Sometimes I want to make it seem like a character might die — but hey, guess what! She makes it! A lot of fiction writers, especially those who write fantasy, science fiction, thrillers, and Westerns, like to write about surviving almost fatal injuries.
Pin or bookmark this post for future reference if you like this kind of plot point! I will probably add to it as I get more ideas. This post is not for the squeamish, though, so please don’t read through it if you think it might upset you. I’m just trying to save you some Googling time so you have more writing time.
I’ve included links to what seem to be credible sources. In a few cases, I haven’t linked to the source because it’s so upsetting or it contains disturbing images, which you won’t find here.
Please note that this post is for WRITING PURPOSES ONLY and is NOT MEDICAL ADVICE, which I am COMPLETELY UNQUALIFIED TO GIVE. I am just a lady who looks things up on the Internet.
With all of these, I am assuming that the injury is happening to a relatively healthy, non-elderly person. If you have suggestions or additions, please let me know. If you are a medical professional and believe something needs to be changed, let me know that, too!
Blood loss (for any reason.)
After your character loses about 2 pints of blood, he is likely to go into shock. If he’s not losing blood at too fast of a rate, he will likely not go into the kind of severe shock that would kill him. He can believably survive a loss of up to 3 pints without a transfusion. It’s very likely he’ll pass out, be cold to the touch, and have a weak pulse, so your other characters might have a scary moment or two of thinking he is dead before they realize that he’s still breathing.
Bear in mind that if your character is cut in the jugular vein, the brachial artery in the armpit, the femoral artery in the thigh, or one of the aorta, he is likely to bleed out too fast to be saved.
Head and face wounds bleed like crazy, because there are are a lot of blood vessels close to the skin, which can make minor head and face injuries seem worse than they really are.
Cauterizing a wound might help him from bleeding out, but he also might get an infection that kills him. Until he can get stitched up, pressure and bandages are usually a better idea.
Gunshot wounds.
Your character can survive a shot in the arm or the leg unless she gets hit in a major artery. Chances are great that she will survive a gunshot wound in the torso with prompt medical attention unless she was shot through in the heart (cue Bon Jovi) or, again, in a major artery that makes her bleed out quickly.
Only 5% of people survive a gunshot wound to the head, but with time, some survivors make surprisingly good recoveries. Here’s a good overview of the recovery of Gabby Giffords, a United States Congressperson, from this injury.
Sometimes people even survive multiple gunshot wounds.
Starvation.
Let’s look at some real-life examples. Gandhi was pretty skinny, and he survived a hunger strike of 21 days. It’s possible that he sustained internal damage that I don’t know about. David Blaine starved himself for 44 days (he did have water), and I have not been able to find any mention of permanent damage. (He did damage his liver trying to break the record of holding your breath underwater.)
So your guy can probably go 3 weeks without food and be all right eventually, assuming he has some water. But you can’t have him sit down to a steak dinner afterward! His system won’t be able to take it. Here’s a report about feeding David Blaine after his long fast.
Food poisoning (E. coli infection.)
Your character is not at all likely to die, unless he is quite old, but he may have an awful week.
Fire.
About 70% of fire-related deaths are caused by smoke inhalation rather than burns. Smoke and heat both rise, so your character has a better chance of surviving if she stays low. She can cover her nose and mouth with a hand, her shirt, or a wet rag if possible, and she can hold her breath for short amounts of time.
Here’s a comprehensive article from the New England Journal of Medicine on probability of death from burn injuries. Britannica.com says: “Most people can survive a second-degree burn affecting 70 percent of their body area, but few can survive a third-degree burn affecting 50 percent. If the area is down to 20 percent, most people can be saved.”
Here’s an account of someone who survived the tragic Station Nightclub Fire of 2003 that killed 100 people and injured over 200 more.
Electric shock.
An electric shock can cause both internal and external burns. It might make your character confused or knock her unconscious. A strong shock, such as from a high voltage power line, can cause ventricular fibrillation or cardiac arrest, but if your character is immediately treated with a defibrillator, she can probably survive.
About 90% of people survive being struck by lightning, but they may sustain nerve damage, ruptured eardrums, muscle twitches, memory loss, and personality changes. The late neurologist Oliver Sacks wrote about the fascinating story of a man who was struck by lightning, had a near-death experience, and afterward developed a deep love for music and music composition.
Plane crashes.
Your character’s odds of being killed in a plane crash are incredibly low: 1 in 29.4 million. Airplane crashes are exceptionally rare, and when they do crash, most people survive it.
