Tag Archives: Starke is not a real doctor

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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Q&A: Psychic Bleed

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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Q&A: Carotid Strike

(I don’t know of this a question for you or @scriptmedic but I’m hoping you’ll be able to help a little) how effective is the carotid strike actually? Will it actually knock someone out and does it cause brain damage like other knockouts? Is there any way to block against it or lessen the effect? Thank you so much and am very grateful for your blog ))

If I’m bluntly honest, I’m not sure how you could strike the carotid artery in a way that would cut off the flow of blood long enough to render someone unconscious without also killing them.

If you’re deliberately cutting off the flow of blood to the brain by compressing the carotid, that would be a blood choke. As we’ve said before, those can turn lethal with shocking speed. But, I’m not seeing where a strike to the neck would temporarily block the flow of blood long enough to put someone under, without cutting off the flow long enough to kill them.

Assuming you managed to find a way to do this, you’d be dealing with the same problems associated with knocking someone out. You’re cutting off oxygen to the brain and hoping you get a very specific kind of brain damage. I mean, this is the problem here; you’re asking for a way to inflict brain damage without inflicting brain damage.

Even if you did manage to put someone down, as with chokes, you’re talking about the victim being unconscious for a few seconds. So, the value of doing so is fairly limited.

The martial arts I’m aware of that practice strikes to the neck, like Krav Maga, don’t particularly care if the victim survives. They’re more interested in decisively ending a threat and, generally speaking, the dead aren’t much of a threat.

There’s an irony here; you’re describing a kill strike that the victim might be able to accidentally survive. Not, the other way around.

Writers like to use knockouts as a “safe” alternative to killing someone. I’m as guilty of this as anyone. But, the reality is that being knocked unconscious is close enough to killing someone that you really can’t selectively inflict the desired outcome. Similarly, you can’t knock someone out for long periods of time, without inflicting severe brain damage. It can, and does happen, but you can’t choose that result.

Ultimately, this stuff comes from a desire to include, “safe” violence. I’m sorry. There is no such thing. No one who engages in violence has full control over the situation. Some people like to think they do, but they’re deluding themselves. You can have characters who try to do the Batman, “I control all the factors,” but without (some very specifically tuned) superpowers, they really don’t.

Attempting to knock someone out, by any means, means you’re taking on the very real risk that the victim will end up dead. That’s a potential outcome.

-Starke

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Q&A: Paralytic Poisons

Would you happen to know how fast it would realistically take someone to keel over when struck with a dart coated in a paralysing drug?

With the quick caveat that I’m not a doctor; from what I remember, most paralytics will take effect in under a minute, and kill the victim in under five. Most of these will cause respiratory arrest. You’ve paralyzed them, so they can’t go anywhere, but you’ve also paralyzed their lungs, so they’ll also stop doing that pesky breathing thing.

If you’ve got someone on life support, there are some real medical applications for this. Particularly in surgery. When it’s administered in the field, they’re dead.

You’ll also find a few animals that administer paralytic poisons. This is some seriously scary stuff. Same problem though, in higher forms of animal life (read anything with lungs) it will stop respiration and result in the victim asphyxiating because their lungs are paralyzed.

The mode of action, as I recall, is that the poison actually interferes (or blocks) the neurotransmitters responsible for muscle control. It doesn’t matter how badly the victim wants to move, their body can’t get the message.

-Starke

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Q&A: Unarmed Knockout

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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Q&A: Shock

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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Q&A: Unarmed Parry

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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Is it possible to walk, well, attempt to walk, on a broken leg in any way? Would this result in permanent problems, such as a limp after healing? I assume it would…

All I remember about broken legs is the one I got when I was twelve, which was a spiral fracture of the tibia (but the fibula remained intact). After I was helped to my feet, I immediately started falling down again after I tried to put weight on it as the whole thing just gave out. I needed two grown adults to help me get to a nearby bench, which I hopped to, and then got carried out to the car when my mother finally arrived to pick me up. It was pretty terrifying.

Now, that’s not all breaks. So, I suggest you go check out @scriptmedic as they can probably give you a little more help in the medical department than we can.

-Michi

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I was reading one the questions you answered awhile back about gunshot wounds. Sometimes people can still keep fighting. I believe you mentioned that the adrenaline rush could dull the pain. Is it possible that the same can happen if someone was shot in the leg with an arrow? Would they be able to run?

No. A bullet will pass through the victim (usually) damaging
organs and tearing tissue in its path. This can limit mobility, particularly if
it breaks a bone, or if it tears tendons and ligaments. But, the tissue itself
can still move, to an extent.

With an arrow, you’re pinning the muscles together in
specific configurations, and those cannot
move. Your muscles slide over one another as a normal function of movement.
With an arrow run through them, you cannot move the affected area. Walking,
with an arrow through your leg, to say nothing of fighting with one through
your torso or arm is, basically, impossible.

This is also why the advice if someone’s been stabbed or run
through is to keep the victim from moving. If they try to adjust their
position, they’ll do far more damage to themselves than if they lay still. At
the same time, you don’t want to remove it, because the foreign object (that is
to say, whatever stabbed them) will obstruct the flow of blood. Removing it
will cause them to bleed out faster. That’s the tradeoff with bullets, and part
of why they’re so vicious as a weapon.

If you get shot, there’s nothing left to obstruct the flow
of blood, meaning you’ll bleed faster than if someone had shanked you with a
knife (and didn’t retrieve it), or shot you with an arrow. Because it’s
entirely possible you won’t even realize you’ve been shot, you won’t know to
slow down, and if you remain physically active (because you’re in a fight), you’re
very likely to wear yourself out, only to realize after the fact that you’re
not winded, but bleeding to death. And, yes, this does happen in the real
world.

If you’re hit with an arrow or run through, the blood loss
(from a similar injury) will be slower or partially obstructed, and you’ll
have immediate feedback telling you to slow down, but actually bleeding to
death will take longer. (Potentially not much
longer, and there is a greater risk of an arrow or blade severing something
immediately lethal, like an artery, but, as a general concept the idea holds.)

So, no, an arrow will stop you.

-Starke

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