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Stories will not be written easily. A story without a heart is dead, and the only place it will get a heart is from the author.

Believability: Common Injuries

In stories, everybody loves drama. Whether they’re just starting out in writing, and it’s only for the sake of drama, or they’ve been writing for years and the dramatic event serves a purpose, stories simply cannot be told without some sort of dramatic incident.

In our case–us in this instance being Fantasy, Science-Fiction, and Young Adult writers– drama often manifests itself in how a character manages to injure themselves this time.

I have read stories by beginning authors that are so full of injuries (at the end of each chapter, for instance, many people will knock out their character) that none of the cast would be able to walk away after it, or even walk ever again. That, however is a topic for another time. Instead of talking about how frequently you should injure your character, today I shall type (it is easier than talking when one is running a blog, as I’m sure most of you know) about what happens when you do injure your character.

[Disclaimer: I’m not a doctor, but I have done rather a lot of research on each injury here. I shan’t be using technical or medical terms for the sake of my readers who won’t understand, just as I didn’t. If you look up what I say, though, you’ll be able to verify it with medical terms and official information.]

Something very common in fiction, be it television shows, movies, or books, is that the character will be shot in the shoulder. (In case you were wondering, if you go to a minion training school, you’ll see person-shaped targets in the shooting areas, with the bulls-eye on their shoulder.) They’ll grimace, say “Oh no! I’ve been shot in the shoulder!” and proceed with whatever they were doing before. There was one point in a story where I saw someone bleed extensively from being shot in the shoulder, but afterwards he was perfectly fine, and even did things with that arm.

What people seem to not understand sometimes is that being shot in the shoulder is very serious.

In spite of the fact that there are no vital organs in the shoulder (unless you’re writing a novel with creatures other than humans, in which case you might find a heart in one’s shoulder–but that’s not very likely), there is a very large artery, a terribly complicated joint, and a bunch of nerves.

If your bullet hits the artery, your hero is going to bleed more than you want them to. An average adult human male has somewhere between eight to ten pints of blood in him. After losing 40 percent of one’s blood, a hero would need an immediate blood transfusion to survive.

If your bullet hits the nerves, your hero could very likely have a permanently paralyzed arm. If your hero has a bullet hit their nerve group, they’ll most likely need follow-up surgery to get their arm working at all again. They’ll likely lose all feeling in their arm, and maybe never get it back.

If your bullet hits the joint, it could shatter, and no surgeon on this earth has the ability to piece the joint back together after that. This seems to be actually the event hardest to deal with. In some stories, you’ll want your hero to have to, say, lose their arm or their ability to use their arm, because it’s part of the character development. In others, you might want your character’s arm to stay intact, as it’s kind of difficult to shoot a gun, or do other exciting action-adventure things. This has a lot of potential in stories, but most people just don’t know that it will happen.


Another common thing (indeed, probably more frequent), is a blow to the head strong enough to knock someone out.

Knocking people out is oftentimes an essential part to many stories. It’s considered a convenient way to get the hero out of the way without killing him or her, and without lasting effects. It provides a moment when your villain can get in while the hero is conveniently unable to do anything, but when they wake up, they’ll gasp, say, “Oh, no! I was knocked out! I need to go catch that dastardly villain who managed to get past me and do whatever his evil plan was!”

What writers need to know, though, is that a blow to the head that’s strong enough to cause unconsciousness is very serious. Aside from the normal symptom arising in fiction, memory loss, a blow to the head can cause severe long-term problems–if it doesn’t kill immediately. Unfortunately, there’s a lot of trouble arising from head injuries–so much I wouldn’t have time to finish and post this today if I went into all of them. However, there are some common ones that writer’s should know about before thrusting their character into this particular situation.

Your character could die immediately. Pretty straightforward, that, yes?

The blow might cause a dent in your hero’s skull. When a person is knocked out, it takes a hard blow. Humans have hard skulls, so it takes a lot to get past them–but once you get there, you’re going to do a lot of damage. With unconsciousness, the blow might cause the skull to cave in, which could lead to immediate death, or lasting brain damage.

A common reaction to a concussion is seizures. Your brain controls basically all of your body. It’s the place of origin, where all of the nerves go to, where all of the commands come from, and when it’s damaged, there might be problems in connecting to certain parts of your character’s body, or commands might be skewed. Your character may end up suffering from long-term seizures after a strong blow to the head.

Your hero will vomit. I know, not very glamorous is it? Vomiting is one of the most common reactions to a head injury, though. And while we can create our own worlds, our own rules, sometimes it’s just best to stick with the way it is in our world.

Your character might suffer from lasting mood swings. With the brain being the origin site for chemicals, which influence what our emotions tell us, your character might very well go into a phase where they’ll be very happy one instant, and most displeased the next. The most common psychological reaction is depression, though.


