Tag Archives: brain damage

So it’s obvious that trying to knock people out is mostly unrealistic and often times lethal. But what about when someone is tired from their injuries? Is there a difference between passing out and being knocked out? Where’s the line? Can trauma from head hits not knock someone out, but result in passing out? Can being knocked out for more than a few seconds be bad news, but passing out for hours just be regenerative, and if so what would cause that distinction to physically manifest?

The distinction between passing out and knocking out is very simple:

1) Passing Out: Your body is so tired that it can’t go on.

2) Knocking Out: Someone else is traumatically forcing your brain to rapidly shut itself off by convincing it that its dying.

When you’re talking about hitting someone in the head as opposed to strangulation, this generally means a concussion. They have hit your head so hard your brain has bruised itself against the inside of your skull and you have now gone unconscious. When you punch someone in the head, you have zero control over what actually happens to them. You can hope, but you can’t control it. In comparison to a choke hold, where you have almost total control over their body and can feel for the moment they go limp (and a mistake is still going to potentially end their life), it isn’t worth it as a tactical choice.

Humans are persistence predators, they can go and go and go for a very long time. You have to work pretty hard to physically exhaust them to the point where they’ll collapse on the battlefield. Their brain/body will usually stop them long before that point arrives. When you’re talking about combat, they’re far more likely to die before they ever reach a point of total exhaustion. We’re talking days without rest, the kind you’re only ever likely to encounter in mass battles or with a character who is being hunted.

The truth is that if you see a character who has been consistently knocked out multiple times on screen, they’d either be suffering from serious damage to their brains or dead. Most of them would be dead. If you ever feel like testing the theory out, go check out the late life prospects for boxers and football players who’ve sustained several concussions over the course of their careers.

The whole “knock someone out to get rid of them” is a Hollywood trope built for narrative convenience. The actual process of physically subduing someone is long, drawn out, and takes a great deal more energy and effort than a one, two punch or a knife to the gut.

The “Knocking Out” Contrivance in media acts like character death but without the audience having to evaluate the protagonist’s morals or the narrative’s values. They maintain their “good guy” street cred, and the audience doesn’t have to ask the questions. We switch easily from one scene to the next without any of the hoopla. The audience gets their action sequence and no one needs to feel bad. It’s a bloodless death. Or it’s a scene transition, or someone’s been taken prisoner without the author having to figure out how they move tie them up, move them, and get them from Point A to Point B. (Nevermind that it’s actually much harder to move dead weight than it is someone who is conscious.)

It’s lazy.

No, yeah, it is.

It’s there for shock value when the protagonist is taken prisoner.

Still, if you want to use this narrative contrivance in your story you can. No one will stop you. The vast majority of general audiences won’t question it. Judging by the number of questions we’ve received about this topic alone, people do commonly think the knockout genuinely works as a tactic for subduing the enemy. However…

The “Knockout” is prevalent in media because it is a convenient narrative tool.

If you’ve got a burning need to use it then use it, just don’t sit there and try to say it’s “realistic” or safe after the fact. It isn’t. Accept the narrative knockout for the bit of smoke and mirrors it is, and move forward.

It’s part of a collection of tropes that I like to call “Feel Good Violence”. They have no relationship to reality or responsibility, but they’ll make the audience feel good and the character seem powerful. It is “Feel Good”.

So, that’s it. I have nothing more to say that we haven’t covered in previous posts about head injuries. Unless @scriptmedic has anything they’d like to add, we’re done with the topic for now.

-Michi

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Hey! Uh with your most recent post about concussions… while concussions are very serious, I think you mixed up brain oxygen-deprivation and concussions. Depriving the brain of oxygen for even a very short period of time will cause irreparable brain damage and can result in turning someone into a vegetable.

Physical trauma to the brain, including concussions can also lead to irreparable brain damage and put the victim in a persistent vegetative state. The list of things that can break your brain in horrific ways is, sadly, not a short one. That said, cerebral hypoxia (depriving the brain of oxygen) is high on the list, and one of the reasons “just choking someone until they pass out” is not any safer than pounding their skull into a wall until they stop twitching.

Now, it’s probably worth pointing out, I was talking about grade 3 concussions. Since the question was about the character loosing consciousness, and lower grade concussions stipulate no loss of consciousness. As far as I know, more mild concussions are less likely to produce that kind of brain damage, at least on the first injury, but they also won’t knock someone out.

In deference to you; there are a lot of shared symptoms between cerebral hypoxia and concussions. There are differences, these are different medical conditions, with distinct causes and long term consequences. I honestly don’t know how much can (or should) be read into the overlap.

