Tag Archives: Starke is not a real doctor

Q&A: Don’t Cook This At Home

How long would somebody be able to be burned on an open fire without sustaining life threatening burns? Also i love your blog 😀 Thank you for your time!

I’m honestly not sure exactly how long, but it’s not going to take much time.

A quick caveat: The data I could find was on conductive burns, not convection burns, so there is a little bit more leeway, but this one isn’t going to end well. Also, this is one of those times where I’m having to make an educated guess. I don’t have this particular bit of info internalized, and I can’t find a concrete answer on short notice.

Direct contact with water or steam over 155 Fahrenheit (68C) can result in third degree burns in around a second. For reference: Water boils at around 212F (100C), so even if you haven’t brought it to a boil, you’re already in range for some serious injuries, just messing around with simmering.

An open bonfire tops out at around 1100F (593C). Technically, the sustained temperature will be a bit lower than that, and it will vary by the wood being used. Of course, when you’re talking about temperatures in the 500C range, five degrees difference isn’t going to mean much. (Also, if that wasn’t enough fun, a charcoal briquette can burn at nearly twice that.)

Remembering that third degree burns are life threatening, and remembering that the smoke emitted from the flame will start out at roughly the same temperature as the fire. I’m inclined to say under a second.

It’s not that being set on fire is an immediate death sentence, nor that there aren’t some unusual circumstances where someone could get away unscathed. (Firewalkers are a thing, after all. They rely on a thin layer of moisture on their feet to avoid burning.) There are also plenty of burn survivors who have been, literally, set on fire. But, this is one of those things that can flat out kill someone. Even if they somehow survive the heat, the resulting smoke inhalation will probably finish the job.

-Starke

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Q&A: First Aid

Wounds and injuries will always happen when fighting. Any advice on treating them? Are ointments and salves a good idea?

It depends on the injury and what you’re applying.

For minor cuts and scrapes, the first thing you want to do is disinfect the wound. Rubbing alcohol works best for this. Turns out, hydrogen peroxide, doesn’t really. Worst case, clean water will clear debris from the wound, and can wash away some potential contaminates. There are other potential disinfectants, though, usually, alcohol is the one that comes to mind for me.

For what it’s worth, even hard liquor will work for this. So if you’re wondering about a western where people are using whiskey or gin to clean a wound, that does work.

On the other hand, ground water, rain water, or melted snow will not, and can present another potential vector for infection. If you boil it first, it can be used to clean a wound, but it wouldn’t have any disinfecting properties.

Once a wound has been cleaned, you can apply a gel to seal the wound over. Most of the time you’re talking about something like petroleum jellies (so Neosporin or Vaseline). These are, technically ointments, if you’re wondering. Another possible (and messier) example would be honey. The stuff is thick enough that it becomes a bacteriostatic barrier, and that can help to seal a wound while it heals.

After that, you can bandage it up and you’re good to go.

Some important details though. Understanding how bacterial infection works is a fairly modern concept. Particularly, understanding bacterial infection and the need to disinfect wounds dates to the mid-19th century. So, knowing you need to use whiskey to clean a gunshot wound in 1895 Texas make sense. Doing the same during the civil war, slightly less so.

More serious wounds will require more involved treatment. Someone who’s been shot or run through will require more extensive medical treatment than just slapping on an ointment and hoping for the best.

For broken bones, you’d need to stabilize and immobilize the break. Yes, setting breaks is a thing. No, you shouldn’t do it unless you’re a trained professional. Also, it’s much harder than TV makes it look.

If someone has been stabbed, and the blade is still sticking out of them, don’t pull it out. Leave that for the actual medical professionals. You’ll do more damage, and increase the bleeding, getting it out, than you would if you left it there. The same thing goes for arrow shafts, bullets, or, really, any other foreign object stuck in someone. Unless it’s actively continuing to kill them, don’t remove it. Seriously, pulling it out, and especially digging it out, will do more damage. There are some rare edge cases, but leave those for the professionals, who know what they’re doing. Pulling the knife out of your buddy can be a fantastic way to kill them. I mean, if you want to pull the knife out of yourself to stab someone else, sure, that’s kinda badass. Stupid, unhealthy, and a terrible idea, but have fun with that.

With bruises, there really isn’t much to do. You can watch it, and make sure that the swelling starts to come down. If it doesn’t, then that’s a much more serious issue. Otherwise, it’s just a sub-dermal (meaning below the skin) hemorrhage (meaning bleeding). You can put ice on it if that makes you feel better, but, really, it’s simply there.

Really, minor bruises are a fact of life for most fights. You’re going to pick some up no matter how “good” you are. Armor does help a lot with these. If you’ve got some anesthetic cream you want to smear on one, feel free. It’s (probably) not hurting anything. You can ice it, if that helps manage the pain, for you. Or you can live with them. Outside of some extremely rare cases, they’re not life threatening.

