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Getting back into D&D with 4e. I quite like a lot of things about 4e, espeically from a DM perspective, but there are also things I don’t like, in particular I can’t rationalize healing surges to myself (or my players). It seems very video gameish to me. 
Healing surges are basically you getting your breath back after a fight. They're your reserves of endurance for the day. When you get a chance to sit down and take a breather, you can get back to fighting fitness.
They're intended to be more of an action-movie-type mechanic, than a videogamey one. Just think Die Hard - when John McClane is getting the heck knocked out of him in a fistfight, he's eating HP damage. When he finishes off the guy, and sits down and patches up his wounds, wraps bandages round his feet etc, he's spending healing surges. As he goes through the movie, and he gets progressively more battered and shredded, covered in blood and bruises, and his endurance goes down... That's his healing surges running out. HP are a 'this-fight' resource. HS are a 'this-day' resource. It helps if you think of HP as they're intended - mostly a reserve of luck, endurance, grit and toughness, rather than literally 'each HP is a wound' or whatever. You're not seriously wounded until you go below 0HP. You're not out of the fight entirely until you stabilise at below 0, or you hit -bloodied/3DSTs. 
Perhaps you could call them Recoveries, which is the 13th Age name for them, if that makes more sense to you and your party.
Regarding what they represent: they are a normalised absolute measure of the character health, independant of levels. So in this model HP are a measure of fatigue/endurance, which scales with levels, while HS gives you the status of how much the character can still take before having to call it a day. As a houserule, to make things more gritty, we rule that characters who drops below 0 HP lose a HS for the rest of the adventure (as recovering it would require a very long rest and medical support).
I like both ideas of losing a surge and the diehard model. Excellent, that's enougth rationalisation for me. Thanks.
Well, it's a bit of a read, and you already seem satisfied, but I'm going to leave you this link anyway. It leads to a blog in which the answer is explored.
I prefer the name Heroic Reserves myself. I think it better fits what they represent.
I love healing surges- one of the aspects that I enjoy in 4th.
Thanks all. 
I like to think of HP as the hero's ability to keep fighting. It's a mixture of health, morale and stamina. From that standpoint, healing surges are your innate reserves to rally each of those things. You can only go to the well so many times, eventually even heros run out of gas.
Previous HP references, if anyone desires:
AD&D 1e PHB p.34: "hit points represent how much damage (actual or potential) the character can withstand before being killed. A certain amount of these hit points represent the actual physical punishment which can be sustained. The remainder, a significant portion of hit points at higher levels, stands for skill, luck, and/or magical factors." AD&D 1e DMG p.61: "Damage scored to characters or certain monsters is actually not substantially physical–a mere nick or scratch until the last handful of hit points are considered–it is a matter of wearing away the endurance, the luck, the magical protections." D&D 3.5e PHB p.145: "Hit points mean two things in the game world: the ability to take physical punishment and keep going, and the ability to turn a serious blow into a less serious one. For some characters, hit points may represent divine favor or inner power." D&D 4e PHB p.293: "Hit points represent more than physical endurance. They represent your character’s skill, luck, and resolve—all the factors that combine to help you stay alive in a combat situation." D&D 5e article Here Spoiler: Show In D&D Next, hit points and Hit Dice are an abstraction that we use to model more than just a character's physical durability. In fact, we have three elements that tie into a character's hit points and Hit Dice.
Here's a brief overview that gives you an idea of what happens when a creature takes damage. A creature with more than half its maximum hit points has nothing more than the superficial signs of injury. There might be a few tears in its armor or clothes, or it could have a dent in its shield, and it has not yet suffered any serious physical harm beyond a scrape, light cut, or bruise. Anyone looking at the creature likely doesn't notice that it has been involved in a fight. A creature with less than half its maximum hit points has suffered a few noticeable cuts or bruises. A casual inspection or quick look reveals that the creature has taken a few hits, so it is noticeably injured. A creature that is reduced to 0 or fewer hit points has suffered a direct hit—enough to knock it unconscious. The attack that dropped it caused a serious injury that might crack bones and cause heavy, ongoing bleeding. Consider the example of a giant spider attacking a 1st-level fighter who has 10 hit points. The spider's first attack deals 3 damage, and the fighter must make a Constitution saving throw against its poison. The bite barely broke the fighter's skin, but just barely. The mark from the bite will clear up in a day or so. The fighter has a scratch that most people would overlook. The next bite reduces the fighter to 3 hit points and requires another saving throw. This bite causes a noticeable injury since the fighter now has less than half of his or her hit points. The fighter will wake up the next morning with a scab over the bite, and it might take another couple of days for the injury to disappear. A good rest erases most of the real physical effects of the injury. Anyone looking at the fighter would immediately notice the nasty-looking bite wound. If the spider drops the fighter, it lands a deadly attack. The wound is vicious and ugly. It bleeds freely, and only prompt attention or sheer luck can save the fighter. If mundane bandages are all the fighter's companions have on hand, it will take a couple of days for the fighter to return to action. At this point, there's a chance that the fighter will have a lasting scar, and he or she needs magic to get back into the fight in the short term. Also, here are healing references if desired: D&D (original brown book, volume 3) p.35: "common wounds can be healed with the passage of time (or the use of magics already explained). On the first day of complete rest no hit points will be regained, but every other day thereafter one hit point will be regained until the character is completely healed. This can take a long time." AD&D 1e PHB p.105: "There are numerous ways to restore lost hit points. The most mundane is by resting and allowing time to do the job. For each day of rest, 1 hit point of damage is restored. After 30 game days have passed, hit points accrue at the rate of 5 per day thereafter." AD&D 1e DMG p.82: "it is absolutely necessary that the character rest in order to recuperate, i.e. any combat, spell using, or similar activity does not constitute rest, so no hit points can be regained. For each day of rest a character will regain 1 hit point" D&D 3.5e PHB p.146: "With a full night’s rest (8 hours of sleep or more), you recover 1 hit point per character level." fwiw: since 4e allows players to refluff stuff without changing the mechanics, I allow death to be described more as 'severely wounded'. The PC's injuries are severe enough to prevent him from taking any actions until he can access some stronger, costlier (500gp) healing.
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