Tag Archives: Starke is not a real doctor

Q&A: Psychic Pain

Is pain easier or harder to deal with if you know when & what kind, or does the answer vary depending on the person & degree of pain? Two characters’ (enemies) bodies are connected in that if one character is hurt, the other will feel it. I thought A could threaten to torment B (as coercion) by inflicting pain on herself out of B’s sight so that B can’t predict when/what the pain will be, but this only works if being unable to anticipate pain makes it worse (or at least B thinks it does).

ree-fireparrot

Technically, the question, without qualifications, is a yes. The source and kind of pain experienced will affect how severe it is, or how difficult it is to manage. Further, individuals have distinct pain thresholds, so, what you can endure may be unbearable to someone else. This is a non-answer in this case, because that’s not what you’re asking; but that’s the question.

Somewhat obviously, there’s not a lot of (reputable) studies on psychically inflicting pain on people, so the question you’re asking is significantly more speculative than it looks.

Specifically, how does psychically inflicting pain on someone relate to actually experiencing pain?

I dunno.

There’s no empirical data on this.

So, let’s split this up into three separate problems to consider.

First, psychic research is a thing. A lot of money has been thrown at researching ESP and other weird, neurological phenomena, but, there’s no smoking gun. A big problem with ESP research is, you can’t really create reproducible results. “With this person, I can have this result,” isn’t proof of anything.

To be clear, I don’t care if you believe in psychic powers or not, I’m just saying, “there’s nothing here to definitively help your question.” If parapsychology is your jam, there’s some fun stuff there, but always remember that this isn’t, really, science. It’s people taking their science toolkit and playing with ghosts.

Also, it doesn’t really matter if this is done with technobabble or magic powers, either way, there’s no real world data to work from.

The second problem is more complicated: sensory data is personal, language is communal. So, when I call something blue, you know what I’m talking about, but are we actually talking about the same experience of a color? Or, do we “see” different colors, but our understanding of language says, “it’s blue?” This gets a little trickier because we know there are some minor discrepancies in what we see, smell, hear, taste, and touch. Because of synesthesia, we do know, that your brain is doing a lot of work processing sensory data. Thanks to EEGs we know there’s some similarities, so it’s not like, “I see green and you see blue,” (assuming you don’t have tritanopia color blindness, in which case green is cyan for you), but pinning down exactly what’s experienced by the individual, without being able to externally audit that data, is frustratingly difficult.

In case anyone’s wondering, color blindness is a physical defect in the eye, leaving it unable to perceive specific (primary) colors (red, blue, and green, because we’re talking about light, not pigment), so everything they see is a mixture of the colors they can perceive.

The reason this is a problem is, you’re trying to psychically inflict pain on another person. Now, is the pain experienced by one person going to have the desired effect on another? I don’t know. It should be painful, but will it be more painful? Less painful? Will the pain be something they can filter out? Will it be impossible to filter? Could you outright kill them from the process?

I dunno.

Normally, this isn’t a problem, but when we’re talking about directly transplanting the experiences from one person to another, it all becomes relevant.

The third problem may be more of a boon. There’s a psychological factor to knowing someone else is being harmed. Your character isn’t being injured, a third party is. Depending on the nature of their relationship, that can carry a lot of psychological weight. Hell, if the person their linked to is someone they despise, feeling that person suffering could empower them with a sense of schadenfreude.

So, as I said, for the basic question, yes. People experience pain differently. People are different. Unfortunately that feeds into a larger issue where, people are different, and what they experience is different. The value in a scene like this isn’t the pain your character experiences, it’s the psychological factor of knowing someone else is being hurt, and having no control over that.

-Starke

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Q&A: Broken Wrist

Hei, I just have a realistic question on fighting whilst injured sort of question, My MC has a broken wrist in a solid cast but is forced to fight for her life in a small corridor to snowy outdoors. She’s a highly trained agent but does get injured further by her assailant who is also highly trained t and much bigger, Would it be realist that her injuries (the wrist, a stab wound to the thigh, stunning blows to her head) would render her ability to fight useless in the long run?

So, three things.

First: Size is completely irrelevant. The faster you come to grips with that, the better off you’ll be. If you don’t know anything about combat, size can be intimidating. Being bigger does not mean your punches hit harder. It doesn’t mean you can take more hits. It doesn’t make you’re more resistant to throw. Your character has been trained; she would know all of this. At that point, dwelling on the size difference is just generating false drama.

If you’re trained, a large foe is just a bigger target.

A character who is in better physical condition is a serious threat. That’s not a function of size. Someone who’s 6’3″ can easily be laid out by a scrappy 5’nothing who exercises regularly, and keeps their training sharp.

When it comes to condition, your character is at a huge disadvantage, and it has nothing to do with size; it’s their wrist. Usually we think of “condition,” in the context of if they’re physically fit, but injuries, illness, and other impairments are relevant. Your character could be a top grade fighter, but if they’re drunk, that’s going to seriously impact their ability to fight.

Broken bones are a huge liability in a live fight. If it’s on a limb (including the wrist) you can’t use that limb at all. If it’s a broken rib, there’s a real danger that any blow to your core could force it into your internal organs resulting in some nasty hemorrhaging.

