Of course it's unrealistic. If it WAS realistic, no one would play (including me).
If you want realism, we could try perma-death. You die, you make a new character. You cannot instantly heal crippled limbs, it would take several months (if you could survive long enough). Same with First Aid skill. Eyeshots are instant death or severe disability, and most shots (be it body or limbs, regardless of armor worn) do severe damage. You are unable to carry more than 120 lbs/55kg, and it's impossible to run with rattle that weighs that much, and you are highly likely to develop severe injuries rucking that around for prolonged periods of time. Need I go on?
That doesn't sound like much fun does it?
The one thing that I never considered being unrealistic is an NPC encounter in the waste killing you utilizing violence of action.
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