Injured Characters: Start From "The End"

I just returned from teaching at Colorado Christian Writers Conference up in Estes Park, CO. Not only is it a beautiful spot– being up in the mountains is stunning!– but it’s also a conference close to my heart. It was this conference in 2006 where I became firm in my decision to seek publication and so much has happened in the last seven years. If you haven’t considered this conference– do so! You get FOUR appointments. It’s the only conference I know that guarantees that.

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While there, I taught my Medical Pitfalls lecture for authors where I teach you to maim, injure and kill your FICTIONAL characters the right way. Several people made appointments with me just to figure out the right way to do it.

It was awesome.

After doing this service for writers for almost three years, I’ve noticed a definite trend. People have an idea of how they want to injure the character but don’t necessarily like the end result. For instance, they’ll give me an injury and then want the character to be hospitalized for several days. However, often times the injury is not severe enough for the character to even be in the hospital. Sad part of today’s medical enviroment is you have to be pretty sick to gain admission.

Other issue is the opposite. The author has given the character a devastating injury but wants them to be semi-fuctional in the proceeding days. Well, maybe in a fantasy world where they can heal themselves would this work but otherwise . . . no.

My suggestion for all writers/authors is to think of your character’s end point by asking yourself a couple of questions.

1. Why am I injuring/killing this character?
2. Do I want them to be functioning in the next couple of scenes/days/weeks/months? If so, how well? Fully? Partially? With great incapacitation?
3. Do I want my character to be in the hospital? If so, for how long? Keep in mind the longer a person is in the hospital the more issues physically they will have– particularly with muscle atrophy, loss of strength, and potential for infection. The longer they are in the hospital the more likely they will need rehab.
4. Do I want this character’s injury to have surgery?

Let me give an example of how I as a medical consultant for writers can help knowing the end point first.

Example A:

Author: I want a pediatric patient to have what the parents think is a fracture that sends them to the ER but I don’t want it to be a big deal. I’m using the ER visit as a moment for them to come together as parents in concern for their child to maybe remember some of the reasons why they came together. However, I don’t want the child to really have injury. Be fine. Able to play and be normal by the end of the ER visit.

Impossible? Why, no, actually.

Injury: A nursemaid’s elbow. A nursemaid’s elbow is a dislocation at the elbow caused by pulling or tugging of a child’s arm– say to prevent them from darting into traffic. It is a VERY common injury among toddlers and parents feel very guilty when they bring them to the ER because they think they’ve broken their child’s arm. Not even an x-ray is required for diagnoses. A simple maneuver will pop the arm back into place and the child is happy and on their way with no restrictions. Back to normal life.

However, let’s take the other end.

Example B:

Author: I want a child to be injured in a fall. I want it to require surgery. Maybe a few days in the hospital.

Injury: Hmm… ideas? I have the perfect one. A supracondylar fracture. This fracture is just above the elbow. Any fall– generally onto the elbow can cause it. Other than a Type I– they generally require surgery to fix. Give a surgical complication– and your child character is in the hospital.

See how knowing the end point is helpful? So– consider this when you consult a medical expert for your writing. It will also open up possibilities you didn’t think of.

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