What's Up, Whump?

Hmmm, interesting! I’m curious about what type of scenes you’ve seen exactly, ‘cause I’ll tell you off the bat that Endotracheal intubation is actually better suited laying supine (flat on ya back!)

Mind if I take the opportunity for a lesson?

What is Endotracheal intubation? Intubation is the process of inserting a tube, called an endotracheal tube (ET), through the mouth and then into the airway. This is done so that a patient can be placed on a ventilator to assist with breathing during anesthesia, sedation, or severe illness.

Endotracheal intubation occurs when a patient requires assistance for breathing. It’s honestly that simple.

What condition has been presented that has brought forth the requirement is a whole other story – pneumonia, emphysema, heart failure, collapsed lung or severe trauma – there’s an abundance of reasons. Whatever the cause, physicians have decided that they must intervene and provide airway management to a patient who otherwise cannot provide it themselves.

What happens during intubation? First and foremost, the patient is typically sedated or not conscious due to illness or injury, which allows the mouth and airway to relax. Forced intubation just isn’t going to happen, you won’t get the tube past the larynx and trachea and will cause some serious tissue damage.

The patient is typically flat on their back and the person inserting the tube is standing at the head of the bed, looking at the patient’s feet. The patient’s mouth is gently opened and using a lighted instrument to keep the tongue out of the way and to light the throat, the tube is gently guided into the throat and advanced into the airway.

There is also a small balloon around the tube that is inflated to hold the tube in place and to keep air from escaping. Once this balloon is inflated, the tube is securely positioned in the airway and it is tied or taped in place at the mouth.

There are different dental guards used when a patient is intubated as well as tube holders.

It is the physicians highest goal to get a patient off aventilator as soon as possible. Being ventilator-dependent can lead to a whole load of complications. Sometimes the complications occur simply from management of being intubated, like feeding. Yes, patients are fed when intubated.

To make it possible to safely take food, medication, and fluids by mouth, a tube is inserted into the throat and down into the stomach. This tube is called an orogastric (OG) when it is inserted into the mouth, or a nasogastric tube (NG) when inserted into the nose and down into the throat. The medication, fluids, and tube feeding are then pushed through the tube and into the stomach using a large syringe or a pump.

Routine surgeries aside, a patient who has been ventilator-dependentfor a couple days must be weaned off. The tube is not immediately removed at a whim, rather physicians take the time to randomly cut off the ventilator support, leaving the patient to breathe on their own. During this time, vitals of the such are monitored (especially Co2 levels). This is called Spontaneous breathing trials (SBT)This will determine extubation success or failure. No, it’s not pleasant for the patient. The road to recovery never is, unfortunately.

Ohhh, and let’s not forget secretions. Tracheal intubation interrupts the transport of tracheobronchial secretions (basically Sputum) through the mucociliary escalator (covers most of your bronchi, bronchioles, and nose.) Because mucus is not transported through the endotracheal tube (ETT), it becomes inspissated – thick and gunky – accumulating in the trachea and in the ETT. To remove accumulated secretions, it is common practice to suction the artificial airways and the trachea.

Again though, this is known to cause some damage. This is why doctors don’t want patients intubated any longer than necessary.

So on that note, position of a patient during their time intubated highly depends on their physical condition. Supine – on their back, is best recommended. However, prone – on their stomach – is not unavoidable, especially during certain surgeries. Lateral recumbent (on their side) may also be required if pressure needs to stay off a certain injury. It’s not impossible for a patient to be positioned like this, but it’s easier to manage the airway and ventilation process if supine.

There is a vicious sort of specialness in a villain dispensing with the big stuff like shooting or stabbing to toy with their victims like a cat with a mouse.  This also goes for petty whump dispensed by the writer without involving the villain, per say.  The first example that comes to mind is from the original Die Hard when John McClane is in a shootout with a baddie and a window gets shot out.  In escaping, he's forced to runn across broken glass and slashes his feet to ribbons.  While not a gunshot wound or something of the like, it is still tremendously painful and physically limiting. I mean, I would write a whole post about the wonderfulness of just foot whump - it may be one of my favorite things and highly under-utilized.

Even less damaging, but still OH so satisfying for its wicked pettiness is broken fingers. either the bad guy utilizes s little snap, snap, snap to get the hero to talk, or the hero needs to break his thumbs to, say, get out of some restraints - something that was utilized both on the series Arrow as well as Chuck, just to name two.  Small broken bones, in general, are excellent because they cause pain but are necesarrily life threatening.  Granted, even that can change, based on the needs of the story.  In an episode of House MD, there was a patient dying from an unknown cause.  After the usual investigation and assuming various reasons, the cause was tracked to a broken toe that had been left untreated.  The exposed marrow... okay, I'm not doctorly so I'll simple it up by saying "made everything ouch". 

Small cuts, are always good - especially if they require stitching. ESPECIALLY if the stitching is of the home grown variety (think Supernatural or, if you're old like me, the first Rambo movie).  SPEAKING of Rambo - just a little add; an injury where the character has to burn themselves to cauterize the wound!

Wounds to the face are another under-utilized trope and I really get it! Just from a production standpoint, it could get extremely tedious to have a permanent scar on a character's face - far better a wound that heals with no lasting visible damage. However, there have been instances where actual scars that the actor has have been written into the story and that is AWESOME!!  Two that I can think of, right off, are Indiana Jones and Burn Notice.  In the third installation of the Indiana Jones trilogy (see what I did there?)  a backstory is created for Indiana when he was a kid, played by the beloved River Phoenix.  After being chased by swarthy yet charming criminals, this teenage Indy ends up, of course, on a circus train, as you do.  He falls into the train car with a lion but, as luck would have it, there is a whip in the car with him.  However, unlike his future awesome self, he's not yet skilled with it and manages to flick himself in the lip - earning the current scar.

In Burn Notice, the actor who plays Michael Weston has a scar near his left eye.  In a later season, a flashback shows how he got that scar.  Not from an incident while working as a spy but, rather, because of the violent abuse of his father.

(where the new, the slightly old, and really old fanfic gets bumped to your attention in broken down, comprehension reviews)

Whump Bump of the Month: Laws of Motion

Written by: pennflinn

Posted on Ao3: November 26th, 2017

(word count: 4,858)

Fandom: Flash (CW TV)

Ship: Barry Allen/Iris West

Summary: A collapsing building is just part of the job. Being buried beneath the rubble was never part of the bargain.

Obvious but obligatory warning: The following contains spoilers for the entirety of the aforementioned fan-fiction. It contains quotes and personal opinions, both done out of appreciation for the author’s time and efforts put into their work.

“Laws of Motion” written by @pennflinn was chosen for the b-lated January Whump Bump of the Month for it’s astounding ability to allure a heartfelt sense of loss of hope, struggle, pain and heroism in its such short word count.

@pennflinn is far from new to bringing her audiences in with little words, instead focusing on simplistic punches that wrap up her plots tighter than a shiny Christmas present. There’s no dragging alongside a prologue or introduction when starting this fic -- rather you’re immediately presented with the problem Team Flash and Barry Allen are faced with: a collapsing building.

As the narrative so wonderfully goes on to say, none of this is new for our characters. Iris makes a mental note that, albeit hesitate to call it routine, burning buildings and breaches in the space-time continuum were all coming to be the norm. Still, Pennflinn doesn’t fail to captivate a sense of urgency between characters, gut-punching usage of verbiage like “His groan turned into a drawn-out yell” and “She was staring at her phone, pale as a sheet” doing wonders to satisfy a whump itch.

Character Whumped:

Barry Allen

The Enjoyment of Whump!Barry:

Barry Allen is a unique character for whump, not in the sense of being a superhero -- of which a lot of fans like to gravity towards for the trope of “hero who can’t save themselves” -- but because he has superhealing and an intolerance to prolonged pain, poisons and medications. It’s the latter that really makes the Whump!Barry spark. Though your time torturing the fastest man alive is limited, it can be intense, brutal and bring a mental and/or emotional pain after.