In the case of your wrist, a broken forearm means you really cannot use that limb for anything. Even in the cast. Abusing it by trying to block or parry is a good way to permanently lose the use of that hand. Best case, she may only need surgery to repair the additional damage inflicted.

Second: The first rule of self defense is avoiding situations where you’ll need to use your training. Violence is a bit chaotic, and even if you really know what you’re doing, you’re still at risk of suffering serious harm. The best way to avoid that happening is not putting yourself in that situation to begin with.

It isn’t possible to avoid all potential threats. The entire reason self-defense training exists is an acknowledgement that, sometimes, things happen outside your control. Sometimes an assailant will attack in a, “safe,” area. Sometimes you simply need to traverse spaces that aren’t secure.

When you’re writing a character who’s been trained, it’s worth remembering that this will influence their behavior. For example: If your character is going someplace unfamiliar, they’re not going to do it alone, and wounded, unless they really have no other option. In a situation like this, it would be better to bring allies, or not go at all and send others. Your character is wounded, if she has option to, she should avoid fieldwork until she’s fully healed.

Third: Let’s reconstruct this for a second. Your character is attacked by a highly trained assailant. He has a knife. His goal is to harm your character. Why doesn’t he simply shank her, confirm the kill, and move on with his day?

If the expectation is that she’ll have her head bounced off the wall (or something else) resulting in a minor concussion, why didn’t he simply kill her.

Again, one of the wounds was a stab into the thigh. Ignoring for the moment that taking a blade to the upper leg can be very dangerous, depending on where it connects, if he’s in possession of the weapon and willing to use it on her, there is no way your character walks away from this fight at all.

Even in the most generous situations, he’s stabbing her, she knows who he is (or could potentially ID him), there’s no reason to let her live. And, of course, if he’s willing to stab her in the leg, and bouncing her head off of something solid enough to inflict a concussion, he’s certainly willing to kill her.

This gets back to the reason behind the second point; you don’t put yourself in dangerous situations without cause, because it can turn nasty, fast.

If the male character is the attacker, tracking her down and initiating the fight, then there really is no reason for him to let her live. His goal is to neutralize her, and the safest way to do that is to kill her.

As a writer, you need to look at violence as a tool in your story. Your characters will resort to violence based on who they are. A well-written character needs concrete goals. These don’t always need to be communicated to the reader, some can inferred, but, they need goals. At that point, their decision to engage in violence needs to be compatible.

If your assailant is highly trained, and bringing a knife to the fight, they’re planning to kill your character. At that point, it’s not going to be much a fight scene. A chase maybe, but if he catches up and puts a blade in her leg, she’s toast.

Now, maybe there’s justification for all of this, which doesn’t show up in the ask, but, it is something to be very careful of. Injuries to your characters aren’t simply damage tracking. They’re persistent effects that should influence future sections of your story. In fairness, that’s sort of here, but at that point you do need to keep track of how severe these injuries would be, and how debilitating it would be to stack them up. Part of the reason why you rarely see writers stacking more than one or two injuries on a character, it becomes a lot of work to keep track of how badly hurt they are.

-Starke

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Q&A: Practical Torture Goals

I would implore you to do actual research on torture and how torturers behave. A lot of the information you present as fact is dangerously misinformed. Torturers are not ‘professionals’ and does not yield accurate information. You shouldn’t be answering any questions on torture if you haven’t read O’Mara. This isn’t about torture being bad. It’s about torture not working at all. I apologize if I seem harsh, but this needs to be said.

I have read Shane O’Mara’s work. Not all of it, and not recently. I skimmed through years ago. Though, judging by your question, I’m not entirely sure you are familiar with his work.

The irony is, there’s not a lot of difference between O’Mara’s position and ours, when it comes to torture. The biggest discrepancy is perspective. He’s a neurologist who had a focus on the specific effects of stress and pain on the brain. My background is political science, so my interest grew out of examining coercive methods used by nation states. As a result, my specialization is more focused on what it does at a policy level. And we both come to, nearly the same point:

People forget the reality of what torture was used for, and has been used for through the generations, a quite different purpose: To spread fear, extract confessions, all of those kinds of things. But, the royal road to gathering reliable information? No.

Shane O’Mara – “Your Welcome” (Podcast Interview)

This gets into a fundamental misunderstanding about what torture is, and why you use it. Many people who’ve never looked at torture in depth, including the interviewer in that podcast, and the person who sent this ask, believe it’s about extracting information.

No.

The perception of torture as intelligence gathering is pervasive. It’s honestly difficult to point to uses of torture in popular media that get at the real point behind its use. The ur-example of this misconception would have to be 24, and it’s ends-justify-the-means embrace of torture.

The problem is, as the US Military’s Enhanced Interrogation Program learned in Iraq, torturing someone only makes them tell you what they think you want to hear. This was not new information. Nearly every organization in history that’s employed torture has understood this.

Most civilians do not. Many organizations have exploited this fact to further their agendas.

Torture excels at extracting false confessions. To make the suffering stop, you put a narrative in front of someone, and they will crack and sign off on it. This is the true power of torture. It doesn’t tell you what’s real, it coerces the victim to agree with your version of the truth.

