.
I think you're just stuck in the mentality that went along with 3rd edition where every single little mechanic in the game was proposed to have only one explanation and you could only do exactly X with your power. Frankly that was what, more than anything else, killed 3e. It wasn't a bad game, it was just built in a self-limiting way and finally reached a dead end. 4e takes a different approach, and while its a bit harder to grasp at first, in the end it has longer legs because a lot smaller amount of mechanics can go a lot further and thus the game doesn't have to bloat itself to insanity in order to present a lot of interesting concepts to use in play. In other words 4e is a lot more scalable than 3e IMHO.
This conversation got me thinking. I play in heavily house ruled 3.5 game where the DM strives for "GRITTY REALISM" at all times. Not only do HP damage ALWAYS represent physical wounds PERIOD, but he also has his own injury system were if you get hit badly enough he randomly rolls to see where you are hit and what additional injury (broken bones, organ damage, internal bleeding, concusions, spinal damage etc.) you receive. These additional effects give significant mechanical penalties until healed and can only be removed after receiving days or weeks of mundane medical attention or by high level healing magic that only removes the effects but not any HP loss (you have to cast more spells for those, yippee).
As I said his aim is to make combat SO FREAKING SERIOUS THAT IT COULD NOT BE MORE GRITTY AND REALISTIC OMG, however the effect (which he is completely unable to see) is that it makes the game play out like a Loony Toons Cartoon. After you have the flesh burned off 80 % of you body, have your kidnyes liquefied, get torn almost in half, have you spine broken, your skull bashed in, have your internal organs hanging out of gapping wounds in what used to be your torso, and so on and so forth and then you spend a day or two having the divine casters dropping a dozen healing spells on you and then you are good as new, it tends to get a little silly. Kind of like the cleric in Nodwick putting him back together in every strip with her holy duct tape of healing.
By comparison saying the fighter at zero HP is on the ground realing and winded from a dozen superficial wounds, and then is roused to fight through the pain by the warlords words, seems much more "REALISTIC" or at least within suspension of disbelief to me.
I didn't like surges at first either. But once I'd played the game a few times I came to view them more as HP that are slowly handed out over the course of the day. If Farga (my 4th level Dwarf Fighter) actually had his full 193 HP then combat would be a lot less exciting than it is with 49 HP.
Also, the first TRPG I ever played was HackMaster and it explicitly states that HP is a measure of how much abuse your body can take before it gives out and I think that mindset was largely responsible for my initial resistance to the idea of Healing Surges; so much so that I too tried to figure out how to play D&D 4e without them.
Eventually I decided that rather than trying to modify D&D 4e it was just easier to play HackMaster or GURPS (and those are the two systems I GM most often even though I'll gladly play just about anything). As I've said before: D&D 4e is by far the least crappy version of D&D thus far... warts and all. 8o)
This conversation got me thinking. I play in heavily house ruled 3.5 game where the DM strives for "GRITTY REALISM" at all times. Not only do HP damage ALWAYS represent physical wounds PERIOD, but he also has his own injury system were if you get hit badly enough he randomly rolls to see where you are hit and what additional injury (broken bones, organ damage, internal bleeding, concusions, spinal damage etc.) you receive. These additional effects give significant mechanical penalties until healed and can only be removed after receiving days or weeks of mundane medical attention or by high level healing magic that only removes the effects but not any HP loss (you have to cast more spells for those, yippee).
That sounds like a GM who should be running HackMaster. Fifth edition (which currently exists only as HackMaster Basic; Advanced HackMaster should be out next summer) strives to be as realistic as is possible for a game that revolves around elves, and magic, and such.
Personally I've always preferred my games to be a bit more cinematic which is one the things I really like about D&D 4e.
Ultimately IMHO any attempt at being gritty to the point of realism in any RPG has to either fail or create serious limitations on what you can do with the game. For specific genre of games that can be fine. I mean its perfectly OK that your CoC character is almost certain to be ripped into tiny bits by a shoggoth and even if he survives he's going to spend 6 months recovering. It fits well with the core ideas of that genre of game. However games like that tend to be pretty self-limiting. They're fun and some, like CoC, which have a rich enough background can support a fairly substantial story arc, but sooner or later they inevitably peter out.
Character advancement is fairly meaningless in these types of games. Any system which adheres to a fairly realistic concept of damage has to pretty well stick to mechanics which allow for insta-kill on any character regardless of how much the character is advanced in power level. Either combat has to be incredibly rare, character advancement has to be extremely rapid, or players have to be pretty much resigned to playing weak characters all the time. None of those are especially good choices for the vast majority of fantasy games.