As always, I’m not a medical professional, though identifying concussions was covered in Scouts. Also, in fairness to you, a lot of the symptoms I think of for concussions are shared with cerebral hypoxia. The diagnostic training from first aid would distinguish them, but when I think of a concussion, the symptoms that come to mind are ones that occur with both (IE headaches, confusion, impaired cognitive function, impaired fine motor function.)

-Starke

Is a blood choke a safe, reliable and effective way of knocking someone out temporarily?

There’s no real “safe, reliable way” to knock someone out that’s not in controlled circumstances. A blood choke like the triangle choke where the elbow wraps around the neck to cut off blood supply to the brain will knock someone out very quickly, but it will also kill them. It happens very quickly, so the margin for error ends up being a matter of seconds. In the heat of the moment, too much relies on aggressor’s discretion and their enemy’s physiology. The brain needs blood to function, if the flow of blood suddenly stops then the brain can no longer work and it shuts down. This is what causes the knock out, but knocking someone out is basically putting them in a coma and one step away from death.

The same is true of oxygen deprivation. When you choke someone, you’re strangling them. You’re cutting off oxygen to the brain by obstructing their ability to breathe. Many chokes apply direct pressure to  windpipe by squeezing with the hands or crushing with the forearm. The techniques always risk permanent damage to the windpipe and to the brain.

In a controlled environment like a martial arts match or a UFC bout where there are referees keeping careful watch on the contestants and are ready to leap in at a moment’s notice if something goes wrong (and the contestants are given the option to tap out before they pass out), this isn’t as much of an issue. The same is true of the Army and the Marines who both teach choke holds, including a more deadly variation on the triangle choke, because they are effective techniques in situations where the survival of the enemy isn’t an issue. Police in the United States used to love choke holds because they are very effective, the reason they aren’t used anymore is because policemen who used the techniques accidentally killed a great many suspects while subduing them. (The same is becoming true of Tazers. Yes, freaking out someone’s nervous system with electricity can in fact kill them.)

Drugs, in the controlled environment of a hospital they work very well, in a combat situation where you can’t control all the variables not so much. There’s also considerations like body weight, height, and resistances to various drugs that vary from person to person. Unfortunately, there are no one size fits all drug types and in a combat situation too many things can go wrong for it to be reliable. Add to that, any time you put someone under there’s a chance they won’t wake back up or will wake up with real brain damage and it just isn’t a viable solution.

This is all before we get to the issues of moving the body. Moving an unconscious person is a lot like moving a corpse (except they could wake up and, while you can guesstimate, you don’t know for certain when that will be). While putting someone over your shoulder in a fireman’s carry works, it’s incredibly aggravating and terribly obvious. Dragging the body is slow and cumbersome, while carrying it with two is awkward. If you saw a pair of guys in black dragging an unconscious body into the back of a black van, you’d probably call the police. On the other hand,if you saw a nicely dressed man putting an obviously drunk twenty something into the back of a taxi cab, you might not question it as quickly.

Whether it’s a hold up on heroes sneaking around a government facility or a snatch and grab off the street, it’s much more viable to make your target move themselves. Kidnappers don’t have fifteen to twenty minutes to exit a scene, they have five. They’re moving fast. This means disorienting their target and using the fear, shock, and trauma of being kidnapped to force them to move. Whether it’s getting hit with the butt of the rifle, a black bag and handcuffs, or getting dosed with an animal tranquilizer (or date rape drug like rohypnol), it’s much more viable to put them in a condition where they can’t struggle or fight back and make the target carry themselves.

I do understand the dilemma here. We’ve been conditioned by countless action movies to believe that a knockout is an easy out. The enemy cracks the character over the back of the head and we change scene. Unfortunately, (and if you look at most movies that deal with realistic kidnapping like Man on Fire, you’ll notice a change in tone) this isn’t how it actually works. The goal of a kidnapping is going to be extracting them alive and scared, but relatively undamaged. You’re taking them because they are valuable to someone (whether it’s for ransom or for sale is less relevant). Anything that jeopardizes that ultimate goal is going to be off the table for a professional. If you’re writing an amateur kidnapper, they may go for a knockout because “that’s how it works in the movies”.

In Hollywood and some books, knockouts have become sort of a “free pass” for badasses. The badass gets to do all the fancy tricks and cool moves but can also get the “good person cred” of not killing anyone. It’s a “have your cake and eat it too” bit where the author handwaves the violence and doesn’t deal with the consequences. It’s in the same range of heroes shooting arrows and bullets through joints and going “Ha! See! I’m super skilled and I don’t have to kill!” but avoids the obvious part about CRIPPLING THEM FOR LIFE!

This isn’t to say you can’t go with it but just remember, no matter what your hero does, if they are using violence then they are always running the risk of killing someone. This is especially true when harming vital organs or the brain.

Seriously.

-Michi