If you want your character to survive an unusually terrible plane crash, here are two stories that might inspire you: a French teenager who was the lone survivor of an airplane crash in the ocean (heartbreakingly, her mother was on the plane), and the sole survivor of a tragic Russian plane crash that killed a hockey team.
Explosions.
There are all kinds of bombs and explosions. Here are three survival stories: a bakery owner whose oven exploded, causing significant property damage; a survivor of Daesh’s horrific attack on a metro station in Brussels, and the survivor of the explosion of the commercial spaceship Virgin Galactic.
Here’s an article on two simple rules to survive a bomb blast in a building.
According to the Center for Disease Control, “The human body can survive relatively high blast overpressure without experiencing barotrauma,” but your character’s ears will probably be ringing, and she will probably have injuries from glass and debris.
Venomous snake and spider bites.
A black widow spider bite will almost certainly not kill your character, but it will cause excruciating muscle cramps. Here’s a firsthand account of a teen bitten by one (related content may contain upsetting images.) Without antivenin, symptoms may last for several days.
Most people survive bites from pit vipers in North America — rattlesnakes, copperheads, and water moccasins. Here’s some information about first aid and treatment, and here’a a good firsthand account about a bad rattlesnake bite and its treatment. Some snake bites are worse than others, depending on how much they latch on and how much venom they get into a person.
Suffocation.
Suffocating a person with a pillow is frequently depicted in TV and movies as a quick process, but it really would take 3 to 5 minutes. Your character would likely still be alert after one minute (assuming he doesn’t have a heart attack in response to being smothered.) He could fake being unconscious, wait for his attacker to let up, and then spring on him.
Strangulation.
Your character only has a short window of time for survival here. Compressing the two carotid arteries on either side of the windpipe can make her black out in 20 to 40 seconds, and can kill her in 2 to 4 minutes. That’s because those arteries carry most of the blood to the brain.
Near hanging.
Hanging is a form of strangulation, unless the sudden pressure on the neck causes cardiac arrest, or unless the neck gets broken (decapitation is also a possibility.) If your character is being hanged, he may lose consciousness at around 10 to 13 seconds and go into convulsions at about 15 seconds. If his friends are rescuing him, they have a very short window to cut him down.
Almost drowning.
Your character can probably hold her breath from 30 to 90 seconds (assuming she hasn’t trained to hold her breath for longer periods), and she can probably stay conscious underwater from 90 seconds to 2 minutes. Even after your character is unconscious, she will probably be all right if someone drags her out and performs CPR on her within four minutes. After four or five minutes, she begins to run the risk of brain damage.
Here’s something pretty cool, though — if the water’s really cold, she may be under longer and still suffer no brain damage. She should be treated for hypothermia, though.
Note that usually, drowning doesn’t look like drowning — people do not and cannot wave their arms and yell for help. EDIT: People who have almost drowned should be taken to a hospital. You can read about dry drowning here.
Hypothermia and frostbite.
Here are tables from the National Weather Service that show how much time it takes to get frostbite in cold temperatures and hypothermia in cold water. Weirdly enough, according the linked article, “hypothermia can occur at any temperature lower than normal body temperature. Factors like body fat, age, alcohol consumption, and especially wetness can affect how long hypothermia takes to strike.” Depending on what you’re writing this article on preventing cold stress while working outdoors might also be useful.
Now, let’s talk about…
A Few Ways Your Character Might Seem to Be Dead.
Deep hypothermia can sometimes make a person seem dead.
People who have ingested tetrodotoxin, the poison in pufferfish, have sometimes seemed dead and then made a complete recovery. (A variation of it is used as a way to fake a death in the movie Captain America: Winter Soldier.)
There are some other rare cases in which people come back to life after seeming quite dead. Here’s the Wikipedia article on Lazarus syndrome.
I hope this list helps you when you want your character to cheat death. If you don’t want to miss future reference posts for writers, follow my blog — you can subscribe below. Thanks for stopping by, and happy writing!
Thanks Bryn! This is some useful information- I’ll definitely be coming back to check this list again I’m sure ?
Thanks, Zara — thanks so much for reading!
My heroine just survived a near-strangulation, and what I learned is that after the event is over, it is possible for the throat to swell closed in response to the trauma. Sadly, if a person does not receive medical treatment within an hour after the event (because she thinks she’s fine now) she has a significant chance of dying later.
Sophie — ah, that is good to know, the forensics site didn’t mention that! I will find a source and update soon. Thank you so much! (Thanks for the kind words, too!)