Flavor of Whump:

Foreign object in the skin -- a building collapsed leaves Barry with a back full of tiny shards of glass.

Comforter of the hurt/comfort:

Primarily Iris West with a dash of Cisco Ramon and Caitlin Snow.

[ Laws of Motion ]

The story transcends similar to a constantly moving camera, capturing moments of time scattered throughout an otherwise routine and somewhat insignificant event in Team Flashes life. It’s even mentioned in narrative that after having his back broken, clearing the use of his legs leaves more than just Barry with a sigh of relief.

[ Laws of Motion ]

| Cisco broke into a shaky smile. "So, you've just had a building dropped on you. How do you feel?"

"Spectacular," Barry croaked. He was cut off from further comment by Caitlin tearing off his cowl and fitting him with her own oxygen mask.

"Does anything feel broken?" she asked, while simultaneously shining her penlight into his eyes. Iris didn't need the light to tell that he was definitely concussed. "Can you move your legs?"

It was always the worst case scenario, ever since the Zoom incident. And judging by the way he'd been hunched over that girl, tons and tons of metal pressing down—

Barry's face scrunched as he agonizingly bent one knee, then the other. He groaned as he let them drop back to the table, but he bent each of his arms up as well to prove his mobility. At least, what limited amount he had. |

The groundwork is laid down neatly and without hesitation as Caitlin goes on to explain what the readers already know, and are subsequently excited for.

[ Laws of Motion ]

| Tweezers already in hand, Caitlin felt around for one piece near Barry's shoulder blade. "I'm going to have to pull these out, Barry," she said, having learned over time to narrate her actions. Whether or not it helped with the pain itself, it at least seemed to help Barry in identifying the source of it. "Some of these are..." She moved lower, frowning at the soft flesh beneath Barry's ribs. "...they're buried pretty deep, and I'm afraid some may have splintered into smaller pieces under your skin. They're going to require a minor surgical procedure—"

Barry moaned, and Iris whipped her head toward Caitlin. "Surgery? Isn't that the kind of thing that local anesthetic is for?"

"Minor surgery. We can't use anesthetic," Caitlin said, her face drawn and tight and deliberately blind toward much of the world. "You know that."

"I don't want to," Barry said, shaking his head, half-delirious, the fingers on one arm clenching and unclenching on the sheets. Based on the look of it, Iris was pretty sure the other arm was broken. "Please. Don't. Not now, please." | 

The introduction of a Barry who doesn’t have the strength, mental or physical, to withstand the usual agony of healing his injuries is what makes this story so unique. Pennflinn goes on to spend time focusing on Barry’s struggle with the pain, his ability to hold it together deteriorating moment by moment.

[ Laws of Motion ]

| She pried the pieces from his upper back first, and quickly, so Iris and Cisco could plant their hands on Barry's shoulders and hold him down while he thrashed, screamed, begged, sobbed.  |

Credit where credit is due to a moment of weakness written sharply yet precisely as Pennflinn makes the decision to capture Barry’s pain in short, gut-punching words.

Comfort is later found in the source of Barry’s lightning rod, Iris West. After giving him as much time as she felt she could, she goes to find him in one of the bathrooms in the deepest part of STAR Labs.

[ Laws of Motion ]

| Barry was facing away from her, and even though he was in front of a mirror, he didn't see her—his head was bowed over the sink, his working hand planted on the side and shoulders hunched. The way his spine curved reminded Iris of how he'd looked when he'd been uncovered from the rubble. Arched over the little girl, bracing against whatever might bear down on them both, getting crushed beneath the weight of a building. A loose shirt covered the damage: the stitches, the layers of gauze, the deep red bruises, the cast that encased his shattered arm.

In the ten seconds Iris waited in the doorway, he didn't move an inch, not even when she gave a light knock. It was only when she stepped into the room itself, her heels too loud on the tile, that Barry stirred. She knew better than to touch him, especially not without warning, especially not now. The physical wounds on his back were one thing, but she knew from hard past experience that they were only part of the unconscious touch aversion in situations like these.

"Barry?" she whispered, venturing to break the ice that way instead.

At this, he lifted his head and met her eyes in the mirror.

The lower lids of his eyes were pink, and his whole face sagged. He met her gaze with desolation, misery, a pleading look that said, I don't want to do this anymore.

Without a word, Iris moved forward. She reached out a hand tentatively. He allowed her to place it on his shoulder, her touch light. His face didn't crumple, exactly, but it wilted deeper into defeat. His breath shuddered under her palm, and she softened. |

The clarity of imagery here is worth noting and while never caught properly on the show, I would pay to see this recreated by an artist. Iris’s ability to wordlessly comfort Barry in his weakest moments, free of any judgement or disgust, is beautifully written here.

It’s not long after that Barry disappears, seemingly stuck in his own head.

[ Laws of Motion ]

| He picked up on the fourth ring, just when Iris was beginning to wonder if he'd left his phone behind as well.

"Iris."

"Hey," she replied. All at once she was very aware that she had no idea what she intended to say. "I just woke up. Are you alright?"

"Taking a break." Barry's voice sizzled, popped, through the phone line. "Might be a couple days. Don't worry."

He hung up before Iris could confirm that she was worrying, despite anything he said to the contrary. She held the phone up to her ear still, listening to the dead air.

It was only later that she'd see the international charges tacked on to her phone bill, a twenty-second call at 5:45 in the morning. |

His return is met with doubt, capturing a side to the hero often not seen. The strong, brass, brave Flash is suddenly exposed in the presence of his loved one, stating his nearing approach to a breaking point.

[ Laws of Motion ]

| After the meta had been safely locked away, Barry sat alone for a long while in the recovery bay, elbows up on the cot, face buried in his hands.

"I can't do it," he'd said when Iris had sat beside him. Even under her light questioning, he hadn't said a word more, and eventually she'd let him be.

That evening in the apartment, Iris kept the evening news on low while Barry made dinner. It was part of her nightly routine, practically required given her choice of profession. Tonight, she tuned out most of the national news, the breaking stories, in favor of listening to Barry putter about the kitchen. Steam whistled from a pot, a knife thunked against a cutting board, a can opener ground dully against metal.

The latter part of the newscast, near the end of the broadcast, was what caught her attention. Not because of what they were saying, but by what they were showing. Images of the ruined apartment building, the few piles of rubble that still remained.

Throwing a glance over her shoulder to ensure that Barry was busy, she turned up the volume a few clicks.

"…still missing, following an evacuation by Vibe. Vibe has since ignored our request for comment. With us tonight we have a very special guest in the studio. Six-year-old Grace Parks was shielded from the falling building by the Flash, and she has a message for him tonight. Grace?"

Grace Parks, round-faced and pink-cheeked and so vibrantly alive that only a six-year-old could be, faced the camera. She wore an earnest expression as she studied the camera lens, no doubt never having anticipated appearing on the news.

"I just wanna say," she began in her squeaky voice, "that Flash told me I was gonna be okay and now I'm okay. And I hope he's okay, too. I miss him." She glanced furtively off to the side, as if looking for confirmation that she was doing well. When she turned back, the corners of her mouth were downturned slightly. "Flash, if you're listening, I miss you. Thank you for saving me. You're my hero. And I wanted to say that. Thank you."

The feed cut back to the two news anchors, one of which was nodding sympathetically. "No doubt we all feel the same as little Grace—"

Some sixth sense caused Iris to angle her face back, and she was shocked to find Barry standing behind the couch, fixated on the TV. She quickly punched the mute button on the remote. |

Barry’s struggle between his own physical well being and the well being of others is so well detailed in the story, if not profoundly stated in the scene that follows.

[ Laws of Motion ]

| Once, when they were kids, Iris had accidentally knocked over Barry's Lego Star Destroyer and sent hundreds of tiny pieces skittering across the floor. Through her tears, she'd apologized over and over, feeling she'd destroyed something precious, something that could never be put back together. But it can, Barry had told her. Staring at the seemingly infinite number of broken parts peppering the bedroom floor, Iris had asked How? And Barry had smiled reassuringly: One block at a time. |

The story concludes as Barry aka the Flash goes to spend his time rebuilding the building that collapsed, inspired by the little girl he saved and returning her home to her.

