1. DischargedKombat
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    DischargedKombat Member

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    Medical Question for Writing Discreptancy

    Discussion in 'Word Mechanics' started by DischargedKombat, Apr 15, 2013.

    All right, I'm going to make this post simple and quick.
    Basically, I have a current notion on a wound for one of my characters. Originally it was a gunshot wound to the spleen, but naturally it changed over time, due to the lack of medical attention, location, need for livability, etc. I've been looking online at different posts and websites and I've been getting mixed results, some saying the gunshot anywhere in the main base of the body is fatal. Others say if it misses vital organs, the character should be fine. I need to know if it is possible if these things can happen while being shot anywhere CLOSE to the spleen for convincing purposes:

    1. The character recovers within a day or two, after supposedly being shot somewhere critical. Another naive character that witnessed the wound finds out that it wasn't as bad as it seemed, and that the wounded character lied to him/her.

    2. The character only needs to patch themselves up. This means no medical attention. Yes I know this risks infection and that is perfectly fine.

    3. The character is able to move around the next day (with pain though, but he/she can stand)

    4. The character is trained military, so they know that they will be okay.

    5. The character loses 2 pints of blood (One is fine too, if this is not possible.)

    6. It is a 9mm bullet.

    7. The character makes A LOT of movement after he/she gets shot. So much to the point that he/she carries someone and he/she also gets in a fight. This is difficult here folks, because this hints that he is okay. But where on the body could someone be able to do that after being shot?

    Now i know this is pushing it, but this is the best I can get so far in the location and period I have written. If I need a change in the bullet's location, you can advise anywhere but the limbs. Doctors and surgeons feel free to respond, as you have the experience. Thanks so much!

    PS: It would also be nice to know the abrasion wound of the location you recommend. I'm no medical expert and that is why I'm asking for your help!
     
  2. T.Trian
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    T.Trian Overly Pompous Bastard Staff Supporter Contributor

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    Simple and quick? :D I'll leave the medical stuff to those who know more, but I'll just mention a couple of things. Firstly, by "main base of the body," do you mean center of mass (in shooting circles that usually means the torso as most shooters differentiate between CoM shots and limb/headshots)?

    As for the rest of the text I'm quoting and part 6: a hell of a lot depends on the variables. Is the bullet jacketed hollow point or full metal jacket? What kind of a gun did the bullet come from? How far did the bullet travel and under what conditions (ballistics will be affected by things such as wind)? How many layers and what materials did it have to penetrate before entering the body (shirts, a leather jacket, a kevlar vest, drywall, a car window, plywood, a wallet etc)?

    If it was fired point-blank range into exposed skin at a direct angle, and it was a JHP, the end result is different (the bullet expands upon impact and creates a wider wound cavity with less penetration) than if it was an FMJ round (which would have created a narrower cavity and likely passed through in one piece except maybe if it hit bone on the way). It would be different, again, if either bullet type was fired from a carbine at 400 yards out so that the round passes through a car window, a thick leather jacket, and a couple of shirts (impact with something hard might even shatter a bullet, causing several narrow wound cavities). Not gonna speculate on the exact end results, but they would likely be different.
     
  3. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    I can speak to some of this.

    If you have liver trauma you are going to bleed to death if not treated. You can remove a lobe or cauterize trauma and a person could survive.

    Hit the spleen and we usually have to remove it or you will exsanguinate. There's no recovery in two days, ain't gonna happen. And I have never seen a spleen repaired. It's possible but I've never seen it. It won't heal on its own.

    Major organs, nope, not without treatment. Lung, you need chest tubes or your punctured lung is unlikely to heal and re-inflate, and it definitely is not going to happen in two days. Pancreas, gall bladder, kidney, none will heal spontaneously let alone in a couple days. Gut, it spills bacteria into your abdominal space. You will die of infection. I can't think of a single major organ that meets your criteria.

    If you damage a major artery, you can't just put on a tourniquet because the blood supply below the site would be compromised.

    The only option I can think of is a through and through that misses all organs and major blood vessels. They do happen. You wouldn't lose 2 liters, a large adult only has ~6. Is there some reason that matters?
     
  4. Mithrandir
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    Mithrandir Contributing Member

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    Sounds like you were a nurse? (Just guessing...)
     
  5. T.Trian
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    T.Trian Overly Pompous Bastard Staff Supporter Contributor

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    Edit: shouldn't post at 4:45 in the morning; misread something and wrote a pointless reply as a result.

    Btw, I lost 2 liters of blood once from just a muscle wound. I was just starting to pass out when the paramedics got to the scene. At that point doing something like participating in combat, dragging someone to safety, or even crawling to safety myself would've likely been hopeless. Earlier on while I still had some strength left, sure, especially with the huge adrenaline dump I got.
     
  6. GingerCoffee
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    GingerCoffee Web Surfer Girl Contributor

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    Nurse practitioner, and in the field for many years.
     
  7. DischargedKombat
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    DischargedKombat Member

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    This is what I am looking for! Is there a way I can have the bullet miss spleen, but make it look like it hit? Like deceive a character that knows only the basics of anatomy? I want to describe it as hitting near the spleen but missing it by a through and through.

    As for the blood, it has to be convincing enough to make another character assume he is gravely injured.

    And if this is possible, what would the abrasive wound be from mid range? It was fired by an MP5K. Is there a possible way of night recovery with it missing all vital organs?

    Thanks.
     