Here are some of my sources (and I realize that I was mistaken – death can actually occur up to days afterwards!)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413082/
http://www.ncbi.nlm.nih.gov/pubmed/19999960
https://www.evawintl.org/Library/DocumentLibraryHandler.ashx?id=540 see “Clinical Presentation” section
http://missoulian.com/lifestyles/health-med-fit/nurse-s-notes-strangulation-conversation-continued/article_8fff526e-06be-11e4-bc06-001a4bcf887a.html
Ahh thank you! (PS I hope you know I believed you! I like to share sources if I can… though a couple of the sites were just too gory to link to, haha.)
I drive my family nuts – if you can’t show me your source, don’t bother trying to convince me of something 😉
(super late comment here lol) But I work with female clients involved in the criminal justice system and I have a client whom survived a horrifically bad abusive situation where the father of her youngest son had very nearly killed her by strangling her. She now has permanently damaged vocal cords, so her voice is always raspy and quiet (literally sounds like she has laryngitis, but permanent). That could be another thing to potentially add to this kind of situation for more depth.
And thank you for this information! (Forgot my manners ?)
Thank you for this awesome post. It’s already come in handy. \o/
I’m a new follower of yours, and I have to say I’m loving your blog. <3
Hi Karen! Aw thank you so much, I’m so glad you like it. Thanks for following!
Great information, Bryn. Thank you so much for this.
Thank you for reading, Artemis! Always nice to see you 🙂
Incredible list – as usual! You are my go to resource.
Aw Lexi, that’s so nice! Thank so much.
Great post! I love researching this stuff. As a clinical dietitian, I have to say people can suffer permanent damage to the heart, kidneys, and bones. Unfortunately, I have seen the death of an otherwise healthy young woman due to the effects of self-induced starvation – anorexia.
Here is a resource describing the effects of starvation (self-induced) on the body:
http://www.webmd.com/mental-health/eating-disorders/anorexia-nervosa/features/anorexia-body-neglected
https://www.mccallumplace.com/health-risks-of-anorexia.html
Michelle, thank you! I’ve had a hard time guesstimating about how long before internal damage occurs… probably because it varies so much from person to person! This is really helpful information. Anorexia is so heartbreaking… thank you for doing the work that you do.
Thanks for the list! I’ll come back to it if I ever need o put my characters through something nasty.
But since you’re (also) making this list for the more speculative genres like fantasy and sci-fi it might be useful to add something about magic and futuristic technology on it. For example: two of my characters only survive a terrible injury (a spear to the stomach and a magic wound respectively) because they could be magicay healed.
And some kind of magic or a special futuristic machine can be used to make someone seem dead, think of voodoo, for example.
Yeah, that’s a good point, Kiete.. with scifi and fantasy you can survive things that ordinarily no person would survive!
Thanks Bryn! This is a wonderful resource! I’ll certainly be referring back to this.
Thanks for reading, Yvonne! 🙂
From what I read about drownings is that most drownings are ‘dry’ drownings, i.e. no water actually ends up in the lungs: the airway simply gets blocked or goes into spasm. Your character can probably survive that quite well.
A ‘wet’ near-drowning, however, where water enters the lungs, is likely to be fatal without treatment after rescue. In the case of salt water, osmosis makes the lungs flood with fluid, and in the case of fresh water micro-organisms from the water starts growing in the lung, again upsetting the fluid balance and causing the lung to fill with fluid.
And I agree on the cold-water drowning: Trauma medicine say nobody is dead until they’re warm and dead.
Fascinating list! Thanks
Niel, always so good to see you!
From what I’ve read, “secondary drowning” is possible but rare. You bring up a great point: in a story with a contemporary setting, the almost-drowning victim should get checked out by a doctor if possible. (That is actually true of pretty much everything on this list!)
Thanks for the kind words!
Finding this was pretty timely! I just shot a minor character in the shoulder last night, and I wanted to make sure he’ll go into shock, but live to fight another day. Your advice on blood loss will be very helpful.
Thanks for the tips and links! I’ve shared this article with my writing association; I think a lot of us will keep coming back to this.
Be very careful with shoulder wounds (torso). Also please be careful with what you mean about shock. Medical shock is a very dangerous thing, and if caused by a bullet in the shoulder, quite likely fatal. Shock is caused by low blood pressure, and if that’s caused by a bullet in a shoulder, that means it’s hit the brachial artery or worse, the subclavian artery or vein. In any of those cases, unconsciousness is almost immediate and death certain without immediate massive medical intervention. Even if those major arteries and veins are missed, the shoulder is full of the nerves for the arms and upper torso. Most (the vast majority) of people would collapse, screaming with pain from any deep-penetrating shoulder wound, or from anything that breaks the collar-bone.