Favorite Aspects:

[ Laws of Motion ] holds a side of Barry Allen that I have yet to see in any other written works. It seizes a side of weakness to his character without over-saturating the emotions. The blip of tears, cries, struggle and agony are all believable if not as well executed as Grant Gustins performance of Barry Allen within the show.

Fantastic question!

Mind if I TL;DR the answer a bit?

Consider the heart to be like your computer monitor or TV screen. What’s the first thing we typically do when the screen starts to frizt out on us, blinking and flickering and going apeshit?

We smack it!

A defibrillator is similar. When the heart’s electric rhythm just goes all wacky, the shock from a defibrillator restores it to it’s normal pace.

You see, defibrillators are designed to produce an electrical shock to disrupt certain chaotic and disorganized heart arrhythmias such as: Ventricular Tachycardia and Ventricular Fibrillation (defibrillate = disrupt fibrillation—see?). These two are known as “shockable rhythms”.Ventricular Fibrillation (VF or V-Fib): This is when the ventricles of the heart are thrown completely out of synchronization and instead of pumping, they begin quivering erratically, which does not allow the heart to adequately contract to get the blood out to the rest of the body. It looks like this:

By sending a shock to disrupt the disorganized electrical activity, defibrillation momentarily stops the heart, allowing it to reset and the natural pace making function to hopefully resume a normal heart rhythm.

Think of Defibrillation as the CTRL+ALT+Delete function when the heart goes haywire.

The reason defibrillation doesn’t work on a heart that has stopped beating is because there is no electricity to shock. Think of it like trying to change the channels on the TV when the TV is off. You need to turn the TV back on for it to work. CPR would act as a placeholder for manually getting your ass off the couch and turning the TV on yourself without the remote. Chest compression can keep the heart working until medication possibly restores a heartbeat. Medications may be able to restore a heart beat in some (rare) situations, but a shock to the heart will not.

As a matter of fact, YES!

Don’t get me wrong, there are so many great whump tropes that I’ll never grow tired of. Appendicitis, anyone? I’m pretty sure both Stargate fandoms (SG1 and Atlantis) have an appendicitis story for 1 of every 5 fanfiction you come across. And each one is glorious in it’s own way.

But at the same time, especially being in the medical field, I come across so many bizarre conditions that I would love to see inflicted on my favorite characters. Unfortunately, I think the mere amount of explaining required in the narrative would take away the enjoyment of the whump for a lot of readers. I’d be worried they’d get confused, overwhelmed or simply not understand and click out. I also wouldn’t blame them.

I can’t think of any specific outside sources of whump, although poisoning will always be a favorite of mine. I have a huge list of physical ailments though!

Some odd whump I’ve daydreamed of:

ESRD – End stage renal disease

ASD – Atrial Septal Defect. | | | Now I have seen similar things like this done in Psych fanfiction to explain James Roday’s/Shawn Spencer’s chest scar so I can’t complain too much!

External/internal fixation devices for broken bones

Internal bleeding – not unknown but not done enough!

Sepsis and septic shock – One of my favorite “easy” go-to’s because it’s basically a really, really, really bad illness so you get all the goodness of throwing up, fevers you can’t bring down, ect ect. I also have a somewhat personal attachment to this one after nearly dying from septic shock myself in my early 20’s >_< It can be a great double-downer for whump if the character initially was stabbed, spent time recovering only to have said stab wound get infected and turn into septicemia!

Respiratory illnesses, like Pleural effusion – Aka, he’s got fluid.

Speaking of lungs – Pneumothorax

Tracheal rupture

Skull fracture – not just a concussion, a skull fracture.

Shattered pelvis – yeah that’s a weird one of mine, I’ll admit to that.

Second and third degree burns

I also have had my own fun with medical equipment before, things like intrathecal spinal pumps being used for torture devices. There’s a whole world of whump you can unload with medical devices!This is also one of the reasons I loved House M.D as a source of whump. So many odd cases and hell, if you wanted to write whump for that fandom than you could pick your choice of bizarre conditions. It wouldn’t be odd for them at all.

That’s a tough one.

My answer is literally this: Yes and no.

You see, 99% of the fandoms I’ve participated in have always been…well, I’ll be honest – they’ve always been superhero based. We’re talking Clark Kent, alien from an outer space planet called Krypton. Barry Allen, the fastest man alive with the fastest metabolism to have him run at lightning speeds. Peter Parker, Logan/Wolverine, Steve Rogers – mutants. I’ve very rarely dipped my toes into the “human” side of whump, though it does exists within the superhero world (ie: Matt Murdock, Tony Stark, ect ect) I have done whump for the TV show Psych though, which I’ll use as my reference point for this question.

So, is it incredibly difficult to apply real-life medical knowledge and procedures to a character that shouldn’t be affected by such things? It can be, yes. In a way, the rules have been thrown out the window while at the same time you’re being instructed to “remember those rules!” But you’re looking out the window and the rules are no longer there and you don’t want to follow them but that voice is still instructing you don’t forget them and…oy. Headache much?

At the same time, it opens the door for so many other possibilities. You get to play with that character as much as you’d like! Using a human character with no “enhanced/mutant/special abilities” means that if you apply real life physics, at some point they will break if you stretch them too far. You can’t re-start their heart with a defibrillator, you can’t slice open an artery and they not bleed out in minutes, you can’t knock ‘em in the head and have them “fall unconscious” for five minutes without any head trauma. Real life physics for anatomy and physiology apply and if you’re writing whump, you gotta be real careful teetering on that line of “real” and “absurd.” Now, some readers truly don’t give 2 F’s – I’ve read some crazy nonsense before just to get a whump fix. But you risk deterring a lot of others who at some point will just check out from the craziness.

With characters who “can’t be affected” by the standard norm, you don’t necessarily have a line to worry about crossing. The hardest part is thinking outside the box. What if your character has unbreakable skin but needs an operation? What if your character can’t metabolize medicine and is in excruciating pain? How will these problems get resolved?They aren’t standard problems and as such, the solutions don’t need to be either. Give your character 500mg’s of Fentanyl – after all, what’s the basis that it’ll kill them?

In a way, while non-traditional characters certainly close the door for “standard” medical whump, there’s a whole, bigger door wide open for much, much more. So to that I say…write away.

Whoa, calm down there, Satan.

Lol, jk, I wouldn’t expect any less. After all,

Honestly, I think my opinion is kinda moot in the grand scheme of things. Don’t get me wrong, BOTH those things are awful and horrible and just plain down traumatic events to suffer through. Like, Christ on a stick, talk about your emotional whump. But I think “which is worse” comes down to the character who will be suffering at the hands of this fate, and how they deal with change/trauma to begin with.

Now, don’t get me wrong. I don’t think anyone can be “tough enough” to withstand that sort of blow. Even the thickest of skins will break, at the very least crack, if either happened to them. But their mental capability might be better suited to handle everyone dying at once rather than one by one. The repeated trauma could easily drive them insane if there’s already signs of psychosis or mental instability lingering somewhere hidden within.

Me, personally? If this were to happen to me, I’d rather everyone be killed in a singular event. I don’t believe I could personally handle the “false hope” of losing a loved one, leaning on the shoulder of another loved one and having THAT loved one die, and so on and so forth until everyone is gone. I’d never be able to love or trust or hope again, lol. So that option would be the worst to encounter – again, just my opinion.

On a serious note, I had a discussion somewhat similar to this a couple years back with my husband. My childhood friend’s father passed away after a grueling 20some year battle with multiple different cancers and ailments. By childhood friend, I mean this family was my second family. Her mother was there for me when my own mother was constantly in and out of the hospital. We unfortunately drifted apart as we grew older but thanks to the wonders of Facebook (back before I deleted all social media) we kept in touch. Long story short that’s how I found out her father passed and that’s when I made the five hour road trip to attend the wake. ‘Cause I felt it strongly in my heart that even if you grow apart, you still carry certain people with you, and time spent apart doesn’t negate that.

