How much emphasis should be put on REALISM?

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Should story tellers focus on narrative and world consistency instead?
Isn't the suspension of disbelief a relationship between the creator and the audience that requires the audience to decide to suspend disbelief while the author tries to make it easier?
Aren't some aesthetic choices just matters of preference that can be prioritized over whether it is realistic within the context since the look of something can be developed from an archetype or serve a symbolic role?
Why does realism come up in discussions about entertainment anyway? Are other cultures like this?