Excellent list and my research has found the same. I hasten to emphasize something you said: prompt medical treatment is usually the key. However, any near death wounds will often leave permanent effects such as brain damage, disabilities, crushed larynx (inability to speak),… The results aren’t binary: alive and fine vs. dead. As for types of death (this is getting long): the details of how it happens is crucial. Burns: the secondary effects, especially infection, are often the cause of death, even from otherwise quite surivable burns. Plane crashes: breakup or loss of control at altitude: very few, if any, survive. Crash on landing or takoff, you are quite right – most survive. Concussion: death can occur hours later even after the character says “I’m fine.” Hanging: without a drop, as you say, 8-13 seconds of hideous pain. (Or a little longer if a sheet or large diameter rope is used, and that’s how most suicides occur.) The “classical” execution style drop is supposed to break the neck. The window of opportunity for rescuing the character ends when the lever is pulled. Even a short-drop will so damage the neck that even if the victim is rescued within the 15 seconds before brain damage starts, he/she will need immediate medical aid in order to survive. Bullets: the weight and speed of that bullet is important: a .22 pistol sub-sonic shot is very survivable (assuming, as you said, no vitals are hit). However, a depleted uranium supersonic hit (even in the arm) will almost certainly kill and very quickly too. Swords, axes and spears: you might want to check out the Battle of Visby: a large fraction of the deaths were from penetrating shoulder wounds – those wounds that TV and movie heroes routinely shrug-off.
I love all this information! Very good to know 🙂 I was wondering if you or anyone else might know about how far someone can fall and still survive? I know there are various factors such as: debris, injuries sustained etc. but one of my characters is going to have a severe fall. I need to know if she can fall from a pretty good height and not die on contact. Thanks for all the other info too!
I’m no expert but I know some numbers. Firstly, training (and/or luck) is crucial within the 10 to 20 feet range. WWII army parachutists hit the ground as if they had free-falled 11 feet (3.3 m). At that drop, landing on open flat fields, they (extremely fit young men) would break an ankle or leg if they landed badly. Training meant that they didn’t land badly, but many enough did break limbs in training. At 15 feet drop, most people, even those with training, will usually injure themselves, and some will die. At 20 feet, surviving is problematic. Landing on a loose un-compacted surface (but NOT a manure pile or mud-swamp) is the best, especially if it allows you to slow down over many feet distance. Water helps too but how you land is crucial: a 20 foot (or less) belly-flop can kill but a 90 foot controlled dive by an experienced expert won’t even injure. And no, landing up to your waist in manure or snow only helps some. It’s much better than landing on concrete, but after watching Frozen, I calculated Anna’s deceleration into the snow. That should have been a very messy instant trip to the morgue. And BTW, it’s not the “hit” that usually does the damage although lacerations fom pointed/sharp ground can and will injure or kill (see below). More importantly (usually) the distortions from the decelerations break bones, rip flesh and scramble the brain,… (so “hitting” a flight spell would be bad: ie the movie version of Hermione’s spell). However, remember that fluke chance can help (some) or hurt (a lot). I remember about a decade ago hearing about a primary-school girl somewhere in the USA. She almost died from tripping over her own feet. She landed on a pencil (or pen) that pierced her heart. She only survived because the teacher knew to NOT remove the pencil, and the ambulance responce was good.
Thanks Chris! I really love your examples (Note to Self: Watch Frozen). I want my character’s fall to be in a warehouse of some sort, probably on concrete, My story is supernatural so she will end up alive supernaturally but once she hits the concrete, she has to be able to survive for at least a few minutes. Thanks for all the info!
Great post! As a fellow writer, I frequently have need of this information (though not human, my characters do have similar dispositions towards injury) and I LOVE the diversity of death/near-deaths you’ve listed. I have bookmarked it 🙂
Thanks!
Very good post.
We’ve used electric shock to treat snake bites in our cattle and the neighbor’s dogs. (We do it with jumper cables, but I’d have to get more information from my dad since I’ve never witnessed it.) In all but one case with a dog, the animals had a complete recovery, even though some had been on death’s door before the shock treatment. We’ve had enough luck with this sort of treatment, that, if one of us got bit by a rattlesnake, we’d certainly try shocking it before going to the hospital. (We’re in a very rural area.)