Confessions are not reliable, in any sense. Someone may admit they committed an act for any number of reasons unrelated to the truth. Social norms put faith in the idea of a confession as, “the truth,” but that is just words; like everything else, it shouldn’t be taken at face value. As mentioned above, torture exploits this norm, and relies on that general acceptance of confessions to glaze over all the incongruities. Even when those confessions are patently absurd or downright impossible, people will still say, “but they confessed.”

I remember an example of this a couple years ago, from another person bringing their favorite academic into a discussion. In that case it was James Wasserman, an author who wrote a history of the Knights Templar. The end of that order came from confessions extracted under torture by one of the Inquisitions. (I don’t remember which one.) Even knowing that the confessions were coerced, Wasserman sees nothing wrong with taking them at face value. (Also the reason he comes to conclusions that radically differ from every rational academic that looks at the subject.)

That said, unlike Wasserman, O’Mara does something interesting. We’ve always known you can’t get good information from torture, and O’Mara decided to take neurology and look at why. The answer has to do with how memories work.

The brain stores memories as chemical chains. Under the best of circumstances, this is not a good, robust, long-term storage system. In some ways it’s surprising it works as well as it does. Stress and trauma both adversely affect your ability to form new memories and retain them. This has nothing to do with torture per se. If you’re put through six kinds of hell, you’re going to forget things.

Again, this isn’t exactly new information. It’s something that most therapists and investigators are well aware of. If you’ve been a victim of violence, even if it wasn’t perpetrated by a human, you may have experienced this. You might not realize it. I’m sitting here, thinking about my first dog attack and realizing, I don’t really remember that day. I remember that it happened, (and I can still find the scars on my left hand), but if I’m being completely honest with myself: a lot of the details are just gone. I do remember the sounds. Unfortunately, and if pressed, I could present a partial chronology of that day, but it would be reconstructed from information I have about when it was, what I was doing, things that happened before and after the attack.

Even without resorting to extreme events like that, your memory of traumatic or highly stressful experiences isn’t going to be completely clear. Ironically, this can also screw you over. If you get stressed out over a test in school, that will impair your ability to study, and even your ability to recover information during the exam.

Within this context, sleep deprivation has a significant effect on your cognitive abilities. This puts a fair amount of stress on your system for no real value. So, pulling an all-nighter before a test is not recommended.

Caffeine, and other stimulants don’t, really, help here. They’ll help you stay awake, they’ll help you feel more alert, but they won’t make up for the lost sleep, so the cognitive impairment will still be there, you’ll just look sober.

So, stating the obvious here but, having bunch of armed men attack and capture you, being dragged off to a dark room somewhere, isolated from any support network, being yelled at, and being threatened… That’s all kinda stressful.

In fact, many interrogators will seek to prolong the stress of capture as long as possible. They’ll use loud music, bright lights, keep the room cold, prevent them from sleeping (with all of the associated sleep deprivation considerations coming into effect) in an attempt to keep their captive off balance, to prevent them from settling into a new norm. While they’re in this state, they’re more susceptible to suggestion.

There is a continuum to all of this. It’s part of why studying for tests in an academic situation is such a good example: In the entirety of your life, it’s a pretty minor stress, but it is stressful, and the details you’re being asked to retrieve are trivial. So that’s some of the first information your brain will dump when things start fraying. When you put someone in real danger, the stress will start dumping much more important things. It’s not like you’ll forget your name, or where you were born, but it could easily dump information an interrogator would be interested in; like the names of people you met at a party last week.

All of this information also applies to witness testimony. Even when the investigators aren’t leaning on you, the stress from the original event can easily play havoc with your memory. This is one of the reasons why investigators need to be careful when they’re interviewing victims, because they can easily corrupt the victim’s memories simply by asking the wrong questions, and getting the victim to reconstruct their memory on the spot, which won’t necessarily match what happened. Of course, an unscrupulous investigator can push a victim to remember things that didn’t happen, simply by asking leading questions. If you’re suddenly feeling a little uncomfortable with the idea eyewitness testimony right now, good. You should. As with confessions, as a culture, we put way too much faith in them.

When you put this together, it explains why torture doesn’t yield accurate information. Again, this was known, but the neurology wasn’t. So, in this sense, O’Mara does make an interesting and useful contribution to the lit. He’s connecting stuff we already knew in different fields and saying, “this is how it works together.” He’s also getting into the neurochemistry, which is interesting to a degree, but not particularly accessible. The exact reasons that your brain has issues with sleep deprivation make for a fascinating discussion, but if I start talking about neurotransmitter reuptake again, people are going to glaze over.

You should start to see why torture excels at getting people to confess to things they didn’t do. Even confessing to things that aren’t possible or are patently absurd.

In most cases, someone will do anything they can just to end the suffering. Being tortured sucks, and if you just need to sign on the line to make it stop, a surprising number of people will do so. Even if it’s not the truth. Even if they’re signing their lives away.

On the other end of the spectrum, torture someone for long enough, and the lines between the real world and fantasy start to blur, or come apart entirely. You’ll get confessions about how they summoned up The Devil for an orgy and bake-off, or how they were plotting to mount laser cannons on frogs to assault New York. It sounds bonkers, but the victim may be so broken, they can’t tell the difference anymore.

