Today I want to talk about medical facts and how they need to inform your writing. My day job is in the medical field, and often I answer questions from my CP or other Roaring Writers about medical facts in their fiction, and today I want to share a “greatest hits” of topics.
When you write scenes with physical conflict, the injuries need to be realistic. I once read a vampire book where this all-powerful being was felled by a paper cut. Literally. I never read another work by that author, as she had not set up the reader for this kind of weakness, nor done proper research as to if a cut in that area would cause the massive blood loss necessary for a supernatural being to perish. Fight scenes and healing are another big sore spot (pun intended:) with me- nothing makes me more irritated as a reader than to have a separated shoulder in chapter 3, yet someone is able to climb up an ice ledge hand over hand in chapter 4.
So without further ado… may I present basic medical facts for writers.
- The time for wounds to heal is pretty constant. Shallow things just involving skin is typically 2-4 weeks. Deeper wounds involving muscle 6-8 weeks. Deeper than that, well, that depends on where the wound is located.
- A broken bone will usually heal in 6-8 weeks as long as it is not re-fractured.
- Electrical burns will be 8 weeks miminum healing time, with a high chance of secondary infection from the dead tissue created along the entry and exit points for the electricity. There may be internal burns as well along the path in the body. Depends on if the body in question is electrically conductive (that is for all you silicon-based life form supporters).
- Infections killed more people in the old days than actual injuries- in the sense that if you fell off a horse and broke your leg, the broken leg did not kill you, but the infection that entered the skin at the points where the bone poked through will quickly spread throughout the body. Treatments for infection varied based on time period and geographic location, and that is where there can be some differences (like some places would use leeches and bleed persons, others may slather the wound in honey or a particular herbal paste). That is where historical research is critical to accuracy in your writing.
- A head injury without availability to a surgeon to release the blood clot/fluid is fatal- then and now.
- Stab wounds in the extremities are not fatal unless they hit a major artery and you die from hemorrhagic shock. Stab wounds in the abdomen or neck will most likely be fatal from internal bleeding or infection.
- Antibiotics changes everything, but not discovered until 1928, used widely in WW II (1942). Some mushrooms and molds have natural antibiotics, but it was not known “how” or “why” they worked. These natural sources only work against gram positive bacteria (like the ones on skin, or strep throat -but NOT on the ugly gram negative bacteria (the ones that are inside the internal organs and the gut). These dudes can kill you quickly.
- Zoonoses were a big deal- these are infections that are transmitted from an animal vector to a human (these were my favorites in infectious disease:)- think typhoid fever, bubonic and pneumonic plague (SARS is a modern example), tularemia (little-known but a big player in most 20th century biological weapons programs). Lyme disease, Rocky Mountain spotted fever, I could go on……These were particularly challenging because of the animal vector, so they are plagues that can flare at any time, travel fast because quarantine of humans from each other does not necessarily stop the spread of disease, and these vectors were not known.
- Fevers are the body’s way of fighting off an infection. If your character has a fever, make it realistic. Most humans die if the core temperature rises above 105 degrees Fahrenheit as at this temperature the proteins at the cellular level denature (fall apart). There is no ability to return from this event as there are no cellular constructs left to resurrect the patient. The normal human body temperature is 98.6 degrees Fahrenheit. My favorite scene from Gone with the Wind was ruined forever when Scarlett called out for Rhett when she was sick with a fever after having a miscarriage when she fell down the stairs. Most patients only moan when they are feverish- rarely do they speak coherent messages or have the brain function to give the coordinates to the buried treasure.
- Cooling the body can be a beneficial intervention as long as the basic life functions of the body are supported. The character who falls in a frigid lake? Yep, may survive with intact brain and body functions, ONLY if rescued soon enough to prevent drowning AND frostbite. Placing a human in a cooled state can help heal certain brain and nervous system failures, but remember, that character needs to be supported by life support systems. Except Captain America. I guess he was flash frozen and had such altered metabolism that he survived being pulled from the ice. Thawing Han Solo from the carbonite- realistic, in that it takes time for the body systems to readjust.
- Surgery saves lives now, but not in the old days. You amputated a limb to stop blood loss, or prevent gangrene or infection from spreading, but the surgeries were crude and because of the high risk of infection and blood loss, most perished.
- NASA, ESA, pretty much everyone surmises there are bacteria and viruses in space. Mainly because we carry them on our skin, in our excrement, and humans have travelled to space. There is an active search for life forms on other celestial bodies. When and if a space plague occurs, there will be massive devastation to the human population. Our immune systems work on the premise of defensive medicine- that they cannot predict what they might need to develop immunity to, only react when presented with a new infectious agent and then try to mount an immune response. We have seen this already in the Zika virus, Ebola, smallpox, mumps, rubella, etc. Vaccines are the only effective proactive mechanism to stimulate the body to make an immune response before exposure occurs as there are NO definitive treatments for viral disease. Nothing irritates me more than a “plague” that underwhelms- it creates massive lethality to those that catch it, but the main character can be covered in blood and gore but never fall ill with no immunity to the disease.
I hope this answers a few questions for everyone, and I will answer any other questions you may have in the comments.
Until next time!