I found this website that has some info on it.
http://venomshock.wikidot.com
Thought you would find this interesting. Did you know that you should not ice bites? I forget if this is just for snake bites, but with certain types of venoms, cold makes the poison travel quicker. This could make things more dramatic for your characters.
I did not know that, and that is really good to know. Thanks, Madelyn!
I promise to be short this time. One of the things impressed on us during first aid training was the smell. More than one instructor for recerts has said that what hit them on their first “real-life” accident scene was that smell: vomit, blood, sweat, urine, feces. So to make those scenes come alive in your writing, don’t forget those smells, if applicable. However, be reasonable: you don’t want to “gross out” your readers too much.
Excellent post!
Oh thank you so much J. Kathleen. Thanks for reading!
Greetings! I’ve been following your site for a long time now and finally got the courage
to go ahead and give you a shout out from Porter Tx!
Just wanted to say keep up the excellent work!
Hi Jane! Oh my gosh, thanks so much for following. And for the kind words! It’s great to hear from you! 🙂
Hello, Miss Donovan! I’m a big fan of your posts, but would it be alright if you could add something to your ‘drowning’ section? If your character passes out underwater and nearly drowns to the point people need to use CPR, they should probably go to be checked out by a doctor. After someone is nearly drowned, there is the possibility they will experience what’s called ‘dry drowning.’ Basically, water builds up in the lungs after they’re out of the water. It’s difficult to spot and usually happens several hours or so after the incident. Anyway, thank you so much for the list! I have a feeling it will be extremely helpful.
Hi Amanda — thank you so much for the reminder. I meant to do this after another comment and it just slipped my mind! I will get to it 🙂 Thanks for the kind words, and thanks for reading!
Hi,
Just happened to read this via Pintrest. I am not a writer but love reading mystery and suspense novels. One thing I have been taught by people in the first aid business…not teachers but those who use it on a regular basis is that more then likely when CPR is administered rib bones will be broken.
Hi Naomi — welcome to the blog! It’s so funny you should mention that… I just got certified for CPR this month! Our instructor told us that a broken rib was a definite possibility, though it didn’t usually happen… I think the bottom line is, most people would rather be alive with a broken rib than, you know, not alive. 🙂
I agree! I got this info from two people who work in the Canadian military and use first aid and interventions higher than that but are NOT doctors. So just thought I’d pass it on. Not doing anything will leave an already dead person…dead. So ya you can’t really do much wrong if they are dead in the first place.
What about arrow wounds? Are they similar to shots?
Great website!
I suggest this website on bow and arrow injuries,
https://allthingsliberty.com/2013/05/battle-wounds-never-pull-an-arrow-out-of-a-body/
Thank you. Some of that information about arrow wounds will be very useful in one of my stories.
Thank you so much for sharing the link!
Found this post on Pinterest, of all places, Bryn. Good, helpful, interesting stuff. Thanks!
Thanks for this post. Seems like there is always a great deal of research required if we want to be believable, and TV/movies certainly are not a valid resource (Frozen, as noted, and I have to think that the dwarves in The Hobbit wouldn’t all just walk away after that tremendous fall in the Goblin cave – yet none were even scratched!).
Right now I’m working on trying to believably kill someone instantly (must be by knife or breaking their neck). It’s amazing how much conflicting information is on the Net, so finding something that seems truly authoritative is a challenge.
– Deandra
Oh you’re welcome, Deandra! And yeah, I am always noticing in TV and movies when there’s no way a character could’ve walked away from the ordeal they just went through.
There certainly is a lot of conflicting information out there. Also, there is one thing that rarely gets mentioned, probably because few people want to think about it: the fact that many deaths aren’t immediate. A friend of mine, his office mate broke his own neck playing sports – and survived. He was lucky that none of the nerves were severed. Many suicide jumpers survive for a while – they aren’t lucky. Very few poisons act quickly. A knife in the heart amounts to a massive heart attack. The most merciful I’ve been able to find are those that unconsciousness almost immediately and therefore don’t cause prolonged pain, like beheading, drop-hanging, anything that causes blood prssure in the head to go to zero, like cutting the carotid, or failing that, a massive heart attack or severing any major artery like a spear/sword/bullet in the chest or shoulder (brachial artery) or even the femoral artery in the leg. Death can still take a while, but at least the victim is already out cold. Wounds in the abdomen are chancy. They can kill quickly, or they can take hours, just depending on what exactly was damaged and how badly. From what I understand, death from low atmospheric pressure (plane depressuraization at altitude) is fairly merciful, not because it’s quick, but because there is little pain.