I’m honestly unsure where this line about, “no professional torturers,” comes from. Especially given O’Mara has talked about the NKVD, CIA, Enhanced Interrogation Program, and many other intelligence agencies. That is to say, groups that do employ professional interrogators. I’ve seen this line come up several times, and the only way I could possibly attribute it to O’Mara is by deliberately misreading his methodology. The idea that no one gets paid to lean on others is patently absurd. Even the Mafia and Cartels have professional torturers. How well they do their job is a different question, but I’ve seen some genuinely disconnected comments about torturers being nothing but unhinged psychopaths, and that’s not supported by any reputable source.

I get the appeal of being able to say that, “a rational person couldn’t do this,” because it makes the world feel safer, but the truth is, there are people out there who come across as normal and are paid to do horrific things to other human beings.

The other side of this is that some of the EIP interrogators did end up with PTSD. It takes a pretty specific mindset to be able to do this to someone without suffering psychological harm in the process. That said, it’s not that different from other careers where you deal with horrific experiences on a regular basis, such as EMS, LEOs or soldiers.

The horrible thing about the real world is, torture works. It doesn’t gather usable intelligence, and if you thought that was the point, you fell for the big lie. Torture is about making someone confess to things they never did. It’s about making them agree with your version of the world, irrespective of the truth. It’s about scaring people. Convincing them to never oppose your organization. It does all of those things, and if you’re stepping back and saying, “no, it can’t possibly be that bad,” it worked on you.

Torture is scary; it shows how horrible the world, and the people in it, can be. There’s no shame in looking away and saying, “I can’t deal with this.” I don’t blame you. But there’s no virtue in lying to yourself and saying, “no, it doesn’t do anything. It can’t. I need the people who do this to be cartoonish super-villains.” I don’t blame you for the instinct, that’s better world, but not the one we live in.

-Starke

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Q&A: Structural Collapse

Beg pardon, but I was wondering what kind of survivable injuries could be expected from someone having a building fall on them. I presume that in the immediate term you’d have crushing injuries from large pieces of building fall on them, but what kind of crushing injuries would be most survivable? I also assume that there would be deep penetrating trauma from exposed rebar, but in what parts of the body could someone have rebar in them and survive? Thank you for your time and attention.

eliasraine

It depends on how flexible your definition of, “survivable,” is.

The big threats from having a building drop on you are: Something you need gets crushed. Think, your head or chest. Lose those, and you’re done. Limbs are negotiable. Getting run through by rebar is a threat and can lead you to bleed out, but this is more forgiving than you might expect. Search and rescue.

Because of the rough surface, rebar has a tendency to bind into wounds, sealing them against bleeding, with a couple major caveats. You do not want to aggravate the wound, by moving, you do not want to pull it out. This means, if you take a chunk of rebar through a limb, it probably won’t kill you on its own. That said, this is a major risk of infection, and getting impaled through the torso is extremely dangerous, even if you don’t bleed to death. Also, if you do struggle to move around, it’s entirely possible you’ll work the wound lose, and bleed out that way. Especially if you’ve taken it through the leg. Finally, even if you do survive, it will result in some serious deep tissue trauma. Figure a leg or arm that’s been run through will never be quite the same again.

Getting crushed under concrete, or other reinforced structures are a similar story. If it’s a limb, it can potentially hold the artery closed, acting as a kind of accidental tourniquet and save your life. The limb itself has been reduced to pulp, but you can live through it. Obviously, having your torso or head crushed is going to be less survivable. Though, having the lower torso crushed is particularly nasty, as it won’t result in immediate death. There’s also some nasty permutations, where simply cutting off the flow of blood to a limb for an extended period of time can do horrific things to you when blood flow is restored, even if the limb itself is mostly intact.

Note, in both cases above, this is only buying time. Someone who’s had a chunk of rebar run through an artery will still bleed to death, but they may have hours instead of minutes. Similarly, if your thigh has been pulverized, the weight will keep you from bleeding out for awhile, but it probably won’t stop the loss of blood entirely.

After surviving the initial collapse, a major threat is asphyxiation. This can occur either because there’s insufficient access to breathable air (pulling fabric over the mouth and nose as an improvised mask can help), or because of weight on your upper torso interfering with breathing (without it actually crushing you.)

A major danger is the search and rescue teams who come in to find survivors. This is for a couple major reasons. Moving the ruble has a real risk of causing the debris your under to shift. This could either allow you to start bleeding again, or it could crush you. The second major threat is once they’ve found you. Successfully extracting victims from a collapsed building is dependent on having on-site medical attention. Again, any of these injuries that won’t kill you on the spot are survivable with medical attention. Now, the good news is that most well trained Search and Rescue teams understand the things I just outlined, and have sophisticated tools for finding survivors, and understand the need for on site paramedics.

Also worth knowing, the odds of survival start out pretty good, but drop off sharply after the first day. So, it is possible to be trapped under the rubble for up to a week (depending on injuries), but if your character has suffered serious trauma, the clock is ticking, and without rescue, and medical attention, they will die.

So, this is survivable, but it’s also going to be a life changing moment. It can get pretty horrific before it kills you.