Of course, there are other common injuries, and perhaps some other day, I’ll go over them. For now, though, just know that injuries are often made out to be much more simple than they are in fiction. They’ll have serious consequences in the short-term, but none in the long-term. That’s not how we work, though.

Research your injuries before you inflict them on your character (research carefully!). Perhaps your search history will make you look like you often get yourself into the hospital, but you’ll be able to write much more realistic injuries if you do.

And we, as readers, appreciate that. Not only does it enrich the story, it shows us that you care.

Do you struggle with unrealistic injuries in your writing? Do share! (As a reward, I’ll share some embarrassingly bad injury in my writing.) 

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29 thoughts on “Believability: Common Injuries

  1. I absolutely hate the “knocked out” thing when someone does it on purpose and it works just like they wanted it to. (I’d be a little more forgiving if there was a scuffle and someone got knocked out by accident.) Normally with my writing, I struggle to avoid using knock outs. This does make capturing a character who is determined to die rather than be captured difficult.
    I’ve avoided shoulder wounds. So far, my favorite are leg wounds when I want to knock someone down. (Of course, I also have to base wounds off what medical abilities are around.)
    In sci-fi, I prefer to use various high-tech weapons and drugs. These allow me to get the result I want and I never have to worry about Mythbusters or doctors trying to say I’m wrong.

    • In my early days of writing, I did a lot of knocking out my characters, mainly because it was very dramatic and I found it very convenient; instead of having them kicking and screaming their whole way to the villain’s lair, why not just have them wake up in it? I do like to think I’ve avoided that considerably more now, though.
      I haven’t done a lot of research into leg wounds, but I’ll remember that for later, if I need to rapidly make a character unable to resist something. These days I’m doing less injury-recovery-injury-recovery work in my novels; half because I always make it a point to research it, and that takes a long time (last week I was researching whether or not a sharp blow with a blunt object to the side of the head could cause a ruptured eardrum; it took me a ridiculously long amount of time to track down different things, only to write a few-hundred word snippet which I sent to myself to return to later).

      Heh. That’s a great idea. *tucks this away* You make me wish I write more of that type of sci-fi…

  2. An excellent, well-researched post— and I don’t think things are excellent very often. Well done.

  3. This is great! I’m so thankful I have a doctor in my church whom I peg with questions about characters’ injuries. Favorites from my finished book are probably my MC’s dislocated shoulder and the bullet he took in the forearm. (Yes, he did have a blood transfusion and surgery to put in pins, screws, etc.)

    As for those pre-research-fanatic days, my most unrealistic injury was probably a bullet wound to — you guessed it — the shoulder. Though that’s not what makes it bad; the hero was captured, and while he was unconscious, a doctor removed the bullet in a house bedroom. Nothing wrong with that picture at all . . .

    • A doctor you can question? That sounds awesome. Ooh, that sounds exciting. On the same arm? He must have been so irritated. “I would have appreciated it if my arm had time to heal before you injured it again!”

      That’s the first injury that comes to my mind, too. If I remember correctly, what I said was, “even with a moving target [henchman #1]’s aim was perfect.” After which he hit my protagonist in the shoulder. She dropped to her knees, gritted her teeth, and then got up and ran the rest of the way home, functioning normally for the rest of the novel. Add a miraculous healing to that… and you pretty much have a summary of my writing skills five or six years ago. Heh. Maybe it was a sterile bedroom?

      • It is awesome. 🙂 She’s gotten some really strange questions but is such a great sport. And yes, on the same arm. Can’t say I feel bad for him. The drama was great.

        That paragraph sounds like a few I’ve written. 🙂 Oh, for those days when we were young and everything was cool and dramatic (and unrealistic) . . .

        I’m pretty sure the bedroom wasn’t sterile. :O

        • What, strange questions? From a writer? Never. :p …If I ever doubted you were a writer, any and all doubts are gone. xD We writers thrive on drama. Far more than we should sometimes…

          And nightmare-inducing when we read over them… I really wrote that? *shudders* It’s enough to give anyone even vaguely interested in words terror of opening the document for weeks.

          Ah, fun…

  4. Megan on said:

    I never thought about injuries while reading. Now that I do, the knocking out part is so clichéd and unrealistic at the same time! I even have it in my own writing! *Panics, so adds to the editing list* Also, sometimes the characters don’t really feel much pain, I mean yeah they have an arrow 3 inches into their leg but they aren’t hollering and screaming. They don’t even begin to cry! I would be going crazy. Another thing I notice is that, especially in battle scenes, the POV character never gets hungry or thirsty or even has to use the restroom! The necessities are totally ignored. I would love to read something where in the middle of action, somebody needs a drink or food or has to use the restroom. Sorry for my very loooonnnggg comment. 🙂