So anyway (didn’t I say long story short at one point? Oy) I was discussing with my husband which we felt was worse: Being a family member/loved one of someone dying very slowly from painful diseases, or just – dying. One day dying from an aneurysm or a stroke or being hit by a bus. Obviously, if this were US dying, we’d chose the latter. We don’t want to suffer. But as a family member/loved one, do we let that person suffer so they can “live” a few more years, and in turn give us time to prepare for grief and mourning? Can we even prepare for such a thing? Does, in a twisted sense, knowing that their time is up soon, that they have a somewhat definite timer set on their lifespan help us grieve? Or is it easier to grieve ripping the band-aid away? Or is it HARDER to receive that sudden, blow-to-the-gut news that soandso died in a car accident?

(where the new, the slightly old, and really old fanfic gets bumped to your attention in broken down, comprehension reviews)

Whump Bump of the Month: The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street

Written by: caraminha

Posted on Ao3: August 13th, 2018

(word count: 12,946)

Fandom: Marvel Cinematic Universe/Avengers/Iron Man/Spider-man: Homecoming

Ship: Platonic Irondad/Spiderson

Summary: Prompt from my Tumblr: Have you heard of tetanus? I’m studying it for school and it’s got lots of angst potential - it causes severe, seizure like muscle spasms which can break the patient’s bones, but they’re conscious and fully aware of what’s happening. It also causes fever and lockjaw, and difficulty breathing. I’d love to see an angst fic where Peter has bad tetanus and Tony and co are looking after him whilst his symptoms get worse and worse.

Obvious but obligatory warning: The following contains spoilers for the entirety of the aforementioned fan-fiction. It contains quotes and personal opinions, both done out of appreciation for the author’s time and efforts put into their work.

“The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street” (a mouthful, ain’t it?) was chosen for December's Whump Bump of the Month, and subsequently the first Whump Bump of the month is due to its captivating ability at creating a tense whumpy and hurt/comfort dilemma in short a short span of words. I always find myself referring back to this fic either for references or mere enjoyment, and I’m never not amazed that everything occurs in a simple round-off of 13k words. It never feels rushed or poorly paced, and even the most simple sentences tend to leave a punch to your gut.

From the beginning, Caraminha leads you to feel the tension of an approaching storm, like dark clouds looming over the horizon the moment the story begins – which, by the way, is one long and smooth one-shot. We begin with Tony Stark driving, Peter Parker as his passenger. We’re told in narrative that the two have taken a road trip to California, specifically to visit colleges. It’s almost a “calm before the storm” moment as the two laugh heartily, Tony assisting they take the Audi being a nice tie-in from RDJ’s sponsorship of the cars and the “Peter’s driving lessons” videos, of which I insist are cannon. It takes less than 1k words to establish that the two have a unique bond, a fatherly/son type of air between them that isn’t forced into the narrative with “son”’s and “dad”’s ending off sentences.

It isn’t long before the whump starts.

Character Whumped:

Peter Parker

The Enjoyment of Whump!Peter:

Peter’s such a smol bean, an innocent fray to this crazy world of the MCU. He’s a protagonist to his own story, even when paired with Tony Stark, which tends to be a go-to for a lot of whumpers who prefer to see their main guy get whumped. Even in stand-alone versions though, comics or Marc Webbs/Sam Raimi’s movies, there’s a certain appeal to the superhero getting hurt. Heroes like Peter Parker can’t buy their way back to recovery, usually needing to find a way to survive on their own. And when paired with characters like Tony Stark, a lot of whom consider to a pseudo-father of sorts to young MCU Peter, it can bring out a nurturing father/son trope that fans love to flock to.

Flavor of Whump:

Tetanus, a serious bacterial infection caused by Clostridium bacteria.The bacteria live in soil, saliva, dust, and manure. The bacteria can enter the body through a deep cut, like those you might get from stepping on a nail, or through a burn. It affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and can threaten your life.

(We have a vaccine for it. Get your kids vaccinated.)

Comforter of the hurt/comfort:

Tony Stark

The narrative wraps up their trip, making fun of Peter’s child-like wonder of Tony’s expensive taste in hotels and the enjoyment they have a the Golden Gate Park. The author brings us back to the car-trip, where in one line the whump is dumped on the reader in a glorious way.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| “Tony’s smile turns at the corners into a grimace when he sees the position Peter’s in – slumped forward, his neck at a weird angle. Peter had mentioned yesterday that his neck and jaw had been a bit stiff and sore. Tony had joked that he was probably sleeping on the ceiling just because he could, and that was why his neck was playing up. Peter had laughed, said something about taking a hit on patrol.

From then on, Tony couldn’t help but notice every time Peter rubbed his mouth or winced slightly at a movement, and had resolved to take the suit in for upgrades; starting with more head and neck support.” |

Our comforter, in this instance Tony, has already told us what we need to know going forward: Something’s up with Peter’s neck and it’s getting worse. The simple usage of the word “grimace” implied how Tony’s concern is deepening, and in so it relays to us – the readers – that shit is about to go down.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| Peter doesn’t stir. Tony sighs, leaning over to push him back against the seat with one hand against his chest. Once he’s there and the seatbelt is more lax, he tries to ease his head back a little, withdrawing suddenly, fingers curling at the surprise heat he finds on Peter’s brow.

He coughs under his breath, confusion spreading under his features. He corrects the car’s course an inch to the left, thankful they’re on a straight, almost empty highway, and presses his entire hand to Peter’s forehead. |

After Tony succeeds in waking Peter up from his (later to be discovered) feverish sleep, their back and forth banter gives both the characters and readers a false impression of hopefulness. Peter insists his fever is only due to his hoodie and that he’ll stay awake to keep Tony company. They stop for food and despite Peter’s still increasing temperature, he seems like himself, only quieter. Narrative, of course, tells us a different story.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| He definitely doesn’t inhale his food like he normally does, or order seconds like he normally does, and when Tony orders himself seconds, he excuses himself to the bathroom.

Tony eats the onion rings first in the couple minutes he’s gone. He has his suspicions that the strong smell wasn’t agreeing with the kid. And, as always, his jaw’s bothering him. Neck, too. |

Escalation of Whump:

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| Peter breathes out a laugh that turns into a more forced exhale when he moves to sit up straight. He leans forward tentatively, head in his hands. Tony’s jacket slips down from the window into his lap and he digs a hand into it.

Tony balks. He can’t reach for him, the road around them is busy. “Hey, hey, hey. Easy. What’s wrong, buddy?”

“M’okay. Just got sorta dizzy.” Peter says, not moving from his position. “I thought—it’s okay.”

“You thought what?” Tony pulls up into gravel of the shoulder as gently as possible. He undoes both his and Peter’s seatbelts.

He hesitates over what to do now he has his hands free and settles on rubbing a hand up and down Peter’s lower back. “Stay like that if it helps, Peter.”

“Thought I might pass out.” |

It’s when Peter nearly passes out in the car that the situation takes a nose-dive. The urgency of the situation is written as Tony tries to find any sort of hotel or motel to stop at for Peter’s comfort, and it’s when they stop at a motel that his concern is spoken without words – Tony Stark typically does 5star hotels, not dingy motels. It’s a small action like this that speaks to his worry.

It’s there at the motel room that things seem to take a turn for the worse. A simple attempt at a tiresome yawn has Peter’s jaw locked with rigid muscles, turning concern into full-fledged panic.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| He inhales deeply, as though about to yawn, and Tony takes that as his cue to move away back to his makeshift office, when Peter yelps in shock. He shifts back around to see the kid with his mouth hanging half open, hands probing his jaw desperately.

He’d have made a joke about the wind changing if he had a little less tact.

“Pete?” He comes to sit on the bed, taking his hands calmly and moving them away. Peter barely allows his ministrations, his groan coming out more guttural and unsettling since his mouth was open. He rolls onto his back so Tony can see better. He winces when Tony’s fingers brush against his face. “Hey, it’s alright. I’m just taking a quick look. No surprises.”