Yes a lot of TV shows, movies and books get it wrong, I guess that is because they go with the old adage, “don’t let the truth get in the way of a good story.”
I have done a lot of research on injuries, such and spinal cord injury and cortical blindness, because I required there to be damage to my poor sods who survived, and scars, don’t forget them … unless you not to worried about the truth getting in the way. 😉
I have a hundred and twenty-eight year old question. I am writing of an accident that happened to my great grandfather in 1891. He was alone, returning home on horseback. He was bringing home two wild mules he had purchased from a ranch about 15 miles away.The newspaper account written, was by his own mother, after his death. She said he lived for (two months) after he was “dragged, causing severe injuries internally – chest and kidneys most acute. He has spit blood, and at times has vomited the same, ever since.” He was in a great amount of pain, and also given a “strong mixture of coffeeberry and whiskey for medicinal purposes”. His mother goes on in the article to say that all the family knew during this time that he was declining. He was 31 years old. My grandpa was only a year old when this happened to his father. He also told me his that his father’s dead horse layed on him all night until his family found him the next day.
I am writing about this accident, but I’m courious, how could he live two months? With your knowledge of accidents and injuries, do you have a guess as to what might have been going on?
Your great grandfather evidently died of internal injuries.
The spleen is not an essential organ, so if it gets ruptured by itself it does not cause death. But an interruption of blood supply to the spleen might lead to necrosis, which could cause a general decline in wellbeing before death.
Or it might just be a infection.
“Mixture of coffeeberry and whiskey” sounds like a terrible medicine to give to a mortally ill man: today we would call it “Red Bull and Vodka”. But then it was probably all they had.
Niel! Hey there 🙂 Thanks for jumping in there! I tend to agree with what you’ve said.
The frustrating thing for me about researching injuries in general is that there is so much variability. You see people take a long time to die from injuries that seem like they would be quickly fatal, and sometimes even in centuries past, people would survive terrible things. Niel brings up a great point in particular about infection. It can still be an issue with surgeries and professionally treated wounds today, but it was much more of a problem in the past.
That you mention infection is important. Some studies of historical warfare have suggested that until recently, disease, starvation, and infected wounds generally killed more soldiers than while actually on the battlefield fighting the enemy. So whether the hero(ine) gets infected is a crucial point. If you didn’t take care to keep it clean, or if it didn’t fit you well enough, your own armour could kill you.
Hi Chris! Wow, I never thought of the irony of being killed by your own armor!
Hi, I’m am still in middle school, and I am working on a novel that I hope to publish. Your blog has helped me so much, thank you! I will definitely come back to your blog in the future
Hi Hannah! That’s awesome that you’re working on a novel, and I wish you the best of luck with publication. So glad you like the blog. Thanks for the kind words!
That’s awesome! I’m working on a novel as well, and I’m in high-school- maybe someday I can read yours! Good luck!
Interesting post. I have a character in my upcoming novel who got shot in the abdomen with an arrow (its 1872 and the majority of my characters are Native American). I had learned somewhere else he had a small chance of surviving this, and I think I may have to have him going to shock on the lengthy trip to the doctor after reading your information.
That sounds great, Ellen! Having your character go into shock is going to add even more realism, I bet.
This is such a brilliant and helpful post, thank you! But I notice you didn’t include stab wounds – what are the ins and outs of those? Thanks!
Many (most) stab wounds kill from blood loss. As Bryn says, if it hits an artery or the heart, death can be quick. In fact it can be so quick that the person is dead (or at least unconscious) before “they hit the ground”. Or it can take hours (see Bryn’s section on blood loss and shock. Most people badly underestimate the consequences of shock.) Deep stabs to the torso (including the famous TV trope – “only a shoulder wound”) are almost always fatal unless medical aid is available. If you know what you are doing (medical knowledge needed – or sheer stupid luck) there are small spots that are less dangerous, but infection is still a problem. Hit the lung or even open the chest wall (so most stabs above the diaphram that manage to get through the rib cage – which is harder to do than most people think) will collapse a lung quickly or slowly. Below the diaphram, there are the liver, stomach, kidneys, spleen, intestines, and while you can function with damage to those for a while (possibly many hours), medical aid will become essential eventually. So again, an abdomen stab really depends on whether it hits a major blood vessel.
