Guest Eileen Dreyer: Physical Trauma on Characters

Hi friends! I’m really excited to welcome Eileen Dreyer back to ALBTALBS, and she’s got an excellent post. It ties into one I posted last week, written a long time ago about some pitfalls in romantic suspense. Eileen made a comment on FB a while back about what she says below and I was like “omg yes exactly!” Then I asked if she’d be willing to write a guest post about it, and here we are! 😀 Enjoy!

Don’t Shoot Him In The Shoulder

With a Vengeance by Eileen Dreyer Book CoverThis blog began the way a lot of conversations do around the bar at writers’ conferences. Somebody read a book in which the hero got shot and immediately rogered the daylights out of the heroine.

“I find that hard to believe.”

“Where’d he get shot?” I ask.

“Well, only in the shoulder….”

Ah, yes. The good old shoulder shot. On the screen everyone from Wild Bill Hickock to James Bond has shaken off the annoyance of a bullet in the shoulder as he saved the day. I mean, it’s a great place to shoot a hero (or heroine), isn’t it? There aren’t any major organs to worry about. Nothing but connective tissue.

Wrong. Besides the lungs, which have an annoying habit of getting in the way by expanding when we breathe, major blood vessels like the subclavian and brachial arteries run across the impact zone along with the brachial nerve, which impacts the entire arm. And that doesn’t even take into account the bones, from the easily fragmented collarbone (clavicle) to the humerus.

The only time I’ve seen someone show the actual impact of a shoulder shot was a Spencer for Hire episode entitled The Road Back. When Spencer suffers the famed shoulder shot, he winds up with a paralyzed arm. The entire episode revolves around his difficult recovery and the very real chance he never will regain the use of his arm.

I’m not saying don’t shoot your hero or heroine in the shoulder. I’m just asking that the possible impact is acknowledged (“Holy cow, Mary. Do you know how lucky you were? That bullet missed everything!”).

One more note. From personal experience, I can tell you that digging for a bullet isn’t the breeze it seems on TV. Those little buggers move around! I’ve seen more than one surgeon throw instruments against the wall in frustration and still not come up with the bullet. If it’s a contemporary book, leave the stupid thing there.

A Walk on the Wild Side by Eileen Dreyer writing as Kathleen Korbel Cover

And then there’s blood loss. This is a favorite area of misconception, especially in romance. One of my favorite jokes is this: “And the lord said to man, I have good news and bad news. The good news is that you have both a brain and a penis. The bad news is that you only have enough blood to work one at a time.”

All this time later, nothing has changed. If somebody has lost enough blood to pass out (and here’s a tidbit—people don’t pass out from pain. They just wish they did), he does not have enough blood to have an erection. Instead, if he gets aroused, he passes out again.

In fact, I’ve made use of it as comic relief in more than one book, a suspense (With a Vengeance) and a romance (Walk on the Wild Side). Every time the hero gets excited, over he goes. So if you hurt him enough to cost him a couple pints of blood, give him some liquids and a good steak and be kind enough to let him wait a few days.

Authors are also fond of conking people in the head. In fact, there are TV P.I’s who should be in a long-term care facility from all the times they’ve been knocked out. If you hit someone hard enough to knock them out, you cause damage. If you do it repeatedly, you will cause long-term disability. Think of the retired boxers and football players out there who suffer from the debilitating effects of their sports.

And if you knock a character out, they will be symptomatic; some variation of dizzy, nauseated, sweaty, confused. And those symptoms can last for quite a while.

Another thing to know is that if a person blacks out from a head injury, they always suffer a certain amount of retrograde amnesia. If they lose consciousness, they don’t remember how. The longer the period of unconsciousness, the more time they lose. When I worked ER, it wasn’t at all uncommon for an accident victim to remember nothing past breakfast.

Barely a Lady by Eileen Dreyer Book CoverEven if the person doesn’t completely lose consciousness, the trauma can cause amnesia. It’s like the body is kind enough to flood the victim with endorphins that blank out the initial pain and trauma. I came across an accident once right after it happened. The victim never quite lost consciousness, even though he was gravely injured. And yet when we met years later, he told me he remembered nothing from breakfast that morning to the moment two weeks later when he found himself in the ICU.

Yes, some of the memory might come back (okay, I used that one in Barely a Lady), but not all of it. So having the heroine wake after a week to remember the drug dealer swinging a club at her head just doesn’t work.

The thing is, there are plenty of people out there who have this information. If you don’t know a medical person, somebody you know does. And if you still can’t find anybody, look up D.P. Lyle, MD. HTTP:// . He not only writes a blog for authors but answers questions. It’s easy to check. And if it’s a major plot point in your story, it’s even more important to clear it first. You know, call your friend the trauma doc and say, “So, if I have a hero who’s been in a car accident and broke his thigh, six ribs and his nose, can he get it up?” You might make your friend’s day.

And if all else fails, I’m around. I’m not DP, but I did sixteen years as a trauma nurse, am trained in death investigation and tactical medicine. I can at least tell you if a guy with six broken ribs wants to be doing push-ups with his significant other right after he gets out of the ER. I would be happy to help keep a reader from snorting and saying, “Well, that’s not gonna happen.”

Places you can find Eileen: Her website, Facebook, Twitter, and Instagram.

(I’m everywhere, but I spend the most time on Facebook)

Thank you so much, Eileen! I snort laughed through parts of this every time I read it. And yes! Spot on! Come on authors and readers! What did you learn? Have you fallen into any of these oops or faux pas before?

6 thoughts on “Guest Eileen Dreyer: Physical Trauma on Characters

  1. dholcomb1

    This is a really cool post!

    Concussions are no joke. The one I had last summer was the worst. Took me months to recover from it. My oldest had one so bad when he was in high school, he had an academic note from the doctor. They are TBIs.


    1. Limecello

      Oh my gosh, Denise, months!?!?! 🙁
      And your poor kid too.

      I got a concussion in HS – blacked out and everything … I’m still salty about it because of the repercussions from a totally “random” thing – I missed an after school practice -ONCE in THREE YEARS because of the concussion. Because of that the “coach” said I “didn’t show dedication” and pulled me from the team for states. Bitch.

      1. dholcomb1

        I’ve had a couple from car accidents, but this one was from a fall. I slipped on wet pavement and went down hard on my driveway. I never posted it on social media. Injured my knees and an elbow, too. But, my cognitive stuff was a little messed up. Put my writing on the back burner. Worst timing, too. My husband was out of state because his mom was having cancer surgery at Memorial Sloan Kettering. Other stuff, too, but I don’t need to tell you all of it. Craptastic time.

  2. Limecello

    Thank you so much for this post, Eileen! I’m going to have to watch out for a hero passing out (or not passing out) in future books. Would kinda love to see it in a historical too, and maybe the ensuing [confusion?]
    And I did NOT realize just how tricky bullets are to get :X … for the old ones/in historicals – was it because they were made of lead they needed to be dug out? Or was that “just the thing everyone did”? (Thanks!)

  3. Lil Marek

    I know I’m coming in late here, but thank you for this post. I suspect a lot of writers are like me—all we know about injuries is what we read in novels or see in the movies. Although since I know three people who have fallen and broken a shoulder in this past year, I’m less likely to think a bullet there would be any kind of picnic. I’ll settle for a graze if I need a wound, I think.


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