Hey Guys, My MC was knocked out for 4 hours after a bang to the head. (She had an injury in the same area when she was younger). So... -What would she be like waking up after 4 hours? -What symptoms would she suffer and how long would they last? -How functional v how messed up would she be? Thank you kindly for your help!!
She would be diagnosed with a concussion, possibly a step beyond mild. She may have some memory loss of incidents immediately surrounding the event. There could be headaches for several days, and certainly at least a tender spot where she was hit. A CT would likely be done, and an x-ray, but check that with a med professional. The headaches could persist for weeks, even, and it's doubtful her memory of the hour leading up to the event would ever return. Long-term sequelae could be difficulty with short-term memory loss ("Where did I put that book.....what? I missed an appointment?") and headaches, among other things. Again, check with a med professional. On immediately waking up, there would be a great deal of disorientation. Where am I, what happened, why does my head hurt, etc. There's a slight possibility she could have a deeper amnesia, such as forgetting who she is, but that's not very common. My only qualification is I'm a medical transcriptionist who often types traumatic brain injury exams, so take all of this with a grain or two of salt.
Usually the rule of thumb with concussions is, if they're out for more than a few seconds, then they're either in a coma or dead. That's something that often makes people upset about movies where characters are out for hours. It doesn't really work like that. Even concussions that last for a few seconds can cause some serious issues like @Sileas described, and there's also a risk of further concussions occurring, which is why concussion victims are kind of forced to stay awake. If she was out for exactly four hours, I'd expect her to have some brain damage.
@Sundowner: Yes I feared one does not simply be unconscious for 4 hours and go about their daily life! I will revise the scenario to suit. Thanks. @Sileas: Thanks so much. Super helpful.
There are also other concussion symptoms that are really interesting but that can be hard to work into fiction. A lot of people have significant changes to their personalities for at least a few days after the injury, often longer. Stoic people will become weepy, passive people will become aggressive, cheerful people will be irritable, etc. (As far as I know, it doesn't work in reverse - irritably, aggressive, weepy people don't suddenly become easy-going and kind!). Difficulty concentrating is a big one, too.
Of course, I'm not saying you absolutely have to give her brain damage or just avoid concussions altogether. It's fiction, and it's your story, so you can give her a four-hour concussion if you really wanted to. Just make sure to explain it, like have a doctor be bewildered by her survival or something. Have it be a miracle. As long as you're acknowledging that it should impossible, I don't think any nit-pickers will mind. I've done similar in my stories.
Being irritable or moody after a concussion is not usually seen as a personality change. It doesn't last long enough. But the idea of a possible effect on emotions is correct. Being unconscious for 4 hours would be considered a severe (grade III) concussion. Grade III: loss of consciousness for more than five minutes or amnesia for more than 24 hours. WebMD: Signs of a Concussion (Traumatic Brain Injury) @Sundowner is correct in that losing consciousness for 4 hours would be a very severe concussion with significant brain bruising and swelling.
One thing no one talks about because it is icky, is that after being knocked out or passing out, 99.9% of people will vomit immediately upon waking up. I've seen one person knocked out and five people pass out, and all of them vomited immediately upon waking up. Including myself. I've passed out once from an illness, but never had a head injury, and got sick when I woke up. This is a serious issue because if there is a chance the person cannot move around correctly, and they might aspirate.
No, 99% of people with concussions do not vomit. It is a common symptom but by no means will it affect 99% of people. So as a writer writing this scene, you can put it in or leave it out, your choice. Passing out from an illness is a different mechanism. That's the vagus nerve and vasovagal syncope does consistently include nausea in the cluster of symptoms. Symptoms
Hi, I've been knocked out - by a door! - and lost about five minutes I believe. Most of my symptoms involved pain and bright coloured vision / stars which lingered for a while. I didn't lose any memory. Didn't vomit either. Oddly though, the one time I did lose memory - I wasn't knocked out. It was a car crash. I was on a bike heading down George Street Dunedin, a woman in a car was coming the other way and suddenly decided she needed to turn right, directly in front of me. I remember seeing her turn, trying to hit the brakes on the twelve speed, watching the front side of her car approach, and then sliding along the road losing all the skin along my forearms inthe process. Everything from when I hit the car, slid up the bonnet, up the windscreen, flew through the air (doing a cartwheel according to witnesses!) and then smashed down on the road on the other side is gone. No head injury, just traumatic fear responce I suppose. Cheers, Greg.
Just going off experience. My father had a concussion from a horseback riding accident [still has the fracture] and he did it. My husband hit the pavement, walked around for a bit and did the same. He almost aspirated. This is why I thought it would be important, because it is a huge concern that many dismiss or don't realize happens as a delayed response to concussions. And it kills. Maybe it is the amount of time you're knocked out. My husband was unconscious for just a few minutes, the subject of this thread was unconscious for hours.
I don't doubt your experience for a minute. I just wanted it to be clear that the vomiting was not a universal concussion symptom.
She may even wet the bed the next time she goes to bed. That's what happened to me but I was only out cold for a few minutes. FYI I was 13 years old.
Personal experience: I was knocked out for a brief time (how brief? Hell if I know). Woke up, was kind of shaky and groggy, but didn't upchuck. But other people, some of them EMTs, have told me that it happens all the time. So I guess you can write it either way without being wildly inaccurate.
Don't want to highjack this thread, but I'm thinking it'd be redundant to start a new one on the same subject. Today I was line editing my novel and it hit me: "Wait a minute. That being knocked out thread on WP wasn't just a matter of random interest. I need to find out more about this getting-bonked-on-the-head, unconsciousness thing, too." So, briefly, I've got a guy, my MMC, who's been beaten about the head and body by one thug while another restrains him so he can't fight back. He suffers, at the least, a bad cut to the left temple and a nasty swollen bruise over the right cheekbone. Then the two thugs half-drag, half-walk him a certain distance to a cell, where they throw him in. The FMC is already locked in there, and she (and the reader) has to be afraid, momentarily, that he's dead. On the other hand, he has to revive pretty quickly (with the heroine's help), and immediately be able to recall who beat him and have a good impression of why. My question is, in this short-lived groggy condition, what would his eyes be doing as he lands on the ground in the cell? Would they be open or closed? Would they be rolled back in his head? And, is it realistic for him to be unconscious at all, if I need him to recover with only a nasty headache? (He has some hero stuff to do after this, and there's no getting to the hospital for him until he does it.)
I'm not sure without looking it up but the only time I recall seeing anyone with their eyes open and rolled back (or to the side) are people whose hearts have stopped. There's a different physiological mechanism with a concussion (brain swelling) and a coma from lack of oxygen to the brain (heart stopping). You just have to write the scene how you want it, readers are forgiving. If a thug beat the crap out of a man who is restrained, it's usually going to break bones and knock teeth out and that doesn't fit in most of our fictional scenes.
Really. I can do with a little blood, or quite a bit, but no tooth loss or fat lips. After all, this is romantic suspense, not comedy. I've bent over backwards trying to be realistic as I can, given the plot line. But I think I am going to keep the good old-fashioned Suspension-of-Disbelief-Required-Here trope of both my MCs being capable of all sorts of physical exertion, not to mention mental efficiency, even after being beat up and battered for a good part of an evening. Because, ya know, Heroics. But I think I'll ditch the open eyes when he's pitched into the cell. Unless his assailants turn him around, he's much more likely to land on his face anyway.
@Catrin Lewis : High jack away! As @Sundowner said earlier, it's your story but give it believability, account in some way (maybe your handsome man has some hard hitting adrenaline) or at least note how unusual it is. I've read articles on-line about great feats of endurance and strength people have enacted in order to survive or save those they love. Crazy stuff, so I think your good. @BoddaGetta : High five, that is the exact next part of my story. She vomits, Poor girl. @ The effect on vision, nicely noted, I will be using that, and the traumatic fear response is interesting to me.
Take it from me, there's a certain point in a fight where you decide that the best thing to do is just lie still and hope they stop hitting you. He doesn't need to be unconscious to just have the fight knocked out of him.