Tony takes his chin in his right hand as carefully as he can. Peter’s mouth is almost shut, his teeth bared like they usually would be mid-yawn. They couldn’t have been more than an inch apart, his mouth more a rectangle than an O.

He was gasping at the back of his throat, eyes roaming over Tony in question. “It’s okay, easy. You’ve probably just clenched it too hard in your sleep and it’s locked. It’s happened to me before.” Peter tries to nod in Tony’s hold.

Tony takes his hot face more firmly in his hands and runs his thumbs in circles along the highest point of his jaw bone, the bases of his palms just above the wrist cushioning his chin. “Stop me if this hurts too much, alright?” |

There’s something oddly pleasing about reading sentences like “Tony takes his chin in his right hand as carefully as he can” and “He was gasping at the back of his throat, eyes roaming over Tony in question.” It really brings forth a sense of uncertain necessity to one character so desperately needing the others comfort, like how protective a mother cat becomes once giving birth.

Like highs and lows of a roller coaster, we’re once again lead to believe that maybe, just maybe things will be alright. Peter insists, “It’s not so bad. I’ve had worse.” Tony isn’t fully buying it, but the spider-kid’s body is so weird he isn’t sure what to think. They both fall asleep for a short while.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| “Mr Stark? I— ah—” A gasp.

He pauses for a split second, checking to make sure he didn’t imagine it, then sits bolt upright. “Peter?”“Mr Stark,” he sounds breathless. Tony reaches for the lamp.

Illumination billows into the room like smoke and he feels his pupils constrict. His eyes go straight to the kid sitting on the floor, knees drawn up. “Peter?”

Well, whaddya know? It is that bad. |

You really gotta love the use of that last narrative line. Telling us what not only Tony knows but implying so much more, that the false security they both had been trying so hard to relish in was officially stripped away, gone, blown in the winds a tornado and never to be seen again.

Tony has no idea what to think – again, it’s a Spider-kid physiology and this could be anything. We’re led through his impossible, erratic and panicked thoughts as he tries to get Peter back on the motel’s bed.  

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| Up close, Peter smells of sweat and the same floral detergent that their entire apartment smells like. Tony thinks of May, and what she’d do. |

A fantastic line of narrative as again, we’re not forced to read about this father/son relationship the two have through “it’s okay, son” and “help me, dad” but rather a simple inner thought of how Tony isn’t a father, he isn’t paternal and he’s left wondering what the actual parent in the situation would do.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| Something flashes through his mind, a possible diagnosis that rings a bell when the words lockjaw and stiff neck and fever go together, but he shakes his head. Peter’s been vaccinated. May is not, was not, never was and never will be, an anti-vaxxer. He knows that for certain.

But it looks so much like… |

Peak of the Whump:

Tony immediately jumps into action. He calls Happy, insist he get some sort of transportation to his location a.s.a.p. Bring Bruce Banner with him, because he’s still clueless and his best guess is only a guess, and one he hopes to God is wrong.

And then he’s left waiting.

The time between Happy and Bruce’s arrival, and the time he’s left alone is wonderful emotional whump within a physical whump story. We see Tony pacing, panicking, trying to comfort Peter while not having a full fledged panic attack. We see Tony, someone so normally calm and kept together, unraveling at the seams.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| Tony turns and palms Peter’s face, hoping Peter’s going to ask him to do something for him, to give him something to do to help.

“Kid?”

“I think I’m gonna throw up.”

Peter’s sitting up and heaving and crying before Tony can grab the trash can, and suddenly he has a sobbing kid covered in vomit and their only bed faring not much better.

“Sorry. I’m sorry. I’m sorry.”

He’s really crying now. He’s holding his stomach and bent over it as much as his neck will allow. |

There follows a touching yet uncomfortable moment where Tony has to help Peter undress from his own sick, insisting that the older man close his eyes as he changes his pants because, well, he’s still a teenager and that’s mortifying for him.

Lines like “Peter whines softly into his shoulder” and “Tony’s stomach pitches in affection and raw concern” go on to demonstrate the quality of whump the author strives to achieve. It’s not whump for the sake of whump, it falls into hurt/comfort territory that wants to build character, not stagnate them.

Peter passes out, Tony does a regretful WebMD search, and not long after  both Happy and Bruce arrive. They’re quick to transport them to the nearest helicopter, stationed miles away. Bruce tells Tony what really matters – teanus or not, whatever illness he has is taking advantage of his enhanced state. It’s progressing faster than what it should.

Our answer is provided in a cell phone conversation between Tony and May.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| “Tetanus? Oh, my god. My poor baby. Tetanus? Tony, it can’t be tetanus. I got him immunised. I—I made sure he got all his boosters! He hasn’t been bit by any feral animals or—how do you even get it? What’s happening to him? Where are you? I need to see my baby.”

“I believe you got him vaccinated. Bruce thinks he needs to be re-immunised after the spider mutation. And it doesn’t have to be through an animal bite. I don’t really know how else, I only Googled it for a second. Dirt? I don’t know.”

“The mud run…” May breathes.

Tony straightens. She’s right. |

Conclusion of Whump:

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| Peter comes round all at once. He shouts out in agony, and Bruce leaps to dole out the analgesia.

Tony cups his cheek instantly, blocking his eyes from roaming around the darkened room. “Hey. Look at me, kiddo. It’s okay. You’re okay. You’re alright. Bruce is gonna help you.” |

Peter’s informed of his condition; that he’s contacted tetanus and they’re going to do everything they can to fix it. But because of his abilities, pain medication isn’t going to effect him much, at all. It’s here Tony and Bruce have to remorsefully tell him he’s going to experience painful, agonizing muscle contractions and seizures.

And Tony has to stand by to watch it happen.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| Peter’s eyes are open, darting around and terrified. His entire body seizes at once, his torso, arms and legs aggressively jerking inwards every second or so. It looks like some kind of demonic possession in a horror movie, and Tony wants nothing more than to look away. To just let it pass. He’s never wanted something to end so much in his entire life. And he’s been captured and tortured by terrorists. |

Tony’s concern really shines through with the last line, showing how much more painful his emotional connection to Peter is when the going gets rough. They manage to get through the helicopter ride and bring Peter back to the compound, where May waits for them both.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| May goes almost… green when she sees Peter. They’re pushing him on the stretcher into the med bay, which she’s sat outside of, ripping up an old receipt into little pieces that fall into her purse.

Peter’s whole body is jolting again and again and again like he’s being electrocuted and there are wires going everywhere, and the big scary oxygen mask dwarfs his face. He’s making a broken keening sound in the back of his throat, which heightens when Tony reluctantly lets go of his hand to give the team room to work around him. They disappear through the medbay doors, one of them requesting they give them some time to stabilize him.

May is frozen, standing there with her purse on the ground. Pieces of receipt are scattered everywhere. |

There’s a heart-to-heart between her and Tony, one of which I love because it shows a soft side to May that just doesn’t get around much. She’s not angry; she’s sympathetic. She knows Tony cares for Peter and doesn’t dare admonish him or entertain his blame. She supports him and insist he goes takes care of himself while they wait in limbo for news.

What surprised me the most about this fic was the brief but adorable team scene that occurred not long after this. Steve, Nat, Wanda, Clint are waiting to hear news – it travels fast up the grapevine.

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| “Sam’s sent me 4 texts about him.” Steve huffs a laugh. Tony smiles.

“He’ll be ecstatic to hear that.” Tony knows Peter thinks Sam Wilson is about the coolest guy on the planet. He’s pretty sure the feeling is mutual, especially ever since Sam found out that Peter had chosen to write an essay on him, specifically on his work as a PTSD counsellor.

“So he’s okay?” Wanda asks.

Tony sighs. Their faces fall. “No. He’s not good right now. Bruce says itis tetanus, and he’s given him the antitoxin, and the antibiotics, and the anticonvulsants… he’s had about every anti under the sun at this point, but…”

“His enhanced healing isn’t working?” Nat asks.

Tony shakes his head, holding up his hand to lazily point at her in agreement. “I’ve never seen the kid get so much as a runny nose before, let alone tetanus.”

