Realistic and Unrealistic Injuries In Your Books

The ones of us writing fiction might have come across the one or other injury our characters are experiencing within the story. Depending on your genre of fiction (most significantly probably in crime stories, SiFi, occasionally fantasy, or mixed genres), these injuries might be more severe than a paper cut. (Even though they really hurt and nobody ever believes it, but that’s for another time.)

We all had the situation we watched a movie or read a book and our hero took a blow to the head or a bullet to protect his beloved… In movies, it’s normally quite simple. We watch the beloved carefully dab a tiny cut (where does that come from?) on the hero’s temple, most likely with a part of her clothing, and he comes around, pitifully whining and groaning. After three minutes he tells her they have to flee, jumps up, and with three bullets in his body, saves the situation and the girl. My hero…

One of my favorite examples at this point is the ‘Die Hard’-movies with hero John McClane. ‘The Week’ has taken a closer look at John McClane’s injures with a professional back in 2014. You can read the article here. )The poor man fights all by himself (mostly) against groups of criminals, using all his wit, experience, – and a handgun. Generally, he wins the fight by a hairsbreadth, with his, once white, undergarment dark gray and blood-soaked, cut feet, cuts, and lacerations all over his body, limping, and somewhat between two to five bullets in his body. Admirable – and completely unrealistic. So what? Hollywood has a monopole for explosions, fake catastrophes, bullets, freak destructions, and unrealistic injuries… But what’s good for Hollywood is not necessarily good for a debut writer.

Let’s have a look at a few examples in books and movies and analyze their grade of realism.

  1. Head Injuries

A human taking a blow to the head and collapsing is better off in the lateral recumbent position anyway, but that’s only a detail. If the blow was hard enough to keep the victim unconscious for more than three minutes, the chances are high that there is a concussion, or even a more severe injury, like brain injury, bleeding within the brain, or brain swelling. Jumping up and running around after several hours of unconsciousness won’t be possible. The victim would most like just helplessly stumble or have problems with the eyesight and orientation.

2. Dismemberment

You are writing fantasy and your victim gets dismembered? Losing an arm or a leg is no laughing matter. In such a case we look at a severe injury that, in real life will end fatally, if the victim does not get help within the shortest time and the wound is professionally taken care of immediately. The heart would still pump blood through the exposed arteries, which would splatter the blood all over the place in remarkable fountains. The wound would have to be carefully secured. The blood loss would weaken the victim severely. After the fast loss of approximately 1/3 of a gallon (1 liter) of blood, the victim experiences rapid heart rate, confusion, weakness, shallow breathing, blood pressure difficulties, and medical shock. There is no ‘continued’ fighting with only one arm.

3. Broken Bones

If your character experiences broken bones, the victim will face horrible pain. Depending on how bad the break is if it’s clean or dangerous multiple fractures, the pain can lead to dizziness, lightheadedness, and finally pass out from shock. The limp with the broken bone won’t be able to move, a possible numbness could start if the break involved nerves. The healing of a broken bone can take between six weeks and six months, depending on how severe the bone is broken, if it was a leg or an arm, hands, joints, feet, and wrists are usually taking longer. If the bone is older the healing takes longer too.

4. Bullets & Stab Wounds

They are generally called ‘puncture wounds’. We are, at this point, talking about an object ‘entering’ a human body, injuring the body in the process. From what my research showed me, there are low, medium and high energy puncture wounds, caused by, for example, spears or knives (low), arrows, or crossbow bolts or handguns (medium) and high-powered rifles (high). Puncture injuries are described as sharp pains, often stinging, occasionally burning. They might take up to six months to heal and very often result in late consequences. These wounds are never harmless. There is no place in the body where it’s not dangerous. Puncture wounds can turn into massive blood loss and death within only a few minutes. (Getting up and solving a case after two days is not going to work, oh Hollywood, city of illusions).

5. Some Other Injuries

Of course, there are other injuries. Burns, cuts, slashes, even toxic influence on the body, or in rare cases, decapitation. Buns and cuts can be treated and, depending on the severeness, can heal quite quickly, within ten to fourteen days. Unless the burns are more severe, then they will need far longer. Slashes most likely need stitches. As for the toxic influence of substances on the body, that depends on the situation and I won’t go deeper into that subject. There are too many toxic substances and I suspect, some research would be needed in such a case. Decapitation ends fatally to humans, period. There’s no way out. If the injury happens to supernatural creatures, the writer does have some freedom with the recovery process.

I hope, this list helped a bit to keep the injuries in your books on a realistic level. Your readers will appreciate your sticking to reality in this case.

Picture courtesy of

17 thoughts on “Realistic and Unrealistic Injuries In Your Books

  1. What a great post. So usefu For people writing fantasy, and even historical fiction, like I do. In my first historical novel, my protagonist broke his leg. Maybe I didn’t make enough of his pain.
    In my current wip, (fantasy) my protagonist has a very severe burn. I need to go back and rewrite that bit, I suspect. And in my yet to be started, fantasy novel, the protagonist loses part of his arm at the beginning. I need to think that through. Maybe it’s so badly mashed up it has to be amputated, rather than being lost in the encounter.
    Thank you for bringing this to our attention.

    Liked by 2 people

    1. Thanks so very much for a huge compliment and for sharing your thoughts with us. I too think, that sometimes we don’t give these injuries too much thought or attention.
      As I said in the article, I admit, as a fantasy writer, I do have some advantage with ‘fast-healing’ supernatural creatures.

      Liked by 1 person

      1. Yes, that is an advantage. My burns victim had the benefit of magical healing, but I’ve to decide how much he’s healed, and the effect of the damage to his looks has on him.

        Liked by 1 person

  2. Thank you for this.

    A few years back, I did a beta read for a fantasy author who had one of his characters get “sliced to the thigh bone” in a sword battle and then be carried on a litter for five days through the woods. I pointed out that he probably would have died from arterial blood loss within *minutes* based on the injury, since it was highly unlikely that the femoral artery would still be intact with an injury this severe. Plus, if by some miracle the femoral artery were still intact, the pain would have been excruciating and the risk of infection enormous. Yet, when they get to the village, Hero Man has his leg wrapped up, leans on a crutch, and is just fine. This is extraordinarily unlikely, to say the least.

    He was not best pleased because he thought it made for great story-telling.

    Liked by 1 person

  3. Thanks so much for telling us this. You’re absolutely right. In a time when they were still using swords, a wound ‘to the tight bone’ would most likely have been fatal. It was in the tight, fine, maybe the sword might have missed the femoral artery by a hair width, five days through the woods without proper cleaning and sterile protection of the wound, unstitched and just covered with a wrap? If he, by any chance would still be alive and not suffering from traumatic fever, I suspect, there would be quite a number of fly eggs in the wound, the maggots ready to feed. The conditions and hygiene back in these times were not in the favor of the injured warriors.


    1. I agree. Of course, fantasy stories might be a bit different. But even there, a bit more reality wouldn’t be a bad thing. My characters might heal a lot faster, but they still go through the pain of the injuries.


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