Honestly, Hardcore isn't that big of a deal. The only real problem is the Stimpaks not healing instantly, but that can be circumvented by activating a dozen consumeables at a time and getting an ungodly health regeneration.
Other than that, the biggest drawback is being pretty much forced to take the Strong Back perk, to allow you to carry around your ammo (which suddenly weighs some) and some food/water.
The whole having to eat, sleep and drink thing is fairly trivial. The game throws food at you in huge quantities, Gecko meat and Dog meat is widely available and easy to cook. Water is also easy to find, there are sources of clean water all over the map, even irradiated water isn't a big problem since taking 2-5 Rads to remove all your thirst is trivial.
Companion death is a nuisance at worst. Also, once you figure out that Stimpaks heal instantly for your companions and that you can acess the companion wheel in combat, they are essentially immortal.
Crippled Limbs needing a Doctor is inconvenient, but there are plenty of Doctors around, plenty of Doctor's Bags and Hydra heals all your limbs.
FateDarkstar said:
Also, how the hell did you even go through the first playthrough with all the damn bugs swimming around the damn place.
Patch the game. I've had zero bugs since I patched it and only a few minor glitches (an enemy or two got stuck inside a nearby mountain). The game cleans up nicely.