-Starke

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Q&A: Adrenaline and Pain

Hi! I dug through your page and found that adrenaline can numb a person’s pain, as I though it might. However, my character is supposed to die of her wounds (a stab into her stomach by blade and into both of her arms, cutting through muscles). It is not like a gunshot wound that could go unnoticed, so do you think adrenaline would be enough? Since adrenaline is a hormone, would it kick in instantly? Or only some time after the wound was inflicted?

rokokokokolores

Adrenaline usually kicks in before the injury is sustained. That will happen sometime before combat starts, when your character realizes they’re in danger. So, technically, yes, there is a delay between when the adrenaline starts pumping and when it kicks in, but it will be up and going before your character’s injured.

Also, the biological half-life is only a couple minutes, so your character will come down from adrenaline pretty quickly once the threat has passed. Strictly speaking, when medically administering adrenaline, the dose only lasts about 5 to 10 minutes, depending on metabolism, when your own body is producing the stuff, the effect can last longer, as it’s regulating the adrenaline.

Once she crashes, she’d feel the pain. Personal experience is that the pain gradually filters in. The intensity doesn’t change, but your ability to ignore it fades. (Michi’s personal experience with a broken leg is the pain kicks in quickly, especially once your body realizes there’s something seriously wrong.) For example, there’s not going to be any ignoring or powering past an arrow piercing through your calf.

Blade and arrow wounds tend to directly impair your body’s ability to move in a way that gunshots, normally, do not. Your muscles form a kind of complex “pulley” system over your skeletal structure. Unless a bullet shatters bone or specifically severs tendons (before someone asks, no your character can’t make a called shot for someone’s tendons with a gun), the system will continue to work, more or less, until something does break.

Blades tend to sever the meat. Meaning they cut through muscle tissue, reducing your ability to use the associated body part. Deep cuts on the arm can impair or prevent use of that limb.

Arrows are a similar story with a slightly different detail. Muscles are layered, and these layers move over one another as you act. When you’re struck by an arrow, it skewers those layers together, which can completely arrest movement in anything controlled by the affected tissue. If you take an arrow to the shoulder that completely immobilizes the upper arm.

So, adrenaline can keep your character from noticing the pain of a sustained injury, but they would probably notice that they couldn’t lift their arm. The gut wound might be something they could overlook for a few minutes, but in that case, the blood loss would slow them down pretty quickly.

Now, one important thing to remember, pain is transmitted to your brain through your nervous system. As with your muscles, nerve damage is more likely when you’re getting carved to pieces. Depending on the nature of the injury, this can result in partial (or complete) paralyzation of the affected limb. In a case like that, severed nerves cannot relay information to the brain, so there would be no sensation whatsoever. Pain or otherwise. However, if the nerve was severed along with a chunk of meat in the upper arm, that’ll hurt.

Another detail worth remembering, adrenaline increases the heart rate, and blood flow through your body, significantly.  This means you will bleed out faster while you’re in an adrenaline rush than if you’re not. This is mostly an academic detail, because if you’re bleeding to death, you’re probably going to be a bit stressed, but it is part of the reason why you’d want to keep someone calm, after they suffered a traumatic injury.

Finally, new detail for the day, since I didn’t know this before I went and double checked my research: It seems that adrenaline increases the intensity of newly formed memories. As you pointed out, it is a naturally occurring hormone, so it should be unsurprising that it has a variety of effects depending on the affected tissue. I have no idea if my inclination to agree with the statement is simply power of suggestion, or if that really does mesh with my own experiences, though I’m inclined to believe the latter.

-Starke

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Q&A: Gunshot Wounds

When it comes to gunshot wounds, are there any places that are “less lethal” than others to be hit or is it all fair game for ending up fatal? Like, would a shot to the shoulder be less serious than a shot to the knee or something like that?

I know what you’re fishing for here, but no. There is no, “less than lethal” way to put a bullet in someone. There are more dangerous places to get hit, but there’s no way to safely shoot someone.

There are less than lethal munitions, such as beanbag rounds and riot slugs, but these are still dangerous.

Shooting someone in the limbs tends to permanently mangle that limb. So, while getting shot in the hand is less immediately dangerous than a round center mass, it will destroy that hand, without surgical reconstruction. Same goes for that knee example; you can kneecap someone, but they’re never walking again. That’s, “see, my character isn’t a bad person, they’re just a sadist,” territory.

Gunshots can kill. The bullet will rip apart tissue in ways your body can’t really handle, and, without medical attention, you will bleed to death. Getting shot in the hand or foot can still kill you, it’s just easier to cram a rag in the wound to staunch the bleeding.

There are places that are more lethal. Center mass, so your torso, primarily your heart and lungs. Take a bullet there, and you’ll quickly die. It is, technically survivable, but you need immediate medical aid. Shot in the head and you’re dead (most of the time.) (Technically, head shots are only fatal about 98% of the time, so there’s a chance. I’ve called this, “surprisingly survivable,” before, and it is.)

Of course, when bullets travel together, the results on a person are far worse. The real metric here is how much blood you lose. Lose to much and you die. So, if one hole gets you bleeding, several will speed up the process. Multiple gunshot wounds are no joke. Even with paramedics on the scene, you might not make it.