-Starke

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Q&A: Blood in the Eyes

Hey! Is it possible to take both of an opponent’s eyes out with a single swipe of a sword without amputating the nose? Thanks so much in advance!

Not exactly what you’re asking, but cutting someone’s forehead so that they’ll get blood in their eyes, temporarily blinding them, was a real tactic. That does work.

Actually taking out the eyes in a single, linear strike, without hitting the nose? I don’t think so. To be fair, even a fairly deep cut to the bridge of the nose wouldn’t amputate, and a slash across the face that would sever the nose wouldn’t connect with the eyes, because of how they rest in their sockets.

Maybe I’m missing something obvious, in which case, I’m sorry. Still, if you want to blind your character temporarily, in combat, cuts to the forehead will do that.

-Starke

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Q&A: Cerebral Hemorrhages

would it be possible for the blood to come from the brain though? i remember in the Butterfly Effect the main character goes to the doctor who tells him part of his brain bleeds during his time-traveling, which led to his severe nosebleeds, but i’m not sure about the medical/physical accuracy

Yeah, cerebral hemorrhages are a little bit more dangerous than just a nosebleed. Specifically, these can (and usually will) result in strokes, brain damage, and death. In other words, not a medical condition you want to screw around with.

I can’t remember if I’ve ever actually watched The Butterfly Effect, so I don’t remember if that was explained in the film.

-Starke

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Q&A: Alcohol

Apropos of the ask on paralytic toxins, are there any substances that could be used as a nonlethal “paralytic” against a healthy human target? That, perhaps, interfere with coordination enough to immobilize a person but without stopping crucial body functions? Or does that just bring is back to typical tranquilizers? And, you’ve probably answered this before, but how fast do those work?

Well, you can get them drunk. Alcohol and most mild sedatives can impair someone without actually putting them under. There is an element of risk, but it’s not particularly pronounced. (Unless you’re combining them, in which case things can turn really nasty, fast.) Usually the hard part is when someone wants to actually put someone under, or when they want to administer this stuff covertly via a dart.

Most tranquilizers take about 30 minutes to kick in (with a pretty massive margin for error based on the subject’s metabolism.) Again, this isn’t much of a problem when you’re dealing with a bear wandering around the subdivision, but doesn’t really lend itself to someone sneaking around.

General anesthesia is an exception to this. In that case you’re looking at an onset of under a minute. But, as we’ve discussed before, the problem with anesthesia is, you need someone there monitoring the subject’s vitals to adjust the dosage and keep them alive.

-Starke

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not sure if this counts as a fight question, but in stories (esp tv/movies with high visual impact) that have a character that does psychic power things with their mind or are victims of psychic powers, often they’re shown bleeding from their nose or ears to illustrate when they’ve “overdone it” (re Stranger Things) or if they’re overcoming psychic control (re Get Out) and i’m curious why that is? is it just pressure on the brain and blood coming from the nearest orifice? what are the logistics?

It’s a burst blood vessel. Or, sometimes, multiple ones. This is a real condition that can happen. Not the psychic powers, but if you’ve ever coughed, sneezed, or vomited hard enough to get a nose bleed, same thing. This can also lead to minor hemorrhaging in the eye. Unless it’s happening frequently, this stuff isn’t a serious medical issue, just an annoyance.

Bleeding from the tear ducts or ears is less common, but It can happen. If it’s a one off thing, a ruptured blood vessel in the nose isn’t usually something you’d need to worry about, unless it’s recurring. If it does happen repeatedly, than you should probably see a doctor.

-Starke

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Is there any relatively safe way to knock someone out with no resources but your hands? My character needs to knock this person out so they don’t run off, but he has nothing on him to do so. It’s necessary to the story that he be knocked out. Thank you!

No.

We’ve gone over this, many times, before. There is no safe
way to knock someone unconscious. By definition, you’re specifically attempting
to damage their brain, with the goal of getting it to take a little vacation.

More than that, there aren’t even many reliable means to
knock someone out. Blows to the head can, theoretically, work, but they can
also, just as easily, piss off the person you’re attacking, without much ill
effect.

Tranquilizers take ages to kick in, and are very difficult
to dose. Too much, and you’ve got a corpse. Not enough, and you’ve got someone
who’s groggy, but still ambulatory.

Choking is, in theory, the safest, but the fine line between
unconscious and dead is still something you can’t spot intentionally. Choking
is something that can be practiced in a safe environment, but using it in the
field is incredibly finicky.

And, it gets better.

