I'm writing an urban fantasy story set in 1998 involving things like vampires and werewolves, and thinking about the concept of an "emergency transformation", the practice of using the transformation into a magical being in order to heal them from damage that would have killed them had they stayed human. In my setting, while there will be several instances of it being done, a point is made that it is not done lightly. A lot of vampire/lycanthrope "clans" have very high standards for the sorts of humans they will give magical powers to, and people who are sired merely to save their life, thereby bypassing all of these standards and requirements and therefore often being highly incapable, unqualified and/or mentally unstable, are highly looked down upon in most circles, and often pejoratively referred to as "rescues". The people who rarely do decide to save someone's life will therefore only even consider doing so in situations where they are absolutely certain someone is going to die even if they took them to the hospital immediately. So, naturally, now I'm trying to get a sense of what sorts of wounds we'd be talking about here. The sort of damage that would leave someone still alive and conscious (so they can still participate in their part of being turned into a vampire), but doomed to die no matter what medical attention they received. What sort of damage should I be aiming for when writing characters in situations where they have to be transformed or they'll die?
How badly does someone have to be wounded to be beyond a 1998 American hospital's ability to save? Depends on their insurance. JK. I would focus on organ damage. I'm no medical expert, but bleeding can be stemmed, lost blood can be replaced, limbs can be salvaged or sewn off, spinal injuries below the neck are survivable, but multiple organs shot or shredded (some of this is going to depend on what sort of injury you had in mind, i.e. gunshots, claws and teeth, etc.) would be difficult to repair or transplant in time, but might leave the patient conscious, if extremely unhappy, for a short time.
Severe burns over a large percentage of the body. Crush syndrome. Of course either of these would still be devastating, unless the transformation involves regeneration of the body (which I assume it does). Ingestion of a lot of toxic substances. Cancer and other fatal diseases.
It does, more or less. It has limits (it can't regrow entire limbs or organs that were lost before the transformation for instance), but it can heal almost anything as long as the human isn't dead yet.
recovery from wounds really can be up to an individual's constitution, which cant really be measured. During the battles of Lexington and Concord, an American Patriot named Samuel Whittemore, a veteran of the French and Indian Wars, loaded up his musket, two pistols a French sword he had captured in the previous war, and went off to fight Redcoats. This was at the age of 78. He shot one with the musket, got two more with the pistols, charged the rest with his sword before being shot in the face by a musket, clubbed with a buttstock, and bayonetted 13 times. When his neighbors ran up he was still trying to load his musket again. They hauled him away to the local doctor who said he was a lost cause. Despite the miraculous nature of 1776 medical science, he not only survived his wounds but lived another 20 years, passing from old age at 98. This being said, it doesn't really matter what the age you place them in...if they are vulnerable as any average human without transforming, I would give them a cross-section of human endurance where they might go into shock and die from a single 9mm round if they don't transform right away or you can give some of Samuel Whittemore level endurance where they are still trying to go after taking an unholy amount of damage.
You might be overthinking it (or maybe underthinking it). Unless the specific lycanthrope is an expert in the current state of medicine in the U.S. in 1998 and can fully evaluate the victim's injury or injuries, what matters most is how the lycanthrope assesses the situation, and this can be anything from being completely ignorant of human recovery ability to ER surgeon level knowledge. Older vampires (and maybe lycanthropes too) are often portrayed as very sophisticated and knowledgeable so I'd think they'd have more medical expertise than the average person, but it's whatever you want it to be. You could even have some really dumb werewolves that never surpassed prehistoric intelligence ("He hit head. About to die.")
The judgement call of the transformation's necessity could also be a point of conflict between new-bitey and his usher.
People who come in with that level of trauma would be in a significant amount of pain, if they're conscious at all. Pain control is a high priority in most ERs and he's going to get a strong dose of opiates as soon as possible. He may or may not be lucid enough to participate in anything. Whatever he is required to do can't be complicated or he likely won't be able to process it, so keep it fairly simple. Bruce has a good point, though. Most people won't know. I've been in medicine 30 years and I'm still sitting here thinking, " What DID we do 25 years ago?" You can get away with a lot.
Blunt force trauma is one of those things that can see someone walk away from an accident and be dead a few days later. Internal bleeding was and a lot of times still is beyond the abilities of modern medicine to deal with. It would have been worse in the late 90s. Just finding the bleeding organ requires a lot of advanced scanning technologies that didn’t exist then.
I work in these situations irl quite a bit. Those that are close to death from trauma tend to come into the ED already obtunded, +/- intubated. People who come in with stroke or heart attack can still be conscious, same with burns, conditions that suggest catastrophic cancer, bleeding in places that are hard to control (like inside the chest or puking or pooping out copious amounts of blood). Someone mentioned toxic ingestion. Maybe consider weaving in how something might not be catastrophic in a major hospital that has trauma surgeons on call that can be there in a moments notice to whisk into the operating room to get internal bleeds under control but might be if it occured in a rural community setting that didnt have these things. Maybe fingers were crossed that a medivac air ambulance would arrive to transport them to a legit trauma center, but there was a blizzard that night that percluded them - that kind of thing. Sorry, hope that helps!
I would not consider cancer to be an emergency. Seems to me, they would have that diagnosis long before it develops to an emergency state. And, the hospital I worked in the 90's had MRIs and CTs back then, in a city of 170,000 or so. Now, like @trevorD said, it would be more likely in a rural setting. Lubbock and Amarillo had medevac helicopters in the 90's and even earlier, but it won't and still doesn't help for some injuries if that flight takes more than 15 minutes response.
Medieval works if the patient can be stabilized for transport. Consider the accident victim, who cannot be cut out of the car, because the pressure from what is trapping them is the only thing keeping them from bleeding out.