Also, because, again this about blood loss, nicking or severing an artery is very bad news. That’s your limbs. Take a hit in the shoulder and you could be fine, or it could nick the axillary artery, and you’re dead in minutes.

Guns aren’t safe. There’s no safe way to shoot someone. Bury a slug in the meat, and people can survive. There’s no one shot and down, outside of maybe a headshot, but there’s no such thing as shooting to wound. You shoot someone, you’re taking a real risk that they’ll never get back up.

Now, I alluded to this with the comment about head shots, but humans are remarkably resilient. Stuff that should kill us, sometimes doesn’t. So, while there’s no safe way to shoot someone, it’s entirely possible someone might manage to cling to life after taking five or six shots in the chest. Or they could bleed to death from a shot to the wrist.

It’s not possible to predict where a bullet will end up, at least not in real-time. Bullets can ricochet off bone and bounce in unexpected directions, or shatter spraying shrapnel around inside the victim. This stuff gets messy fast.

Best circumstance is the bullet goes in, and comes out “clean.” It doesn’t hit bone, doesn’t destroy anything vital. A wound like that is very manageable. Not, “good,” it can still kill you, but you have the most margin for error. Everything else goes down hill from there.

-Starke

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Q&A: This Space Intentionally Left Blank

Hi, I’m writing in a medieval/high fantasy setting and would love your ideas on how this scenario could go. A deserter on the run in alpine terrain, chased by both the unit he deserted from, who need to capture him alive, and local militia intent on killing him. He has training, gear and a crossbow, sword and fighting knives. I know this situation is dire. The plot outline is to eventually have him captured by his former comrades, but my question is how this would realistically play out?

You’ll see an answer pop up on multiple choice quizzes, “The question cannot be answered with available information.” That’s apt here, because there’s just too many potential factors.

Let’s start with the consequences and work back. Desertion is (almost always) a very serious offense. Combat, especially in war, is extremely frightening, so running is a very natural response. The result is that any organized militant force needs to deter that behavior. You understood this because you had him being hunted.

Here’s where the unknown factors become a problem. Let’s start with the organization that trained him. Depending on who he was working for, the consequences could be anything from being dragged back in chains and spending decades in prison, to being used as a target in live weapon practice for the next wave of recruits. After all, nothing says, “don’t do this,” quite as much as getting recruits to serve as executioners. So what happens? I don’t know, but it’s probably somewhere between these two extremes. And, yes, being court marshaled and imprisoned is about as benign as it gets.

There’s a wrinkle here, though. So he might not make it back to face the music after all. There are few insults more repugnant to a soldier than cowardice. Deserters are viewed as cowards; they were too scared to do their job. This is also a direct betrayal of their former comrades. Again, the best possible outcome is some minor psychological abuse on their trip to a cell. It’s entirely possible that your character would be mutilated and allowed to expire. Again, this depends on the characters involved. Depending on the structure of your setting, but, realistically, the results would not be pretty. If your character is lucky, their former commanding officer may simply summarily execute them once captured.

So, that’s a personal problem.

I’m not even going to question why their buddies were sent out to apprehend them. It seems like a mistake, unless you’re going full supervillain, with something like, “find him, or you’ll all be executed.” Which would not endear him to his former friends, (in case there was some confusion on that point.)

So, that’s what happens after, but it still leaves a lot of blank spaces working up to it.

Alpine terrain tells me very little. This could be high altitude, it could be mountain ranges near the coasts which are relatively low, but still, “alpine.” If it’s the former, and he wasn’t acclimated, altitude sickness is a serious pain in the ass.

Assuming a roughly earth like atmosphere, altitude sickness starts to manifest at around 2,000m above sea level. At 3,000m above sea level, the rate of incidence exceeds one in four. There’s good news, you can antagonize it, resulting in symptoms at altitudes as low as 1,600m, if you’re so inclined.

Altitude Sickness is hypoxia resulting from there not being enough oxygen in the atmosphere. Symptoms include, nausea, vomiting, headaches, insomnia, fatigue (there’s a fun combination), and vertigo. Short version is, if this goes acute, you’re not doing much of anything until your body acclimates.

Physical activity for extended periods, for example, fleeing through the mountains while pursued by local, acclimated militia, would probably end badly. Also, overall physical fitness is not a factor in resisting altitude sickness. Just because your character is a soldier doesn’t mean they’ll be mysteriously immune.

There are chemical ways to help cope with altitude sickness. Historically, indigenous people in the Andes chewed Coca leaves for their stimulant effect. This also had the effect of combating altitude sickness. I suspect this is because coca functions as a vasodilator, increasing blood flow, and as a result, the available oxygen in the user.

If your character is dependent on chemical assistance to survive, they’d face a logistical problem. They could only carry a limited amount or supplies, while their pursuers would have access to resupply.

Also worth noting that, historically, the Coca plant was viewed as having religious significance, and as a result, consumption among the Incas were restricted to royalty, senior officials, and the military. It’s not implausible that a similar situation may exist in your setting.

In case this was somehow missed, the altitude will make engaging in melee combat basically impossible, as even one skirmish could easily incapacitate your character.

