СТАРЕНЬКИЙ ТРАМВАЙ

Your action hero just got shot in the shoulder, stitched it up in a motel bathroom, and is now running through a forest. I need you to know that a shoulder wound severs muscle, nerves, and sometimes bone, and the human body's response to that is not "mild wincing followed by full range of motion." here is what injuries actually do to peoplee...

⊹ Adrenaline is REAL and it does allow people to do extraordinary things immediately after injury, BUT it is a loan, not a gift. you borrow the function and you pay it back later with interest. Your character might genuinely be able to run for twenty minutes after being stabbed. and then the adrenaline drops and everything the body was delaying arrives all at once. the collapse is NOT weakness. it's biology collecting its debt. write the debt collection. it's more interesting than the heroic sprint anyway.

⊹ Blood loss changes cognition before it drops you. you don't go from "fine" to "unconscious." you go through a whole middle stage of confusion, poor decision-making, emotional dysregulation, a strange calm, tunnel vision, difficulty forming sentences. Your injured character making a bad call, saying something they normally wouldn't, becoming suddenly and inexplicably gentle--that's blood loss. use the middle stage. it's dramatically rich and almost nobody writes it.

⊹ Recovery has a timeline and the timeline is long and boring and inconvenient to plot. a broken rib takes six weeks and during those six weeks sneezing is a genuine emergency. a concussion means no screens, no reading, no bright lights, and symptoms can persist for months. a stab wound to the abdomen means weeks of infection risk, limited mobility, and a specific kind of exhaustion that has nothing to do with sleep. Your character being sidelined and frustrated and useless for a long time is not a narrative problem. it's the story.

- Re: the shoulder injury above - if someone sewed up the skin but didn't reattach nerves, tendons, etc. that were (fully) severed those things still will not work! Look up the anatomy of the area you're injuring and what the things there do

- Even if things aren't fully severed the pain and swelling in an area can make healthy muscles unable to contract as a protective mechanism (ask anyone you know who's had an ACL tear about their quads post injury/surgery). That's why an injured leg "gives out". If the situation is important enough (like your character is running for their life) their brain miiight override that but not necessarily

- Most nerves carry both sensation and motor signals so if you damage a nerve you will likely have numbness/tingling/maybe pain (in specific distributions that you can look up) and also weakness or paralysis of specific muscles depending on the severity of the injury

- Nerves take for freaking ever to heal (axons regenerate at ~1mm per day or ~1 inch per month) and sometimes they just don't (especially if they're fully severed and not surgically reattached)

- For most common injuries you can look up healing timelines but be careful with what endpoint you're looking at - for example you might be back to ADLs (activities of daily living like walking, dressing, maybe cooking and cleaning) in as little as a week but that doesn't mean you're back to running or sports or fighting bad guys

- Also with timelines there's a limit to how much you can push them. Like yes a pro athlete (or spy or superhero or whatever) might be pushed to go back "too soon" but if you're cutting 3 months off of a 4 month recovery timeline either they're 100% going to get reinjured because the tissue isn't healed yet or they're straight up like not even walking yet

- Pain, especially chronic pain, is super complex and interesting, and so often misunderstood or misrepresented (in medicine, not just in writing). If your source for how chronic pain works is more than ~5 years old it's probably wrong. There almost always BOTH physiological/biological factors and psychosocial factors in chronic pain and reducing it to just one or the other is both probably wrong and also likely not as interesting to your story - for a while we kind of thought it was all biological and then the pendulum swung to it being all psychological but it probably is both for most people

- A note / expansion on the above point about adrenaline: the phenomenon described is totally accurate but it's not just because of adrenaline. Pain is at its core an alarm system that your brain/nervous system uses to protect you. So if the most dangerous thing for you right now is the bear chasing you, it might not produce a pain experience to alert you about your broken leg, but once the bear is gone the broken leg is now the most important thing and your brain will make sure you're in enough pain that it's your top priority

"I got stabbed in the abdomen but LUCKILY it didn't hit anything important!" drives me completely fucking insane as someone who knows anatomy, just saying. You've got your intestines in there; try stabbing a sausage and sewing the skin back on, go on. Sausage skins are literally intestines. Look how thin they are. That shit is DELICATE!

Along those lines if you get stabbed in "the side"... your large intestines are there. That's where all the poop is. You get poop in your open wound you are dying in agony without surgery because it's poop and it's riddled with bacteria. Because yeah your bowels will have to be stitched up.

Abdomen wounds are agonising because if your bowels don't open up and drown your wounds in poop, it's your intestines or stomach drowning your wounds in acid. Also you need your abs to sit up. You need your side to twist the around. Nothing in your body is redundant.

A lot more wounds need surgery than you think. A lot of broken bones need surgery. Pre-modern medicine this meant disability. Pre-modern medicine a compound fracture was a death sentence.

Sometimes pain takes a few days to REALLY kick in. My dad broke seventeen bones in a car accident and kept declining pain relief because he was totally fine. He eventually gave in because different doctors kept suggesting it. Four days later, even with that pain relief, he could barely talk, he was in so much pain.

Which reminds me, what's with the sheer amount of fantasy stories with no pain relief??? Everyone focuses on healing the wound but nobody acknowledges pain exists except for the, like, first five minutes, and then after they get medical attention it's just a bit sore at most. A lot of stuff people treat like bruises will actually drop your character for weeks.