Strip away all the terminology and a concussion is just
bruising on the brain itself. You get hit, your head gets jostled around, and
your brain bounces off the inside of your skull. You may have been using that
organ for something, and might understand why you don’t particularly want it
getting directly injured. Either way, this will, absolutely, interfere with
your ability to think, remember unimportant information like your name, or
count the number of fingers some well meaning smartass is holding up. Still,
probably won’t knock you out, though.

When you’re talking about knocking someone out, you’re
really asking, “how can I directly assault their brain, without having to
develop psychic powers?” Yeah, that’s never going to be safe. It turns out,
getting the human brain to stop working, temporarily, is a lot like trying to
get it to just flat out stop working in general, and it’s a crap shoot, which
you’ll get.

Concussions are cumulative. This should be fairly obvious,
when you actually think about it. If your brain has been pre-tenderized, it’s
going to be more susceptible to future concussions, and the ones you receive
will be more severe. This means someone who’s had a few before will be knocked unconscious
or killed far more easily than someone with a relatively healthy brain. Even
then, it’s not like there’s a stable baseline of, “you can hit your head this
hard before it kills you.”

Knocking someone unconscious for more than a few seconds is
very bad news. If you’re knocking someone out for more than a minute, there’s
going to be irreparable brain damage. (The specific threshold is usually around
30 seconds, but for each unique brain, there’s equally unique catastrophic
brain damage.) So, you’ve, “safely,” reduced someone to a vegetable. More than
a few minutes and you’ve (probably), “safely,” killed them.

So, what do you actually
do when you need to be somewhere else and someone is intent on getting you to
stick around? Knock them off balance and run. Sucker punches to the stomach are a good option.
If unexpected, they’ll usually wind the victim, and give you a good head start.
Knees to the gut are another classic. One common variation is to knee the gut,
and when they double over, knee them again in the face. Slamming a door in the
face, or knocking them to the ground are also excellent options. Really, there
are a lot of options. The goal is to simply create an opening and escape. You
don’t need to knock someone unconscious to do that. You really don’t want to knock someone unconscious to do that.

-Starke

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In film often when characters get stabbed/assaulted they can often continue to fight or don’t pass out immediately. How does adrenaline or shock factor into the physical reaction, especially when the character isn’t a cop or military and isn’t accustomed to being in these violent situations. How long would they be able to function before they crash? Is it possible to run away or even fight?

Taking these questions in reverse order: Yeah, kinda,
sometimes, and it varies wildly, based on the injuries sustained. Also, it’s
not the adrenaline crash that kills you.

Adrenaline rushes mean that you’re often unaware of injuries
sustained in the moment. I’ve never been fully certain if adrenaline actually
dulls the pain response, or if it simply causes your brain to ignore it. Either
way, while you’re under an adrenaline rush you can suffer injuries and be
unaware of them. It’s why you’ll sometimes see characters (and, for that
matter, real people, with prior experience) checking themselves for injuries
after combat (or any other traumatic event). It is entirely possible to be wounded
and have no idea it’s happened until you’re trying to figure out where all that
blood is coming from.

Depending on what you’ve just been through, coming down off
an adrenaline rush can be deeply unpleasant. Your brain is sure something’s
fucked up, but it can’t pin down exactly what or where, so it’s going to take
that out on you, and everything aches. Adrenaline crashes won’t kill you. (There
may be some weird outliers here for people with heart conditions, but, in
general.) A crash may make you wish you were dead, or make you want to throw up on
people, but it’s not lethal.

In the moment an
adrenaline means that you can suffer (fairly severe) injuries and keep on
fighting. If the injury doesn’t outright disable a limb, you can keep using it,
even if that’s a very bad idea. Getting stabbed or shot is no guarantee that
someone will sit down and peacefully bleed to death. Actually, shooting someone
is a pretty good way to ensure they won’t sit down and bleed to death without
protest.

When you’re trying to figure out how long it will take
someone to die, you’re actually asking about how fast someone bleeds out. This
relates directly to the injuries sustained. Someone who’s had a knife driven
into their neck isn’t going to keep fighting. Someone who had it run through
their bicep or buried in their shoulder blade, probably can.

We’ve covered blood loss before (and I strongly recommend you take a look at that tag, if you haven’t), but that’s the real factor
here that controls if someone can fight. If they still have enough blood in
their body to function. Lose too much, your ability to fight is impaired, and
you’ll eventually fall unconscious and die.

Blood loss is why concepts like, “first blood,” are important
in duels. Once that happens, the clock is ticking for that
character; the longer the fight goes, the more their ability will decay, and
unless they find a way to turn it around, they will die. (Even if they manage to prevail, they may still die without medical attention.)

Fighting through a stab wound is a fantastically bad idea.
Engaging in any physically strenuous activity that raises your heart rate, (for
example: fighting someone, or running away), will speed up blood loss, meaning impairment
kicks in sooner. Still, the point of adrenaline is to keep you functional after
sustaining an injury, so that you can survive.

If someone suffers an injury which disables them in some way,
such as breaking an arm, there’s no powering through that. Adrenaline won’t let
you override shattered bones. The biomechanical pulley system of muscles and
tendons simply doesn’t work with broken bones.

So, the short answer is, “yeah, kinda.” You can keep fighting
after being attacked. So far as it goes, there’s plenty of cases where someone
took a stray bullet and kept on fighting, only to bleed to death later.

-Starke

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Hi, I’ve seen a couple of your posts about knifes and defensive wounds and I was wondering if autopsies can tell which order the injuries were inflicted. Like if someone was knocked out first then stabbed, could that be worked out or would it have to be guessed at. Thanks in advance.

If enough time passed between the injuries, yes. But, we’re not talking about tracking injuries that someone suffered during a fight, this would be wounds that were suffered on different days.

If your characters are trying to piece together a murder, the autopsy is useful for telling them everything that happened, but not the order in which it occurred.

Sorting out what happened to someone right before they died is a bit like those logic games, where you’re asked to take a dozen pictures and rearrange them into chronological order. It involves getting as much information as you can and then recreating a timeline. Sometimes you know when something happened, such as when the victim was last seen in public, and when their body was found. But, what happened between those concrete points needs to be reconstructed.

There’s no magic bullet here. Your investigators need to look at the crime scene, piece together what they find there, look at the victim (and the autopsy report), sort out exactly what happened to them, and assemble all of this into a plausible sequence of events.

All of that said, the autopsy will offer some hints, sometimes. In your example, your victim would lack defensive wounds on their hands, meaning they were unable to defend themselves before being stabbed. Combined with a the headwound, and it’s reasonable to infer they were knocked out first, then stabbed, and that the killer really wanted them dead, or has watched way too much bad TV, because they weren’t willing to settle for the headwound getting the job done.

So, no, the autopsy won’t (usually) tell you, but it can help sort things out.

-Starke

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How realistic is stopping a knife from killing you by grabbing the blade with your hands?

Kind of.
It’s realistic in the sense that it can and does happen. At the same time, it
probably won’t save your life. Knife wounds to the palms, (called, “defensive
wounds,”) are fairly common when someone has been attacked by a knife wielding
opponent. Usually, what happens is they’ll attempt to block the knife by
putting up their hands, palms out, and their palms and fingers will take the
initial assault. That I’m most familiar with the term from autopsies should say
a lot about how well this usually works out for the victim.

If you’re
dealing with a situation, where someone’s trying to stab you and your only
option is to catch the blade with your hand, it is better than dying. However,
it is also a very temporary solution, and one you can’t repeat after using. It’s
also, probably, not your best option.

When you
bleed, your body is trying to do two things; first clean the wound and expel
any foreign objects in it, then seal the wound over to allow the tissue to heal.
Fresh blood is aggravatingly slick. Once exposed to oxygen, blood becomes tacky
and coagulates over the course of a few minutes. (Specific clotting times vary
based on a number of factors. For example: if your character is an alcoholic,
their blood’s ability to clot will be severely impaired.) It only remains tacky
for a few minutes, and will then harden into a solid mass, so the window here
is fairly narrow.

When you
take a knife to the hand, you’re going to bleed all over your hand. That means
your hands will get slick, and have a harder time gripping the blade. This is
before you consider the part where your hand is actually getting cut to pieces.
Eventually the blood will clot (whether you survive long enough to see this or
not), at which point gripping the blade would become easier, but that’s not a
realistic consideration because the fight won’t last long enough to get there.

As I’ve
said before, your body functions on a kind of pulley system. Your muscles pull
on tendons which in turn tense against your skeleton, causing your limbs to
move. When you start cutting tendons, the pulley system starts to break down.
Some of the most delicate pieces of this system are in your hands and feet.
Start carving those apart, and your hand will
not work
. This isn’t an, “oh, I can force my way through on sheer
willpower,” situation. The mechanical components critical to making your hands
work will be damaged or destroyed. The spirit may be willing, but the flesh has
been turned into butterflyed steak. Catching a knife with your hand will stop
that strike, but it means your hand will
not work
again. Yes, if you survive, it can be repaired surgically, but
that’s not going to keep you alive.

The
better option, if you have sufficient manual dexterity to catch the blade is to
catch your opponent’s wrist instead. Again, this isn’t a great position to be
in, and wrist grabs are some of the weakest and riskiest holds, but it is far better than trying to grab their
knife. Your arm or hand might get nicked by the blade, but that is vastly
preferable to taking a direct blade to the hand. Going for the wrist is a
legitimate strategy and a part of some knife fighting doctrine. Granted, your
best option would be to maintain distance, and never let a knife wielder get
close enough to attack, but that’s not always a practical option.

-Starke

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