Even if the game diverges from reality enough to admit of higher power characters that are largely immune to instant death the whole maiming mechanic inevitably leads into the death spiral trap. Once you start to take serious damage you're hosed. Each increment of further wounding just makes you that much less able to avoid the next wound and that much less likely to be able to defeat your opponents. Thus combats pretty much devolve down to a situation where the first side to do serious damage to the other side is virtually assured of eventually winning, and when the losing side is the PCs the players basically just get to play out round after round of an ever more hopeless situation.
There can be somewhat of a middle ground. Traveler for instance did a fairly decent job of striking a point where combat was pretty gritty, but still usually survivable and wounds weren't overly crippling. Even so combat was pretty dicey and most PCs were unlikely to survive long if they fought battle after battle.
You know, for the most part, even in the grittiest of stories, the main characters generally do alright. They may get hurt, but not permanently, they may get killed, but not usually randomly.
Unless one is planning a game where each player controls 3 or 4 characters, then any involved campaign arc is going to have to depend on the idea that the characters that start it have some chance of finishing it. The deadlier our game system is, the easier a random mishap can de-rail our plans.
Addendum: It seems to me, that the grittiness of many stories derives from the authors willingness to up the body count around the main characters. Easy gritty; create an interesting and compelling NPC to interact with your players, give them a reason to like the guy, hint at some future purpose for him, and then slaughter him. Works for George RR Martin. He hasn't killed a main character since his first book, and he telegraphed that one all the way from the backfield. But his body count of non-POV characters (ie, PC's) is legendary. Do that, reinforce that your PC's, no matter what their power, can't save everyone, and your characters will feel as helpless before the fickle death gods as they would in a game with a 100 entry injury chart and death on a 20.
Addendum: It seems to me, that the grittiness of many stories derives from the authors willingness to up the body count around the main characters. Easy gritty; create an interesting and compelling NPC to interact with your players, give them a reason to like the guy, hint at some future purpose for him, and then slaughter him. Works for George RR Martin. He hasn't killed a main character since his first book, and he telegraphed that one all the way from the backfield. But his body count of non-POV characters (ie, PC's) is legendary. Do that, reinforce that your PC's, no matter what their power, can't save everyone, and your characters will feel as helpless before the fickle death gods as they would in a game with a 100 entry injury chart and death on a 20.
That hit the nail right on the head, there! Personally, so long as the illusion of death exists in my game, I think it all works out. Then again, I did kill off two PCs in my last session. So, there's that. 
Frankly, I've never run (or played in) a system that had a simpler, better system for making characters feel "exhausted" after a string of tough encounters the way the healing surge mechanic does in 4e. Compared to the bagful of cure light wounds wands we used after every battle back in 3.x, the healing surge mechanic does a fantastic job of forcing the players to occasionally have to make some tough choices. Do we stop and rest? Do we push forward?
Either way, somebody might die. (cue maniacal laughter)
Healing Surges, Inspiring Word, and many other effects of the 4th edition game count on you playing D&D as if it were cinematic, not realistic. The question shouldn't be, "does this work in real life?" but instead, "does this work in the movies?".
And since there are instances of people being brought back from the dead in cinema by a pretty bunch of words (the end of The Matrix, anyone?) or the ability to say something inspiring and get people to get up and fight (that one really cheesy scene in the first Conan movie comes to mind, the one with the dead blonde inspiring Conan? Yeah, that one.) I figure those effects work in the 4th edition of D&D as well as in cinema.
I have moved this thread based on a VCL request. 
You know, this really was more appropriate in the general discussion thread.
Some potential house rules to add on to the healing surge system:
- If you feel like healing surges don't represent wear and tear enough (since they recover after a single extended six-hour rest), you can try this. After every extended rest, you recover a number of healing surges equal to your maximum - 1. This is cumulative for each extended rest. Additionally, you may rule that your maximum healing surge value drops by 1 each time your character's HP drops below 0. The lost surges can be recovered completely by taking a full rest - 24 hours in a civilized/safe location without doing any strenuous/adventuring-type activity.
You know about removing Healing Surge? SCREW REALISM!
There is NOTHING fun about spending an entire fight down because some stupid mook got a first turn hit in that knocked you down to 0 hit point in one shot just because you couldn't fully heal yourself between this and the last skirmish.
And before someone ask YES I'm bitter because I wasted most of tonights SAGA session laying in a pool of PC blood when a Vibroaxe to the head knocked me cold. Stupid First Aid rules. I wanted healing surges and a peptalk and an encounter NOT DAILY Second Wind SO BAD. Everybody was running around fighting and I was sitting there eating cookies and waiting for TEN turn to go by.
Give me healing surges.