Your character doesn't just have to worry about broken bones if they get tossed against a wall, their organs might get hurt as well. And if they have benign cysts on their organs, those could burst. I've seen a lot of kidney cysts in ultrasounds, if you wind up in a bad enough car accident those are bursting. Have fun!

Stuff often hurts either more or less than you'd think. I met a guy a few weeks ago who didn't know he broke his fucking NECK for thirty years because it was just sore now and again. Meanwhile my dad - most of his breaks were ribs, which authors tend to treat as a mild inconvenience. He had spine breaks too (and a burst kidney cyst, see above) but he said the ribs were worse. That's because just breathing moves them and you can't just stop breathing... and even if you could, your ribs will heal wrong because they'd heal too rigidly.

Someone further up talks about how pain is an alarm system and adrenaline is only part of the reason why pain signals are suppressed. Well, that is, in fact, how adrenaline works. Your unconscious mind isn't going "wait until the bear goes away THEN we'll hit her with pain signals!" because your brain is not that smart. What's actually happening is that the adrenaline is suppressing the alarm system. That's literally how it works. It's not separate, it's part of it. Different neurotransmitters and hormones can enhance or suppress pain. Adrenaline is one of the more powerful ones.

Minor injuries can be more deadly or disabling than you think. You can fall over, hit your head and die. Major injuries can also be more survivable than you think. People have shot themselves in the head with a shotgun, blown off their jaw and face, and lived. There's a lot of myths about which parts of the body are the most and least valuable. As pointed out above, a shoulder wound is a lot more deadly than you think.

"My character got a horrible injury but LUCKILY it didn't hit anything important so they are back up and running around like nothing happened after a short rest!" just give your character a stubbed toe. a stubbed toe is what you want. just give them a stubbed toe. George R R Martin was such a breath of fresh air because he never chickened out of disabling his characters, killing them, or giving them extended recoveries, and he didn't treat prosthetics as 1:1 replacements for the limbs they're standing in for. the tendency of authors to chicken out of hurting their characters has completely destroyed the drama of characters getting hurt for me because every time I read a story and a character gets hurt I KNOW the truth is author is going to cop out because they ALWAYS cop out and just pay lip service to pain like they just had a fucking stubbed toe. just give them a stubbed toe istg.

Because it amuses me greatly.

Whoever holds the latest Stark weapons rules these lands.

+Bonus:

in aotearoa, june isn’t our pride, it’s theirs. marsha p johnson and sylvia rivera are their historical figures, not ours. the phrase that “you owe your rights to Black trans women” is true there, but here we owe our rights to (mostly) Māori historical figures. i have the freedoms i do because of the legacy of an entirely different set of people operating in an entirely different context at entirely different times.

But because of american cultural imperialism, most queer people in Aotearoa don’t even know our own queer history. Carmen Rupe, Ngahuia Te Awekotuku, the Dorian Society, Gillian Laundon, Georgina Beyer, and the Wolfenden Association are some of our queer history. We should know their names! we should know what they did for us! but because of the power of the american imperial machine, we don’t.

our national pride month should be july, the month that the Homosexual Law Reform Act passed in 1986. our two largest cities hold their pride festivals in february and march, respectively. american queer history has very little (or nothing, depending on who you ask) to do with our queer history. anecdotally, from my own queries, queer youth in aotearoa know more about american queer history than our own.

There are 760,000 Australians on the National Disability Insurance Scheme, the system that - if they feel like it and your personalised plan says you get to have it - provides funding for everything from personal hygiene care to support workers to therapies to assistive technology. It's already very hard for disabled people to get on the NDIS, regardless of your disability. It's near impossible to access most support and equipment without being on the NDIS. And the government has announced that they want that number to drop to 600,000 in four years. 160,000 of us cut off the Scheme - and countless more denied access. This will cause deaths. People will die and people will suffer because there is no safety net. The NDIS is the only option for most of us. Even private health insurance doesn't cover most of these things. Nobody will swoop in to save us.

The bill wants to give the (non disabled!) NDIS minister basically unlimited power to cut our funding. They're already planning what they'd do with that power. What rights they'll strip from us. What dignity and freedom they'll remove to make their budget look better.

The bill wants to force people to try every treatment out there before they're allowed to be on the NDIS. Including if the treatment is literally impossible to access. There’s a lot of us living in regional areas or out bush who can't just pop to the capital cities for specialists. This will especially hurt disabled First Nations people in regional and remote communities, who already experience limited access to healthcare. Oh, and it includes chemical restraint, too. The government has directly refused to exclude chemical restraint from the required process, calling it "trialling medication".

If you're australian and worried, the ABC did a good breakdown of the proposed changes.

I know australia stuff doesn't really pop up on the radar on this site, but I want everyone to know what's going on. What we're fighting for here. Your australian disabled friends might be NDIS participants fearing for their life, rights, and freedom. They might not be a participant and afraid these changes mean they never will have access. We deserve better. The government built a system with no backup plan, and now they want hundreds of thousands of disabled people to pay the price for their bad planning.

Something something their absence in each other's lives leaves them with an aching void something they are each other's other half something something.

peter: *speaks*