“Jeez. Tetanus. It’s rough.” Clint mutters, looking angry. Clint’s the kinda guy to issue a death threat against tetanus itself. Tony wouldn’t be surprised if he succeeded, either.

“Is there anything we can do?” Steve asks tentatively.

“Hell if I know what I can do, Rogers.” Tony murmurs. “Just… when he gets better,” they all nod enthusiastically at his wishful wording, “come visit him? Kid loves hanging out with you losers, for some reason.”

He smiles at them, knowing that exhaustion and anxiety are blatant on his face. They all smile softly and nod, agreeing unequivocally.

Tony jerks his head back at them. “Thanks, folks. Does, uh, anyone else want coffee? I’ll—”

“Boss, Dr Banner’s about to speak to May Parker.”

“Scratch that. Make your own coffee, I guess, you lazy schmucks.” |

The concern spoken about Peter without elaborate monologues or inner thoughts does wonders for a much needed team-fic fix. You see how much everyone cares in a few paragraphs, Clint himself being a father and Sam having sent so many text messages regarding the situation. It’s a nice bit of world-building in a small moment.

Bruce goes on to tell Tony that Peter’s going to get better, and in one sentence of narrative, “Tony considers the fact that there in fact very well may be a god.”

[ The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street ]

| “Hey! Don’t you move that neck of yours, Peter Parker.” May warns.

Unsettled, Peter tries to swallow and gags on it, and she gingerly strokes his throat to calm him down.

“I’m here. Tony’s here. Okay? You’re safe and you’re getting looked after, and,” she lowers her tone and catches his cheek to get his full attention, “the more you stress out, the longer it’ll take for you to get better. You’ve been really sick, baby. I was scared.”

He gasps twice, convulsively, then settles. “Don’t cry, honey. You’ll set Tony off too. You know what he’s like.” She looks up at him and winks.  |

And so the story ends as it began: With Tony and Peter, a lighthearted conversation that has the two laughing, only this time with less tension in the air. Peter cracks a joke, Tony adds a sarcastic remark, and we’re left concluded with only wet grass to show that it ever stormed.

Favorite Aspects:

“The Primary Reason Tony Stark Would Throw Down With an Anti-Vaxxer in the Street” is a fantastic little burst of whump, written by @caraminha

There’s verbiage through out in at all the right places that really somersaults your gut, a perfect balance of both whump!Peter and comfort!Tony with added May love and Team care. 

Moments like Peter throwing up in the motel room and being unable to dress himself satisfies a whump itch you didn’t know you had until you read it, and it leaves you wanting so much more while perfectly okay with the ending you got.

Tonight I'm pondering the concept, far too rarely explored (imo) of permanent injury/disability whether physical, mental, psychological...

I'll be very upfront- my pool of resources in this regard is likely quite small considering what may be out there so please be aware of that as I blunder my way through this and I welcome all additional insight, details, to help flesh this thing out into a more comprehensive post. :)

Spoilers to follow for Sherlock (BBC), House M.D., How to Train Your Dragon franchise, Doctor Strange, and Iron Man (as well as related Marvel films).

I'm fascinated by permanent disabilities - possibly because, in my life, they are so common.  Nearly everyone I know, friend and family alike, have SOMETHING going on.  For some, it's rather minor and easily ignored.  For others, it informs on every day of their lives.  So why, then, is it such an infrequent thing with regards to beloved characters?  I mean, I understand, from an acting standpoint, that incorporating disabilities has a host of complications...  So, heck, let's lead off with that!

The first series that comes to mind with a disabled character is "House M.D."  From the very first episode we meet a man with a cane and a bad limp - the result of an infarction in his right thigh muscle that led to muscle death and some radical surgery just to save the limp.  However this also left him in permanent pain and battling a rather major addiction to pain medication.  Now, it wasn't just the character affected but the actor, Hugh Laurie, actually developed an injury from his constant use of a cane on set and had to wear a sling and switch the cane to the other hand for a while; something they actually incorporated into the series.

Another character who already has an injury, prior to the series, is John Watson from "Sherlock".  He was invalidated home from military service after getting shot in the shoulder.  He had also developed a psychosomatic limp and had needed a cane - but his work with Sherlock cleared that up.  However, while we don't see much to his shoulder injury after the first episode, the series regularly references his PTSD - typically in the form of nightmares.  It is Sherlock, however, whom we see the development of psychological symptoms onscreen.  I don't know if they truly qualify as PTSD or if another type of mental breakdown simply because his condition is so unique.  Due to severe childhood trauma, Sherlock actually erased memories of connected events - and his sister, in particular.  For decades, he didn't even realize he had a third sibling.  where it is less specified, in the series, is how much this informed on Sherlock's personality later on.  To quote the man himself, "I am the most unpleasant, rude, ignorant and all around obnoxious asshole that anyone could possibly have the misfortune to meet. I am dismissive of the virtuous, unaware of the beautiful and uncomprehending in the face of the happy."  Whether he would be that way, without the trauma, may never be known.  Unfortunately, without further episodes, the impact of discovering his horrific history may, also, never really be known.  The fact remains, however, that the restoration of those memories would potentially be a trigger for some major PTSD.

The next one on my list, unlikely as it seems, is actually a computer animated fantasy series based loosely on a book series of the same name: "How to Train Your Dragon" (HTTYD).  We get a two for one in this film/Netflix series.  The franchise focuses on a clan of vikings living in a village known as Berk.  The primary protagonist is the small son of the Chief who's name is Hiccup.  In this world, Berk has been at war with dragons for centuries.  Unlike his fellow vikings, though, Hiccup finds himself unable to kill a dragon he injured and, instead, creates a friendship.  The dragon, Toothless, was permanently injured when Hiccup shot him down - leaving him incapable of flying without a special saddle and prosthetic created by Hiccup so that, with a rider to control his tail fin, he can get back into the air.  At the end of the first film, Hiccup, also, suffers a permanent injury when he loses his left foot just above the ankle.     

Two more characters of note; whose disabilities happen on screen, are Tony Stark and Stephen Strange.  Tony suffered shrapnel injuries to the chest, leading to the arc rector whereas Stephen's hands were crushed in a car accident leaving him with permanent nerve damage.  Stephen's hands never stop shaking - though the severity lessens a bit after the first months.  However, even as late as Infinity Wars, they still shake noticeably.  For Tony, we never really see the physical injury limiting him in any way - though there is a lot of fan speculation as to what the housing unit for the arc would do to his breathing.  Plus I cannot believe there wouldn't be some chronic pain given the location and the muscles and bone that would be compromised.  Additionally, while it is never specifically mentioned, Tony appears to have chronic issues with his left arm - starting with the injury sustained in Afghanistan.  Repeatedly, thereafter, he is shown either favoring it or re-injuring it (his sling in Civil War).  After Avengers, though, Tony also develops PTSD; which heavily impacts him going forward and leads to a lot of very questionable decisions based purely on his (justifiable) terror. 

So that's canon character disabilities - but when is comes to fanfic, this is, oddly enough, something is seems that a lot of writers, whump writers like myself, included, seem to shy away from if it isn't already established.  I've certainly read quite a few that attempt it and do a fantastic job, really!  What I especially love is seeing how the characters cope and move forward in spite of whatever they're dealing with.  I just finished a Sherlock story where Sherlock suffered permanent nerve damage in his lower legs - which was what led to this whole post.  It was really magnificent; in particular for how it removed Sherlock's ability to race around London like he used to.  But what truly made it great was showing how he was able to make adjustments and find a new way to still do what he loved.  I've read other stories (and written some) that afflict characters in various ways, PTSD is a favorite, I think (understandably so!), as well as blindness, deafness, very rarely amputation...  But, again, these are actually hard to find - where the character doesn't make a full recovery.  As for amputation, I can honestly only think of two stories that I ready with that particular injury. (I haven't even written one lol!).  If this post reaches any sort of a point, I guess it would be an exploration of amputation injury in specific and permanent disability in general.

Huh. So, I’ve have been introduced to something new.

