Writing Tips: Concussions Edition
In keeping with my typical style, this post is not about the medical facts of concussions, as you can google those yourself pretty easily. Instead, it focuses on the more writing-oriented aspects of head injuries, as well as details that require some first hand knowledge to get right. I’m a hockey player, so in my day, I’ve both seen and had some nice bonks to the head to draw from. I’ll start with the hits themselves and then move into the immediate aftermath, and finish up by touching briefly on long-term effects.
The sounds of a concussion are surprisingly varied, and depend both on location and perspective. If you hit your head on something hard like concrete or a gym floor, you will hear a crack like something brittle breaking. You may not focus on the sound for very long (or possibly not notice it at all) but those around you will definitely hear the same gunshot-esque crack. On softer surfaces, like firm dirt and grass, the sound of your head hitting the ground will be more of a konk sound, both to you and those around you.
When you hit your head, it will probably bounce. If you’re not too out of it already, you will feel this and it is kind of funny. In my experience, you get maximum bounce from hitting grass or hitting a hard surface while wearing a helmet, and minimum bounce from direct skull-to-concrete action.
If you hit the ground shoulders or back first, the momentum from your fall will whip your head into the ground, making the impact to your head worse than the initial fall. You can also hurt your neck like this. This motion will be dramatic enough to be noticed by outside observers.
Hitting your head fairly lightly doesn’t usually hurt right away. There will probably be a moment of shock before a wave of pain comes, originating from the point of impact and sweeping through your head.
Light hits to the head (which I will now refer to as non-concussion hits) can still cause a significant amount of pain and disorientation. It may take a little while to accurately judge how hard you actually hit your head, as it is a sensitive region of the body. If the hit was a non-concussion hit, however, the original wave of pain will move through your head and fade away soon after.
Hard hits (concussion-causing) are a bit different. Those might start hurting right away, though not in a way that registers as pain to you. You might indeed see bright lights and blurry images, though they probably won’t seem like the cartoon kind. It’s more of a look like you’re still moving very fast, even though you’re still.
In that same disorienting time period, you probably won’t be able to tell what you’re doing or what kind of position you’re in. Your brain is scrambled and your body is in high-alert. For a good panic-inducing ten seconds or so, you will be living in a world of extreme pain, bright colors, blurry images, and confusion. The best way to describe it is that sensations register in their most simple forms. Someone yelling to you will simply register as sound. Nothing more specific. Just sound.
From the outside, this is a very distinctive look. Someone who has just hit their head will probably curl their arms around their head instinctively, balling up to protect themselves. They may seem completely panicked and unreachable for a little while, and they’ll need some time to process what happened.
Now, there is another level of head injuries: the ones that knock you out. If you get hit hard enough, you might just briefly black out. People around you probably won’t notice unless they know you well (example: I can tell right away when one of my teammates has passed out, but for another girl, I wouldn’t know), and it doesn’t seem like a big deal. If you manage to get up after this, it’s probably because you have no idea what’s happening. You won’t feel any pain. You won’t feel or think much at all for a little while, actually.
If someone is severely concussed (the brain injury kind) they might be in and out of consciousness for a while. They’re not totally out, but they might as well be. This is very dangerous, and you should call emergency services.
Now it’s time to get into the aftermath of a head injury. Not the medical treatment, but the much later stuff. Someone with a history of concussions is much more likely to get one again. That’s fairly common knowledge. What’s not is the fact that those same people may react differently to even light hits to the head. What may seem like a simple tap to you could cause them extreme pain for several minutes at a time. The more times you get hit, the longer it takes you to recover.
Now, let’s talk about writing experienced characters. In the same way a wrestler can tell their weight without a scale, someone who is used to head injuries can probably tell right away if their injury is severe. They know all the signs. They don’t need to wait for the bump.
Fight scenes and concussions make good combos, especially when you bring in experienced characters. A character who is focused on their own safety or some goal will probably spring right back up from a non-concussion hit or even a light concussion-causing hit. There will be a moment of disorientation, sure, but after that, their first instinct will be to run for safety. Get somewhere safe ASAP so you can assess the injury. This occurs almost unconsciously. When I hit my head in hockey, I’m at the bench almost before I know what’s happened.
However, you cannot “fight through” a major head injury. This is something I see a lot in fiction. No matter how badass you are, there comes a point where you just can’t get up, and even if you can, you’re useless. It’s not about pain tolerance or any kind of toughness, because concussions aren’t normal injuries. When you hit your head hard, your world goes away for a little while. You’re in pain, you’re confused, and you can’t really control your own body. There’s no getting up from that, at least not right away.
Hope you guys found this helpful! I’ll be back soon with more whump writing tips, turning my hockey playing into creativity.