One thing to remember, any stab (or other wound) that severs a muscle or tendon will incapacitate the limb. Doesn’t matter how heroic, how motivated the character is, that limb just won’t function. Sever a major nerve bundle, and the same thing, and the pain will be excruciating. Again, it doesn’t matter how heroic the character is – his/her body just won’t function, and it would be heroic indeed just to stay conscious given that amount of pain.
Chris, thank you! This is awesome. I really appreciate it!
This is one of the most helpful posts I’ve read. I have a question relating to the last post. Is it realistic, given the lack of medical knowledge during most of the medieval period, to consider that a knife wound that severs a muscle or tendon or a nerve bundle might, over time, heal? Or will the character have lost the use of that limb forever? What about a punctured lung? Thanks.
I would like to know that too, and would like to hear from anyone with medical knowledge. Medieval medicine being so bad (although it was better than many give it credit for), it almost boils down to whether those things will recover on their own. In every subject it seems to depend on how bad the injury is and also on the character doing the right things – to whit, not making the injury worse.
Severing the achilles tendon was from ancient times a known nasty way to cripple someone for life, and the same seems to apply to any fully severed tendon. Partially severed tendons can heal, so long as the character doesn’t stress the injury. Damaged nerves can regrow, but if the sheath is severed (which from a stab wound is almost a given) then by all reports, full recovery is highly unlikely and even partial recovery is chancy. And I know from personal experience that the recovering person -must- exercise their muscles and flexibility in the regions “downstream” of the injury, otherwise even once the nerves do heal, some mobility will have been lost. However, perhaps other nerve pathways might be able to take over in some cases? In both cases (nerves and tendons), the recovery time is months at best.
As for muscles, I had no idea, but a quick internet search found the following:
“Muscle is actually an incredibly regenerative tissue…[details on how deleted]… Obviously, there are limitations to muscular regeneration. The muscle tissue seems to require signals from our nervous system, and injuries that are too large fail to heal correctly. Often, in cases like this, a fatty tissue forms in place of healthy striated muscle.”
A medical researcher whose research was on that subject said: yes – very true.
So without surgery, I doubt a fully severed major muscle could completely recover.
Punctured lungs, again that depends on how bad it is. A small puncture can heal – so long as the person rests. If the lung collapses, the character will probably die. However again, it isn’t an all or nothing proposition. If they do beat the odds and survive without medical aid to remove the trapped air, there will be permanent lung capacity problems. I knew a woman who lost a significant fraction of one lung but, with 20th C medical help, survived. Any strenuous activity – at all – caused her to gasp for air almost immediately.
Thanks, Chris! That does seem to answer my questions.
This was sooooo helpful!!! I’m working with a lot of injuries as a fiction writer, so it’s always great to be able to have reliable sources I can turn to. Thanks!
This list! What can I say? As a newbie writer, it was vital that I ran across this. Thank you for sharing it. I even used it as a reference for my own blog. In fact, I can think of two other articles you’ve written that have saved me. Ever grateful, Deja.
Deja, aw thank you! I’m so glad it was helpful!!
Thank you!! I am a bit of a wuss at times, and my next novel has my heroine interacting with a highly sadistic serial killer. I do not look forward to all the research I’ll need to do concerning the myriad ways a person can get hurt. Here’s hoping that with this list and the wonderful comments, I can lower my risk of the inevitable Internet gross-outs.
I know this thread is a few months old now, but I just finished the first draft of a project that made me think of this discussion. The protgonist’s team wins in the end, but not without losses. During the climax, I wanted the antagonist to attack two of protagonist’s close friends with a rapier and poinyard, leaving one as a parapalegic and the other to die after a few days. I figured that after disarming them, he’d stab them in the back – severing the spine. So I checked with a friend who is a neurosurgeon and has spent time in emergency wards. Not on, she said. The spinal cord is too well protected and if you did somehow manage to break the spine with a blade, death would be fairly quick. However, she did point out that a deep abdomen stab would do for the slow death. Without antibiotics it would be nasty and inevitable. Having the antagonist throw the friend out a second story window and have them land on a garden wall or the like (I went with a sturdy chair the end) would do for the broken back. And yes, prompt medical help is necessary for the parapalegic to survive – she almost dies from shock.
Awesome site! Thank you! I bookmarked it for future reference. Any chance you have anything on head injuries? I have asked some of my nursing friends so I think I’m good but wouldn’t hurt to compare notes with another author. 🙂
Hi Byrn:
My character has been gang raped. I know, dreadful both physically and emotionally. Have you done any research on this topic with respect to the extent and kind of injuries that could be expected from such trauma, and the amount of time it takes before all evidence degrades too badly to be viable in terms of providing DNA evidence, etc? Some of this information might seem rather evident but I suspect some is not. Anything you can share?