I love creative twists like this. Magic whump I can’t comment on directly, as I truly think this is a first for me to come across such a thing. But it’s always refreshing to see basic whump tropes used in new and resourceful ways.

It reminds me a bit of Flash and the introduction/subsequent use of Velocity 9 (V-9), being a drug that enhances a speedster’s speed. Only, it’s literally the speedster’s version of crack. This, of course, eventually kills the speedster who overdoses on it, like any drug may do.

They literally run themselves to death.

It’s one thing to have a speedster merely keel over from a heart attack, or have their heart implode in their chest cavity from the sheer force of adrenaline…no, they have to run until they disintegrate. The ultimate cost of their abilities.

On the flip-side of man-made drugs, there’s alien entity’s afloat to cause problems. My favorite?

Now, this one’s never been done properly on the big screen (in my personal opinion) but it surely holds so much potential. You see, depending on it’s continuity and origin, The Symbiote is poison. Firstly, it’s mentally toxic to its host. It feeds on the baser emotions of its host, creating an increasingly hostile personality. The longer the host is exposed to the Symbiote, the more overpowering this state of mind becomes. It has empathic abilities, and is able to project desires and needs into the thoughts of its host or potential hosts.

Physically? It’s using the host as…well, a host. Who is to say the hosts body doesn’t begin to shut down from this alien creature taking control? Organ failure, respiratory destroy, brain function — all could be very well out the window! Who’s to say once the Symbiote separates, the hosts isn’t just a walking corpse by this point?

Mhmm, whump.

I love when whump has levels; tiers to the situation, to the circumstance. It’s not just vomiting, it’s becoming physically sick from their own use of magical spells. It’s not just overusing their speed, it’s overdosing on adrenaline, until their molecular dissipate in the wind.

Ahhhh, yes. Comas. Also known as the classic go-to in soap opera’s, the whump-trope that defines the very stories of Days of Our Lives and General Hospital, the misunderstood head injury across the board.

Let’s break it down, shall we?

To understand a coma, it’s best to understand consciousnessfirst.

Consciousness is the having of perceptions, thoughts, and feelings; awareness. When we’re awake, we’re conscious. We’re able to collect, contain and store all of the thoughts, memories, feelings, and wishes of which we are aware of at any given moment. This is a aspect of our mental processing that we can think and talk about rationally. A part of this includes our memory, which is not always part of consciousness but can be retrieved easily at any time and brought into our awareness.

Unconsciousness is the opposite of this. For whatever reason, you’re not aware and you’re not awake. This could be due to drugs/medicine, head/brain injury, or simply our natural resting state (ie: sleep)

We won’t get too deep into the topic of natural unconsciousness. Rather, let’s focus on head trauma.

This is your brain experiencing a concussion – for the most part.

You see, humans have a gel/goop layer (cerebrospinal fluid) that helps cushion the brain from mild whiplash. But since we are human and have made things that make the human body travel faster than what we do naturally (cars, trains, planes, oh my!) our brain goop can’t handle that kind of force (ie falling of a bicycle, hitting you head on the ground, running into a wall etc). The brain shifts and the goop can absorb most of the impact, but the fact that the brain is so soft means that it will accordion up in the skull from the momentum of the force received and bounce back.

That’s not good for the brain.

Okay, so we know that consciousness is when we’re awake and aware. Unconsciousness is when we’re…well, not. Head trauma is something like when the brain gets rattled within our own skull, ie a concussion.

So where does a coma come into play? What is a coma?

Let’s start with the TV Myth: Character gets BOINKED on the head, cut to scene in hospital where doctor tearfully tells the family/loved ones that Character is in a…dun.DUNUNNNNN. A coma. Cue to loved one holding the hand of the Character, crying and begging them to wake up. End with Character finally blinking their eyes open, smiling and hugging the loved one who never left their bedside.

That’s the myth. So what’s the reality?

For starters, it’s a whole lot less dramatic.

Coma is essentially a state of unconsciousness and unresponsiveness. Imagine being asleep, but the rest of your body also cannot work properly, and you can’t wake up until whatever is causing the coma is reversed. In trauma medicine, the Glasgow Coma Scale (GCS) score is used to determine the coma status, which is essentially a surrogate for brain and brainstem damage. Trauma can cause coma, as well as medical problems, drugs, and lots of other things.

Comas are short-term transient states in which the eyes almost always remain closed, normal sleep and wake cycles cease and the patient cannot be roused. When a reaction to traumatic brain injury, comas only last for approximately 10 to 14 days. Once the brain starts to recover, patients may move on to a vegetative or minimally conscious state.(please note here: they do not just wake up and go back to a normal routine. This is the start of their healing journey.)

Speeaakkkingg of the GCS, let’s discuss that briefly. The Glasgow Coma Scale (GCS) is the most common scoring system used to describe the level of consciousness in a person following a traumatic brain injury. Basically, it is used to help gauge the severity of an acute brain injury. The test is super simple and reliable — it measures Eye Opening, Verbal Response and Motor Response. This is a series of assessments for a patient regarding their ability to open their eyes (spontaneously, to voice, to pain, or not at all), give a verbal response (oriented or disoriented, inappropriate words, incomprehensible sounds, or none at all) and provide a motor response(follow simple commands, only responds to pain, withdraws, flexion, extension, or flaccid.)

Each of these categories are graded in numbers, and the lower your grade, the worse you’re off. 8 or less is severe, while 13-15 is mild.

There’s more than just the “hit on the head” coma, of course. Doctors put people into induced comas usually via medications. Anesthesia drugs such as barbiturates are given to patients to induce a coma so that surgery can be performed without the patient feeling it or moving, even surgery on the brain, or to protect the brain from further damage after an injury, etc. Think of someone who is “out” during surgery as medically induced coma. During a traumatic coma for example, they’d be in a similar state when assessed clinically.

The reason the body goes into a coma in the first place is in response to lattice functioning certain areas of the brain, and to restore these certain functions or preserve the body, it shuts down all but the essential processes of the body. This is somewhat comparable to hibernation. It’s a preservation repair process and why sometimes comas are medically induced; it allows higher brain function to be preserved while the body repairs itself and reduces swelling in areas of the brain.

So what causes coma?

Anything that reduces brain function. This includes drugs, alcohol, poisoning, head trauma, strokes, heart attacks, altitude sickness, diabetic shock, hypothermia, ect ect ect.

And of course, random strikes of lightning ;)

“So that’s it, right? A coma is just the brain hiding away for a while so it can recover? Once you wake up, all is well?”

This situation is so, so rare. It depends highly on many circumstances, ie: how long the patient was in the coma, what caused it, the severity of it (think back to the GCS scale) and so on and so forth. Typically, regaining consciousnesses comes very gradually, over the course of days, weeks or months. Sometimes the patient needs to re-learn basic motor skills, like talking, eating and walking. It’s far from the happy ending the media tends to display.

But of course, who wants to watch a character struggle with a spoon full of mashed potatoes? That, I’m afraid, is the truth to comas. If there is a severe injury, whether from trauma (blow to the head), or anoxic brain injury (stroke), it can be hard to determine exactly how/when people will come out of it.  A lot can depend on the area damaged. Generally speaking, if it’s in the center of the brain or in the brainstem, it’s bad news. Scans can tell physicians the damage done but can’t determine level of functionality left. That part is a waiting game. It’s amazing how sometimes people come back from the brink too.

The fanfiction in question here is a MUST READ for any and all Psych fans. Where There is Wailing and Gnashing of Teeth is a mastery at showing the creativity and wonderment of whump and the candy land wonderland of possibilities in hurt/comfort.

Completely shameless plug to follow: Dragonnan is someone I consider to be the OG when it comes to break-your-balls whump. Why just stab your character when you can strip them naked and impale them with a pencil? And why stop there? Why not do more?

In comparison, I might just be the most vanilla person when it comes to whump. Honestly. I can be as Plain Jane with my whump as I am with my food (perspective: I think pepper is spicy. Don’t judge.)

My go-to? It’ll always be sick-fic.