Finally, I’m not even sure if your character can escape. High Fantasy doesn’t automatically mean your character has to deal with magic, it’s likely that magic is a factor. Unless you’ve specifically written around it, and created a reason why it doesn’t exist, mages would be incredibly useful in a military context. Be that as heavy combat units, advance recon, communications, logistics, or even as meat based artillery. Now, it is possible that some of those roles simply aren’t available to mages in your setting for whatever reason.

With that in mind, it’s entirely possible your character, or their gear may be mystically, “marked,” so that it can be tracked remotely by a trained mage. Alternately, it’s possible your character could be tracked by a mage trained in remote scrying. Meaning that they wouldn’t be, “chased,” so much as hunted down.

It’s also likely that your setting may have some countermeasures, but unless your character is also a mage with similar training, they’d be unlikely to know the full range of tracking options available to a recon mage (or whatever term appeals, “auger” or “scrye” are good options.)

So, the short version is, your character’s going to have a very bad time. Desertion, is a very serious crime in any military, usually punished with death, often with a painful death. So, this isn’t going to end well for them, regardless of their intentions.

-Starke

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Q&A: Nailed It

If a character is stabbed and pinned through the hands (like a crucifixion), could they wrench themselves free without bleeding out? I realize they’d be most likely be permanently disabled if they survive, I just want to make sure that “if” is workable.

So, there’s a small historical footnote worth knowing: In Roman crucifixion, the nail would be driven through the wrist, not the hand. The reason being that the hand isn’t structurally sound enough to support the body’s weight.

As for wrenching yourself free from actual crucifixion? Probably not. Someone subjected to that would normally take days to expire. Factor in the blood loss from getting nailed up there in the first place, and being able to break yourself free seems pretty far fetched.

It’s worth noting, there’s very little archaeological data on crucifixions, and only one set of crucified remains dating to the Roman Empire has every been discovered. This leaves us with religious and contemporary documents. Given the time involved, there’s some uncertainty in the details. For example: The size, design and metallurgical makeup of the nails.

If you’re talking about a situation like the character’s hand being mangled by a normal carpentry nail, that’s a little different. The Ulnar Artery loops across the hand, forming the Superficial Palmal Arch, which connects with the Radial Artery. So, damaging this must be bad, right?

Yes, and no. You can bleed to death from tearing the Ulnar artery (or the arch.) This is still an important conduit for blood through the forearm, and no arterial wound is safe. The Radial artery is the one most frequently severed when someone attempts to slit their wrists. So, yes, it is possible to bleed out this way. It’s also extremely unlikely, baring other factors, like a compromised clotting factor, immersion in water, or continued aggravation of the wound. In most cases, your body will clamp down on the damaged artery halting the loss of blood. In fact, emergency first aid for a ruptured artery in the wrist or hand is to keep pressure on the damaged tissue for roughly 5 to 15 minutes, until clotting commences. Depending on the circumstances you could be looking at over an hour before cardiovascular collapse from this injury (if it’s going to happen at all.) So, yeah, you can, theoretically, bleed to death from this, but it’s not going to be fast. Regardless, you can bleed to death from this, so don’t screw around with it.

So how does this happen? The nail goes through, and then you tear it out between the webbing of the fingers. That forces you to sever the Superficial Palmal Arch, causing arterial bleeding. If you’re just yanking your hand off the surface, from whatever it was nailed into, and the nail didn’t damage the arteries, you’ll bleed, but you won’t die from bloodloss.  It doesn’t really matter whether this pulls the nail through your hand or you keep the as a souvenir and implausible, improvised, punch dagger. Additionally, depending on your personal physiology, and the exact point of contact, it’s possible the nail will penetrate outside the Arch, and pulling your hand free, though the webbing, will damage tissue, but won’t be life threatening.

Now, the bad news. If your holding your hand on a surface, someone stabs through it with a knife, and the blade perpendicular to your arm, there’s a real risk the blade itself will sever the Palmal Arch. Again, by itself, this is unlikely to be lethal, but it is something that needs to be taken seriously.

Also, until the wound has clotted, bandaging these wounds will require some real skill. It’s far easier to keep pressure on the wounds by hand (insert a bandage between your hand and the wound when possible), until the initial bleed ends. If the bandage soaks through, then apply a tourniquet. Don’t just slap a bandaid on top and call it good. Also, simply. tightly wrapping a bandage around the hand will not apply pressure where you want it.

This is in contrast to arterial damage near the torso, including in the arm pits and groin, which can result in death from blood loss in under two minutes. It’s an artery, but size and volume moved matters.

One fun detail, if your character takes a fairly normal sized carpentry nail to the hand, assuming it doesn’t specifically pierce anything vital, it can do minimal damage. Obviously, nicking a nerve is permanent. This is in contrast to taking a knife to the hand, where the size of the blade means that it will probably hit something vital.

The puncture wound will suck, and in a modern setting, they’ll need a tetanus booster, and probably an antibiotic, in addition to basic wound care. Surgery can repair non-nerve damage, though the hand won’t be exactly the same again. But this is not something that will your character in the scene.

As always, please remember I’m not a professional hand stabber, so don’t take this as medical advice, aside from, you know, the first aid: keep pressure on bleeding wound that spurts in time with your pulse. Also, as someone who is not a doctor, I recommend you don’t get stabbed through the hand. I hear not healthy.

-Starke

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Q&A: Contact Poisons

I’ve heard of historical cases of people dying by poison being applied to fabric, accidentally or deliberately. Is contact poison a viable method of murder? Could it be used, not to kill altogether, but to weaken an opponent for someone else to fight?

It depends on the poison. There are a lot of poisonous substances that can be absorbed through the skin, including things like Anthrax, Strychnine and Cyanide. (Technically Anthrax is a biological agent.)

There are poisons that can disorient or impair the victim without killing them. Too many to even start to go into them.

Ironically, the first thing that comes to mind and fits both of these is Lidocaine. Lidocaine, and a number of other similar anesthetics such as Novocaine and Oracaine, are synthetic relatives of cocaine, producing numbness on contact, and they’re commonly used in dentistry. You can kill someone with a sufficient dose, as well. Also, the normal topical administration method is via a gel, not a liquid but the idea is there.

One major, historical, issue with accidental poisonings was arsenic. When used as a dye, Arsenic produces a vibrant green color. This was briefly popular in the 18th century, for wallpaper patterns and paints. In a dry environment, it’s mostly safe, however when you add heat and humidity, low doses can be released as an (effectively) undetectable vapor. This won’t result in an immediate death, but prolonged exposure can result in chronic poisoning.

There’s a bit of history here, if you’re interested: In 1815, after his military defeat, Napoleon Bonaparte was sent into exile on the Island of Saint Helena. He’d previously been exiled to Elba in 1814, after a separate military defeat, only to return to France, and restart his campaigns, so this time he was sent to a far more remote island.  Six years later, on May 5, 1821, he died.

Napoleon’s autopsy listed the cause of death as stomach cancer, there were ulcers found during the procedure, and a family history (though that wasn’t, apparently, known at the time). And, that was that… until the mid 1960s.

This is where things get a little strange. Records kept, both before and after Napoleon’s demise, suggest that he may have died from chronic arsenic poisoning. This includes the symptoms he displayed as his health deteriorated on Saint Helena, as well as how well his body was preserved when it was eventually moved from the island to France in 1840. Additionally, surviving hair samples displayed arsenic traces one hundred times what you would expect today. (The biology involved is that, because arsenic is an element, it doesn’t break down in the body, so it is flushed through various sources, including your hair.)

Into the early 2000s, there was a persistent theory that, because he’d managed to escape Elba, the British had decided to finally finish him off (St. Helena was a British holding). Politically, they couldn’t simply execute him, so the theory held that they dosed his private wine stocks with low doses of arsenic.

The competing argument, of course, is that his wallpaper used an arsenic derived green dye, and that the elevated arsenic content found in the surviving hair samples was the result of atmospheric exposure, probably throughout his life, but particularly during his time on St. Helena.

I am skimming over a lot of details here, there are entire books on the subject of Napoleon’s exile to St. Helena and his eventual death, and rumors that the British were poisoning him, or plotting to kill him existed at the time. So, at some levels, this is nothing new.

-Starke

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Q&A: Collapsed Lungs

Hi there! I have a character who gets stabbed in the side and into one of her lungs. The wound is deep enough for air to start seeping out and collapse it. I have a fairly decent idea of how it’s going to be treated, but I’m also wondering about blood entering the lung and how to treat that. Google didn’t help much there, I’m afraid. For the record, this takes place during medieval times and I’m aware I’m going to have to use some plot armor for the character to survive.

That’s not plot armor, your character needs magic, superpowers, or modern medical treatment to avoid a rather unpleasant death. If your character is lucky, they die from an infection, if they’re not, then it’s going to be pneumonia.

Okay, if you’re wandering around today, get run through by an especially strange individual wielding a large knife, and your lung is punctured and collapses, that’s bad. However, it is survivable, if you get medical treatment. The lung can be surgically repaired, you can be put on antibiotics, as needed, and your lung can be re-inflated. I’m not sure on all the options for this, but I know one common example is to simply force air into the lung via a plastic tube inserted down the throat.

I’m not 100% certain what getting blood in your lungs will do, but I am sure having blood in your lungs is a potentially lethal situation (even today). In particular, blood quickly coagulates into a solid clot when exposed to oxygen. In your lungs, this means you cannot extract oxygen from the atmosphere, and it’s not going anywhere. Over time clots break down, but the results are not something you really want to deal with internally.

If you’re getting foreign matter of any kind into your lungs, that’s a vector for infection. Lung infections are extremely dangerous and can easily kill you. Symptoms include a fever, increased respiration rate (with an increased heart rate), chest pains, and increased mucus production (which, incidentally is what’s actually causing the problems in the first place, because that stuff is interfering with your ability to breathe in the first place.) If I understand correctly, getting blood in your lungs basically guarantees an infection, or infection like symptoms.

So, in short, without modern medicine, there’s no way to properly treat the collapsed lung. And, assuming the blade wasn’t clean (which, it wasn’t), any medical treatment your character did receive wouldn’t account for concepts like bacterial infection (because that wouldn’t be discovered for centuries), so your character would get sick, and die.

I realize I haven’t written a hard shutdown like this in awhile, but, yeah, this injury, with that level of medical technology is a textbook example of how to kill a character in an extremely painful, and agonizing way.

-Starke

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