    • Indeed! I do appreciate it when an author researches what would logically happen, but I tend to be pretty forgiving as long as it’s not constantly like that. After all, I had a terrible time getting it into my head, so I try and remember that some people might not have been given the information yet. I never want to make someone wince at unrealistic injuries when they’re reading my books, though.
      Ah, well there is a point in some injuries where the person won’t actually feel a lot of pain. Right after getting hurt badly, especially if it’s necessary for someone to keep moving and fighting (depending on the person, of course), a person might actually not notice just how bad it hurt until they started going into shock.
      Oh, I never thought of that, actually. I know that at once point, (I can look it up and find the time it happened if you’d like) there was a battle in Russia that lasted for days on end, non-stop, so I don’t know if people were able to go off and get drinks or food, but I know that the battle never once slowed. Thank you for the long comment! It wasn’t too long at all. 🙂

  5. Wow, real eye opening! I really never thought about that in my writing, but I definitely will now! It will make my books more realistic. Thanks, Athelas 🙂

  6. Great post! I haven’t ever thought about my character’s injuries, mainly because I don’t use physical injuries very often, I like emotional ones that cut to the heart( I know that sounds really mean…)! When I do use physical injuries, it’s normally a piercing cut to the side from a sword. One that is not fatal, but will drop a man to his knees.

    • I definitely tend toward more emotional injuries in some stories, too, but I have a few stories where the injuries get very physical. Right now I’m planning a story where the hero is very near the villain —who is very likely not playing with a full deck— on a day-to-day basis, which means that he’s much more likely to get injuries than many of my other characters. I have another story where I don’t think I’ve hurt my heroine even once, physically, but she goes through a lot of emotional battles. It all depends on the story. Ah, yes. *nod* I tend to try and avoid the stomach and chest area because there are a lot of vital organs hiding in there, and it’s sometimes difficult to be quite sure on what my sword or bullet would be hitting there.

  7. Very good post. I’m always struggling to make what I write believable.

    And, I’ve tagged you for the Sunflower Blogger award over at Anything, Everything. This is the link:

    • Indeed. For me, as a Fantasy and Science Fiction writer, it’s sometimes difficult to try and figure out how to balance what’s not of this universe and what’s logical and realistic here. I’ve found that it’s best to avoid stretching logic when it comes to the limits of a human (or humanoid) and injuries.

      Thank you! ^-^ It might take me awhile to post it, since I have a lot going on writing-wise right now, but I’ll definitely come to it. I appreciate the tag.

  8. Thanks for the info, Athelas. My story is YA contemporary, which CAN mean stuff like this, but I’m not planning on it. More emotional hurt than physical. 🙂

    • I’m glad it was helpful! I definitely tend more toward emotional hurt than physical, but physical pain can have so much emotional effects. Particularly in heroes who can’t stand to be still, or people who hate being unable to hear very well, or girls who adore the stars and go blind.

  9. Haha, I would say the getting knocked out (especially by being blasted against a wall) is my pet peeve, but I’m slightly guilty of that one…

  10. R. K. Brainerd on said:

    Great post! 🙂

  11. I tend to knock out characters quite a lot… But- I usually look up the aftereffects.
    The most drastic injuries I’ve written is getting cut all over my MC’s body, but don’t worry he had a very realistic aftereffect, he dies!
    Great Post!

  12. Thanks again for the post. If it helps anyone, here are a couple of personal experiences.

    When I was about 10 or 11, my family went camping with a couple of other families in our church. On the last day, all the kids went for one last “hike”. We took along a rope, and at one point I “rappelled” down a rock but because of an overhang wound up scraping my hands, especially the knuckles – so I let go. When I landed, I fell over backwards and hit my head on a rock. That knocked me out briefly. After seeing a retired doctor who just happened to be camping nearby, we drove about 100 miles to our family doctor, who stitched me up. During the trip home, I was in and out of consciousness while lying in the back of our station wagon. Recovery was fairly rapid, and the only permanent damage (as far as I know) is a slight indentation on the right top of my skull that’s about 2.5 inc.hes long and a scar that’s covered by my hair. (BTW, the doctor said that if I had hit a bit further to left, it probably would have either killed me or done permanent brain damage.)

    About 2 weeks ago one of my students had surgery for a chronically dislocated shoulder. (There’s an interesting injury.) The injury was the result of too many years playing football. A fit high school student, he still was out of school for 10 days after the surgery. At graduation, he had his arm in a sling that he will have to wear for about six weeks. He won’t be able to do strenuous exercise until October.

    So much for just picking yourself up after a serious injury and moving on.

    Hope the experiences are helpful to someone.

    • When researching anything for my stories, I prefer reality to fiction. Reality is a sticky mess full of gritty details that do or do not follow the “rules” of what is most common. I may not be writing a character with a head or shoulder injury right now, but your experiences could enhance one of my stories in the future. Thank you for sharing!

  13. I’ve got a character who gets hit in the head, knocked sensless and for the rest of his life, he ends up suffering from frequent, painful migraines, and an increased onset of manic depression.

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