Thanks!
Katie
Any information about radiation burns?
Hi Bryn,
I recently discovered your blog and I just want to say a very big THANK YOU! It has been a godsend! I sincerely appreciate all the work you do here; it’s so thorough and helpful, it almost makes writing a novel seem less daunting…almost! But get a load of this crazy lady over here who’s challenged herself to write two – at the same time! (Completely different genres, as if that makes it seem simpler! *facepalm*) I may soon find this to be a fool’s errand, but the Pisces in me is intrigued by the ‘What if…’ and I think it would make for a cool backstory if I actually pulled it off.
Thanks again and hope you’re doing well! x
Hello Bryn, I fond your blog, because I receive some mails with people asking about my old posts. One I wrote was: “Why we must to kill some characters”. Many asked me, how??? So, I answered them based on my own experience. But I try to read, time to time, another people ideas, and this is a good reference.
In my case, I have a “almost” drowning in one of my chapters. The event happened in a river. You must to remember, not how they could die, but think if they are available to get some help, or medical atention later. In my story the guy was alone, and was in 1576… I made my work and I searched information based on that kind of deaths in middle times, (or near). I fond a tesis which was wroten by a doctor, how wants to knows what happened on “drowning”. His methods, was drowning cats and dogs on real!!! He made several experiments with those animals, keep them under water X time (then he kill them to made autopsy to check what happend time to time on their bodies), so he kill more than 40 animals. But, not happy with that, he try to drown himself (of course just for seconds). The conclusión (based on that time) was: The person which suffer a drowning, got several collapses, and even inconscience time to time, to wake up and try to breath “again”, but that elipse was really painful, the person suffer inmobility on arms and legs, when his lungs “cant breath anymore”. Water can go to lungs, and he can try to trow up, but under water he can´t. At end, he just faint and then… he breaths and get the “golden” to dies. All process can be really quickly, the full death can be between 4-6 minutes. (the first 1-2 they can try to go out the water), but if you sink, dead can be easily 2-4 minutes suffering with all those things I wrote here. Sadly I dont keep the link, or even the name of the doctor, but read about that was one of the most painful things I did, because sadly a cousin dies by drowning in a pool when he has just six years old. Just knows, so puntual, how much a person suffer with that… was devastated to me.
Luckly for my “character”, he saves him self miraculosly (is part of the story), but he suffer all the post sympthoms of that. Pain on chest, head, eyes. Hard to breath, backpain, irritability, lost of memory/time, hypothermia, muscular cramps, etc.
My advise is, you must to understand how works medical services on the time of the event, if the character can get access on time or not. If the story is not on “modern time”, the succesful to recover are less. In past, people dies for influenza, flu, births and even for a poisoned open wound (with oxidated iron for example), remember the posibilities when “antibiotics” doesnt exist. So, simple things can kill someone.
I made an apologize if I was a bit confuse, english is not my native lenguage.
Your post is very good.
Starvation as fasting (religious sense) 40 days is not uncommon,and can be endured if the person is of normal weight. If the person is overweight maybe a week or two longer. Much beyond this will result in organ damage. During long fasts the person will grow weaker have less energy and may require more sleep. A careful diet is required when breaking a long fast.Too much food too quickly will cause great harm
also note many of the prisoners released from Nazi concentration camps died because American GIs shared their food with them, so the careful diet not kept can kill.
Thank for sharing, Bryn. Take care. 🙂
I’m writing a character who falls from a cliff, and nearly dies. What I want is for him to not like be permanently paralyzed, but like near that and take probably years to recover completely, HOWEVER I haven’t been able to find any references to refer to for this particular incident. Is there any way you can help me with this? What would it be like to fall from a cliff and survive?
This is SO HELPFUL!!!! I’m so thrilled I found this!!!! Thank you!!
Some of my thoughts on death dying and surviving. first as an EMT in my younger days, there are only five signs that a victim is truly dead and no first aid is necessary. gross decomposition, decapitation, Lividity, rigor mortis, burned beyond recognition. There is a condition called Internal Decapitation in which a few people survive reasonably well. The spine is severed but the spinal cord is not permanently injured. The spine can be repaired. As a side note, there is a legend that Antoine Lavoisier, who discovered and named Oxygen, was guillotined on May 8, 1794, as a final experiment, promised to blink his eyes as long as possible, it was about 16 sec.