There’s so much underlying potential with sick-fics because hot damn, nothing is more whumpy than a character’s own body turning against them. It’s one thing when someone is shot or stabbed – in a twisted sense, that’s a controlled element. To be shot, someone has to shoot you. That someone can’t shoot you if they’re detained by law enforcement first, right? Well, with sick-fic, you don’t always have a say when your body decides TO UP AND TURN ON YOU IN A FRIGGIN INSTANT BECAUSE….REASONS.

I mean, think about it. A fever exists because the body rises it’s temperature higher and higher to burn off any offending bacteria or infection. It doesn’t stop to think “Oh, wait, the thing I’m doing may hurt the person I’m doing it to. Hmmm…” Nope, sometimes it just keeps going and going and then your character has nurses putting ice packs all over their body to keep the temperature from climbing over 106, which can easily induce a seizure because your own body has decided to fry it’s brain like a scrambled egg.

That’s not just your brain on drugs. That’s your brain sizzling away with a hot, hot fever.

Sick-fic is fantastic for the comfort in hurt/comfort. I love secondary characters providing that good bedside manner to someone who normally isn’t so ill, or has never been so ill before in their life. Plus, it can be down right scary. There’s only so much medical professionals can do for illness. It honestly becomes a wait-and-see game and the stress from that…mhmm, secondary emotional whump.

On that note, there’s really no whump that isn’t my favorite. Stabbing, shooting, internal bleeding, illness, broken bones, concussions…they’re all so glorious. But what really gets me going is the cause behind the whump.

Let’s use stabbing as the example, since I think that can be a big go-to for a lot of authors. In a way, in some fandoms, it’s almost a dime a dozen. That’s not to say I don’t appreciate all and every single fanfiction written that’s out there – someone took time out of their day to write their own story and that’s special within itself. But sometimes you read the same thing over and over again, and it begins to lose it’s “punch in the gut”, if you will. Think of it like summer blockbusters: How many remakes, sequels and reboots before the audience gets bored? We crave originality. 

It’s one thing to just stab your character, have him bleed out, get help and everything is A-okay after 1,000 words or maybe a few chapters. Take it further; deeper. Have the character lost in the wilderness and then they’re stabbed, with a tree branch nonetheless. Put them on an alien planet with little to no way of getting home, and make that item that stabbed them radioactive. The conflict shouldn’t start and end with just the stabbing.

Bring in tension; is Shawn stabbed at the precinct with Henry there to witness it, the latter having overwhelming grief at not being able to do anything? Or did the chapters leading into the “big whump” involve Shawn and Henry arguing over a case and it’s potential culprit, someone who Henry believed was innocent and Shawn guilty, only to have him break into the precinct and attempt to murder Shawn for discovering the truth?

The circumstance for me adds just as much, if not more, punch to the whump than the whump itself. A stabbing fic is just a stabbing fic. It’s the 4 W’s that really make it kick - who, what, where and why.

I love all and any whump fic, always have and always will. But the ones that go further beyond the whump, the ones that take a simple stabbing and turn it into so much more…that’s where it gets fun. After all, in the medical field I’ve seen so many patients who have been stabbed in so many unconventional ways. Scissors, pens, tips of an umbrella, stiletto of a shoe, it goes on and on. Car accidents can lead to impalement, stabbings can lead to long-term life illness’s, broken bones can lead to amputation, kidnappings – as your fantastic fic goes to depict – can lead to cannibalism. My favorite is when the whump doesn’t stop at the initial bodily injury – rather, the author uses it as a jumping off point.

Oh that note, I’m a whore for kidnapping as well.

Yep. Kidnapping slut right here.

To answer this question, I’d like to do a mini-lesson on the….

Aka: our skin, boi.

To understand the effects of a cut or laceration, its best to understand the fundamentals of theIntegumentary System. After all, our skin is not only our largest organ, but it’s made up of many different layers. Think of a Wonka everlasting Gobstopper.

Yep, just like that. Melting and all. /s

There are 3 major layers to understand about the skin. The Epidermis, Dermis, and Hypodermis.

The Epidermis is the only layer you can actually see (assuming that your skin is intact) which is why it’s what you think of when you think of skin. The Dermis just below it is where most of the work that skin does gets done, like sweat and circulating blood and feeling everything..everywhere..all the time.

On the very bottom is the Hypodermis, or subcutaneous, composed mostly of adipose fatty tissue. Each of these layers have additional layers and properties, from deep to superficial, these layers are the stratum basale, stratum spinosum, stratum granulosum, and stratum corneum.

It goes on and on.

So at what point is a cut too deep?

Well, for starters, any wound deeper than 0.25 in. (6.5 mm) will require medical attention. This may be steri-strips (butterfly stitches) or Nylon or Polypropylene type of sutures. A deeper wound will take much longer to close up on its own, especially if the person is moving around and the wound is in a place of constant movement (think your neck, your fingers, the bottom of your feet, ect) Not to mention, an open wound is at risk for infection. Hence why you’d want that sucker closed up.

How would a person know if a cut is too deep?

Yep. The good ‘ol sign of red – Bleeding.

If you haven’t been able to stem bleeding after 10-15 minutes, you need stitches to help close up the wound and aid in clotting.

What would the hospital do when they arrived? Well, let’s play with the scenario that someone called an ambulance for the victim and EMT’s/Paramedics are on the scene. This is typically done for a person who has self-harmed and created an injury of uncontrolled bleeding. We see this depicted a lot in TV/Movies when someone slices their wrists open.

At this point they’ve not only cut through a blood vessel, but also an artery (radial, ulnar, or both, leading to brachial artery. This artery can bleed quickly if lacerated) The first thing they would do is the 3 P’s – pressure, pressure, pressure. That’s the most important step with a bleeding victim. A paramedic might administer a coagulation(clotting) medication, but otherwise their goal is to get the victim to the emergency department A.S.A.P for further treatment.

Treatment varies depending on circumstance. A self-harm patient almost never cuts deep enough to need to clamp an artery, but they could require surgical repair on it. There are basically two end points for either veins or arteries: repair it or ligate it. Again, a self-harm patient almost never ends up in this situation. Once their self-inflicted cuts are sutured up (if required) they’d be held under a 48-72 hour hold for mental health and possibly admitted to a Behavioral Health Unit for additional psychiatric help. The age really only comes into play with parental guardianship. If under 18, parents/guardians would be contacted.

Thanks for the whumpy question!!

Firstthings first –

Chemois not something to fuck around with and I give you mad, mad propsfor enduring it! You’re a hell of a survivor and life ain’t gotnothing on you!

Yoursituation does sound somewhat typical. For starters, the chemo portitself is surgically implanted subcutaneously so there’s really noneed to “go under” for the procedure. While it may not bepleasant to think or look at, it’s actually more dangerous (andexpensive) to place a patient under anesthesia for that type ofthing. Anesthesia comes with a shit ton of risks, after all.

Thegood news is port-a-cath’s (assuming this is what you had) don’tgo or come from arteries. Rather, they are inserted into veins.Typically the superior vena cava, sometimes the subclavian vein orjugular. The procedure, if done properly, should involve minimalbleeding. I can understand why the physician let you hold pressure tostem bleeding, however, I personally wouldn’t feel comfortable withthat. Even for basic, simple procedures both the medical professionaland patient should expect the worst. If they had their back turned tograb a few more supplies and you had passed out for whatever reason,who knows what could have resulted.

Youmentioned the cartoid artery, which leads me to believe yourport-a-cath was inserted in your jugular vein. The cartoid lays ontoof this vein and while extremely rare, can be nicked or puncturedduring insertion of a port-a-cath. Injury from removal is even morerare and the physician would have to be quite reckless to managesomething like that.

CVC’s,PICC’s, ports, ect all come with their own share of risks andanytime you deal with a vein, especially one so close to an artery,you should be tremendously careful. Sometimes physicians perform thesame procedures day in and day out and become accustomed to thepredictability of it all. Still, I believe by-the-book guidelines andJoint Commission would highly recommend an RN be present for anyunforeseen circumstances.

Also, while I have such high respect for physicians and surgeons, I have a feeling this would be their response if I brought to their attention: