posted
I know that a lot of people (especially fantasy and sf writers) have fighting and injuries in their writing. I'm no exception, but I have a slight problem. I'm wondering what the effect of different kind of wounds is. If somebody stabs you in the gut will you die? What is the chance of hitting a vital organ? If you do die, how long will it take (I know that it's a pretty long time). Will it likely be from infection or internal hemorraging? This brings up another interesting question.
I've been operated on before (appendectomy) so I know what it's like to heal from abdominal surgery and I'm guessing that gut wound would be about twice as bad (as long as you didn't hit a kidney or something).
We take for granted that if you aren't dead after several hours without attention, you aren't going to die, but before surgery was very good (or in a fantasy world with limited magic) what were the chances that you actually would die, say from organ failure?
I know that in the Civil War a lot of the deaths were from infected but otherwise non-lethal wounds. This sounds messy. How much more likely to get infected is a puncture wound over a slash or what I like to think of as a mace hit (just shredding somebody).
Feel free to use this thread to post information about other sorts of wounds (or a link to a thread that answers these questions).
posted
Assorted injuries and illnesses always give me a lot of grief---I'm drawn to the medical aspects of it, but have to worry constantly about making stupid mistakes.
There's the added issue in science fiction---improved techniques in treating illness and injury---which have to be described, and, worse, have to be thought up.
I've got one story going, where the main character has received a bullet wound in the leg. For plot purposes I have to keep her incapacitated by it for some time. But the precise nature of it eludes me.
I figure on a thigh wound breaking the bone, keeping her out for a couple of months. But how long precisely would she be out of action? How much time in the hospital, how much time at home? Can she stand up when the story opens, and if so, for how long? Infection, blood loss, what effect will those have on her? Does she walk on crutches, or does she use a cane? What about physical therapy, and does the therapist become a character on stage?
All things that I have to research, and also to come to a firm decision on. Right now I'm plowing through the second draft, and some decision must be made.
(Oh, and I, too, endorse Google as a useful research tool. Somewhere out there, there's usually something on what you want to know, for a story or for amusement. I once needed to know a few details about gold mining in Alaska---enough so that it didn't look like all I did was watch "North to Alaska" a dozen times---and, sure enough, I found a nice spread on how it was and is done.)
posted
If a bullet breaks your femur, you're probably going to need major surgery for your leg to work ever again. A simple break can be set and heal by itself if you immobilise the limb (or limb section), but a bullet isn't likely to make the nice clean break that a sword or a fall might do.
On gut wounds - it very much depends on what organs are pierced. In viking times, someone who'd been stabbed in a gut was given "the onion meal". If the wound subsequently smelt of onions, the general prognosis was that you were going to die; the rationale behind this was that the intestinal wall had been pierced, and thus you were likely to get blood poisoning. A poke through the liver or spleen might be less serious (though hardly pleasant).
posted
I work in Surgery for one of the bigger trauma hospitals in Washington State. Every day I see lots and lots of trauma, from broken bones in car wrecks to blood clots in the brain from baseball bats, to stabbings, gunshot wounds, abcesses. If you have any questions, I have alittle bit of first-hand knowledge about some of this stuff and would be happy to try and tackle some questions. I can always ask the doctors, too :-) Gunshots are some of the most unrealistic wounds portrayed in current media. Getting shot would be (for realistic purposes, not for "action stories") totally debilitating. The entry wound is usually minute, while the exit wound (most times) looks like somebody smashed a melon with a hammer. It blows out. The recovery time for broken bones depends on the severity of the initial injury. A snapped femur, for example, can be repaired in several ways. A nail (a pre-made metal rod) is inserted down the medullary canal (the soft core of the bone) and strengthens it. The incision can be small and reocvery time is a few months. Or, it can be plated, which requires a very large incision (10-12 inches) and the recovery time is more considerable (more intense physical therapy, from muscular stress and such). Infections still play a large role in healing. One of my friends just had hand surgery (she cut herself cooking and was diagnosed with nerve damage). Surgery was finished, but it got infected, pussed out, and tissue ended up dying. She had to go back in again and have a rotational flap (where they move a chunk of nearby, healthy tissue a fill the hole) and then THAT got infected....Now that is a worst case scenario (poor lady was sooo sick), but yes, infections are still around and are very, very bad.
Posts: 22 | Registered: Aug 2005
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posted
For all ills and injuries, I have a simple book called "Where there is no Doctor." It's meant for villiage health-care workers, but it has basic information on disease/injury, how to treat them, and what to expect during treatment. This is especially helpful in writing fantasy because the book assumes that you're in a very rustic place without access to modern medicine, so the remedies tend to be appropriate for low-tech fantasy civilizations.
Posts: 189 | Registered: Jul 2005
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posted
If somebody gets gut-stabbed in a medieval setting, chances of survival are very low. The "onion test" and things like that are just to see if there's even any point trying. Of course, adult humans living in that setting are a good deal more resistant to infection (a function of the high child mortality rates), but they still could die from even a small cut. Tetanus has been around a long time, after all.
How long it takes to die of a given infected wound is highly variable. And the chances of infection of a given type of wound depend a lot more on how much dirt got into the wound than on the type of wound.
posted
Another thing about a gut wound: I understand that if the intestines are cut, there will be the smell of excrement in the wound, and the victim will probably die of peritonitis fairly quickly and very painfully.
Posts: 8826 | Registered: A Long Time Ago!
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posted
Other factors to consider: is the blade of the knife dirty? And is the blade dull, or ragged? Both aggrevate the wound. And all this is assuming there is no poison involved.
Posts: 2026 | Registered: Mar 2005
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posted
From what little I know about combat first-aid, gut wounds are mostly about the damage your leaking organs do to your body. In most cases a victim will die from that long before an infection from external sources like unsterilized edged weapons or dirt getting in the wound.
Like Simon said, media does a lousy job of portraying gunshot wounds (of course, getting shot doesn't throw people against walls or out windows either - but it looks cool). First rule of combat first-aid is treat the exit wound, which could be anywhere if the bullet ricocheted off a bone.
posted
As far as I know, infection was the biggest killer, historically speaking. Even superficial wounds such as sword slashes, minor impalements (a spear through the arm) and such weren't enough to slow someone down on the battlefield, but afterward, the wounds would get infected. They were severely crippling, often resulting in amputation. Most injuries, unlike what we see potrayed around us, or written in books (Dirk Pitt, anyone? :-)) is very, VERY unrealistic. Unless someone's decapitated, or has their head blown up, they'll be laying around screaming for a while. This whole dramatic presentation of people at their friend's side as they lay dying from a mortal stab wound and deliver their final words is crock! They'd either faint, go into shock, or lay screaming in pain. BUT, none of that makes for very good drama. (And then Bob got shot in the stomach and writhed around on the ground for several minutes, bleeding everywhere, screaming in agony. Someone threw up from the neauseating smell, Bob having lost control of his bowels. A few minutes later, our closest friend, and guide on this epic journey, lay dead at our feet. It was over before any of us had a chance to say anything...) Yeah, so much for the dramatic, final last words. Posts: 22 | Registered: Aug 2005
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posted
Right up there with the guy in the cop show who takes one in the shoulder, carries on, and is seen at the end with his arm in a sling. From what I hear, that's a career-ending injury at the least.
Posts: 8809 | Registered: Aug 2005
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Research into the episiotomy (yes, you read right) has shown that lacerations--or tearing wounds--heal much more quickly and with considerably less pain than incisions--wounds made with a sharp instrument.
posted
Going into shock covers an amazing amount of territory. Just going into shock doesn't usually mean loss of reason or the ability to think. The typical "last words" scene is perfectly acceptable, as long as you don't do something dumb that clearly indicates that the person in question is not dying after all (unless you then have that person live, in which case it wasn't "last words").
A minor grazing injury can be painful enough to knock you on your butt and put you in a sling for a week or two without permanently crippling you. Of course, such wounds aren't very likely. If the bullet is a low velocity solid slug from a handgun, even a penetrating wound won't necessarily inflict all that much damage, though it will be worse than a grazing wound. If the bullet hits a bone, especially near or at an important joint, then that's a different matter. You won't be able to "soldier on" with such a wound, and you won't recover the use of the affected limb without pretty intense medical attention (and maybe not then either).
I don't know that episiotomy studies are a fair comparison, since there you're talking about something that's supposed to tear in "normal" use. I don't know what jerkface invented episiotomy in the first place, but it's just a bad idea on the face of it.
At the same time, the comparison is better for deep abdominal injuries than for more superficial wounds. Probably still not perfect, your insides aren't supposed to get torn apart in normal use anymore than they're supposed to be cut, but better.
posted
To add to Survivor's first paragraph on 'shock' The 'shock' of a grievous injury is not the shock you get in a haunted house. It's a physical reaction the body takes to reduce damage - unfortunately, it goes too far and can kill you.
There is a psychological factor to shock though. Until the late 80's, during shoot-no shoot training scenarios with cops the instructors would say, "He shot you. Your dead". The idea being, scare them into reacting faster and appropriately. A number of studies found that cops were getting minor gunshot wounds and dying from shock. They changed the training to "You've been hit." Supposedly, one of the first cases that proved the new training method works is a rookie female cop shot 3 times, once in the heart. She managed to kill her assailant and then attend to her wounds until medics arrived.
posted
FBI statistics state that a determined assailant can continue fighting for up to one minute after recieving a large caliber bullet directly to the heart. This same study concludes that the only sure way to turn someone off like a light is massive damage to the central nervous system.
I guess the relevance of the study (I'll try to find a link) is that even eventually fatal wounds (from infection or toxic shock or perintonitis or even trauma to a major organ) won't neccesarily stop the recipient from fighting for a substantial while.
posted
That's true. The normal adrenaline reaction can keep you fighting/fleeing even despite fatal wounds, including a stopped heart, since some blood flow will continue for a time just with the pumping action of your arteries. But you won't survive something like that. I'd guess that cop was hit in the chest rather than actually having the bullet go into her heart. There are limits on what adrenaline can accomplish.
Posts: 8322 | Registered: Aug 1999
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posted
Reflection's Edge www.reflectionsedge.com , as well as being an interesting market for spec fiction, has an article on violence that talks about adrenaline and wounds. Pretty interesting. (edited to manage the link--not used to UBB code)
[This message has been edited by Silver3 (edited August 30, 2005).]
posted
I'm not so sure about the FBI's one minute rule. I guess it would depend on their definition of a "determined assailant" (i.e. How much PCP does the guy, or girl, have on board?).I only say this because, in my experiences at work, we get gunshot wounds a lot and those to the heart, while allowing maybe a few seconds worth of reaction (like, you get shot, knocked to the ground, and then crawl a few feet), generally tend to produce pretty permanent results. And those people haven't had a "minute's worth of reaction time" to do....whatever. They just hit the ground, and then because of the massive trauma to their system, die quickly thereafter. But, you are right about the abdominal trauma. People can recover from pretty amazing things. Recently there was a guy whose side was torn open, leaving about an 18 inch rent. His stomach and his instestines were hanging out and they found his spleen lying next to him. But, he lived! So, I guess, if somebody can recover from that, well, a bullet wound to a noncritical area seems to pale in comparison.
Posts: 22 | Registered: Aug 2005
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