  8. DischargedKombat
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    DischargedKombat Member

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    Simple and quick? :D I'll leave the medical stuff to those who know more, but I'll just mention a couple of things. Firstly, by "main base of the body," do you mean center of mass (in shooting circles that usually means the torso as most shooters differentiate between CoM shots and limb/headshots)?

    Near the spleen. I am open to torso shots too, although I really wish it could be near the spleen area.

    As for the rest of the text I'm quoting and part 6: a hell of a lot depends on the variables. Is the bullet jacketed hollow point or full metal jacket? What kind of a gun did the bullet come from?


    An Mp5k.

    And I'm going to guess mid range, since the armed man was behind a car and another character could see him.

    How far did the bullet travel and under what conditions

    It was sunny. No wind

    How many layers and what materials did it have to penetrate before entering the body (shirts, a leather jacket, a kevlar vest, drywall, a car window, plywood, a wallet etc)?

    It didn't penetrate anything, but I can make it happen. Like I said I'm open to changes for realism.

    If it was fired point-blank range into exposed skin at a direct angle, and it was a JHP, the end result is different (the bullet expands upon impact and creates a wider wound cavity with less penetration) than if it was an FMJ round (which would have created a narrower cavity and likely passed through in one piece except maybe if it hit bone on the way). It would be different, again, if either bullet type was fired from a carbine at 400 yards out so that the round passes through a car window, a thick leather jacket, and a couple of shirts (impact with something hard might even shatter a bullet, causing several narrow wound cavities). Not gonna speculate on the exact end results, but they would likely be different.

    Lol, all this technical stuff... But I really do approve since this is a war story. Lets try the bullet that would do the least amount of damage with a through and through.
     
  9. mammamaia
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    mammamaia nit-picker-in-chief Contributor

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    why is the spleen so vital to your plot?... without an exam by a knowledgable medical pro, neither the wounded person nor anyone else could tell if the spleen was hit or barely missed, anyway...
     
  10. DischargedKombat
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    DischargedKombat Member

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    This is not true. I never said the wounded character didn't know medical practices. Also, I can point to where my spleen is. If blood is gushing out of my friend and I've never seen a wound before, I might guess between a hit or miss, which is exactly what the naive character is doing. The other character (who knows medical) is assuring it is a miss.
     
  11. Mithrandir
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    Mithrandir Contributing Member

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    Are the specifics really important? Couldn't you just have it seem fatal from your description, but then have him come back. Another character would be surprised with the reader, then you use a phrase like: "The rumors of my death have been greatly exagerrated." Or: "It wasn't as bad as it looked."
     
  12. GingerCoffee
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    "Gushing" says artery and in the torso, that would be a big artery. You can't just plug the hole, large arteries have to be sewn shut.

    A large artery has a thick wall lined with a layer of smooth muscle that controls the diameter of the vessel. The artery has to be elastic enough to handle the wave of blood pumped by each heart contraction. The pressures these arteries have to handle can exceed 200 millimeters of mercury. That's a lot of pressure. I have personal experience holding a bleeding femoral artery and it takes a lot more pressure than you would imagine to stop the bleeding. The point is, that kind of vessel, if bleeding, needs sutures because the blood pressure is too great a force to allow any hope of a clot forming to close the hole.

    If you cut a small artery, you can clamp it off until the blood clots because there are usually (with exceptions like the arteries supplying the heart) collateral vessels that can supply the same area. That is not true with large vessels except in the brain which has a circular structure fed bilaterally.

    Large veins are not under tremendous pressure but in the torso there's nowhere you could put pressure to stop the bleeding. So if you see a lot of blood, you'd again need surgery to stop it.

    The reason you have to remove the spleen or a whole liver lobe is because those organs are like a sponge inside. You can't stop bleeding by sewing up a sponge.

    If you want medical accuracy, get an anatomical diagram and find a place that misses everything, and drop the "gushing". Also, the character can guess he's OK from the lack of blood and pain pattern, but couldn't be positive. Livers, spleens, pancreas, gall bladder, all those are very painful organs. The gut would be spilling the obvious, and you could smell it. Blood in the belly is also very painful. With a kidney you see blood in the urine. A trained person could have a clue about these specific organs. And if you want to add any clever details, look up referred pain.
     
  13. thewordsmith
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    thewordsmith Contributing Member Contributor

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    My sister's an NP. (As you well know, most people consider that a glorified nurse despite the fact that many NPs are better diagnosticians and practitioners than a lot of doctors. WE like to call it, Doctor lite.) lol.
    One thing you did fail to mention, Ginger, is the risk of gangrene if bullet/shot is left in the body. Yet another reason the hapless victim is not likely to be able to simply "slap a bandage on" and be on his merry way in a couple of days. (They make it look so simple in the movies, don't they?)
     
  14. DischargedKombat
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    DischargedKombat Member

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    The character is medically trained. He knows pain patterns all too well due to previous encounters. The reason I was hoping for a through and through near the spleen was because the character has already been hurt in the chest, and he already has bandages. But that injury is minor. I wanted an injury in another place that would allow him to still move. As for organs, I agree. I came into this post knowing that such thing was out of the picture, and I was hoping for a through and through that could be near the spleen. Surgery is not an option. Since you are deeming it possible if I can find it in the human body structure, I will approach from that angle. Thanks.

    Edit:
    So if it was nowhere vital, what would be the blood process within 20 minutes? Is it possible one can lose a liter in that time?
     

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