Author Question: Delayed Death by Crossbow

Ben Asks:

Here’s my scenario that I would appreciate some advice on:
I’ve got a 25 year old woman that is shot through the left calf and the upper torso (I was thinking, maybe having the upper body shot piercing her shoulder) by crossbow bolts made of wood in my fantasy novel. The weapons that shoot her are each one-hand-held, meaning that they can be aimed and fired with only one hand.
What I need to know is this:
1. Would this outright kill the character?
2. If yes, where on the average human female body can I have two crossbow bolts made of wood puncture that body in such a way as to negate instant death, but still leave months of recovery time for that character, if she gets the proper medical help fast enough?
For background information, the science level of the world I am writing is roughly the same level we have today in America and Europe, the same with this world’s medical tech and knowledge.
Jordyn Says:
Thanks for sending me your questions.
1. A wound to the calf is unlikely to outright kill someone immediately. Any bleeding that’s not controlled if brisk enough can lead to death. Infection is a risk with any wound– particularly those that are caused from things (like arrows) that penetrate the body deep into its tissues leaving bacteria and other microorganisms behind.

The shot to the torso has more likelihood to cause death if it hits the right structure. On the left side of your chest are your heart, great blood vessels, and lungs. If the shot was more to the shoulder then an outright kill would be less likely and the risks above would be more prominent (bleeding and infection).

2. A shot to the calf and the shoulder have the potential to set your character back several months. If you don’t want the character to die– I would avoid having a shot to the torso. A projectile to any extremity can cause the bone underneath to fracture. Fractures typically take 6-8 weeks to heal.

If you didn’t want to go with a fracture of the bone from the projectile– you could have onset of infection (depending on how sick you’d want her to be for those months). Systemic infection can easily cause death. Local infection to the wounds can be problematic as well. You could also go with tendon damage to the arm or leg which would inhibit movement of the extremity. Healing and rehab of tendon and/or ligament damage can take months as well. Whenever an extremity isn’t used because it’s immobilized you always get muscle atrophy (muscle wasting) which causes weakness of the arm/leg, etc. It takes time to rehab that as well.


Good luck with your novel!

Living on the Edge

Hello Redwood’s Fans!

You may have been wondering just what has happened to me since I haven’t done these preview posts for a few weeks. Well, it’s been a little bit of a roller coaster ride lately. There has only been one member of our family that hasn’t been to the UC/ER in the last three weeks.
That is no joke.
I came down with a horrible case of bronchitis. Dang that flu shot for not working so great this year! My youngest broke her arm. My husband was in the ER for a heart arrhythmia. 
I know, fun times. I can see the jealousy on your faces.
It’s also respiratory season which means everyone who works in pediatrics is getting their rear-ends kicked at work every shift with increased patient loads of sicker kids. Let me just say my US magazine reading has sharply declined.   
None of us can predict with these life events will happen. It reminds me a little bit of white water rafting. What?– you say. She has certainly lost her mind.
White water rafting is fun but a little anxiety producing. You fear getting tossed into the water. There are all these dire warning about what to do when that happens.
1. Don’t put your feet down hence they get trapped and you drown.
2. Don’t loose your paddle because we don’t want to have to find a new one.
3. Swim to the side because we might not be able to get you.
Why would anyone try this sport? One, the scenery is awesome. Two, it’s a God made roller coaster. It’s fun getting splashed with water– most of the time. Not so fun, getting hailed on but I digress.
In the back of your mind while you’re having all this fun is the thought you might get tossed out and what will you do if that happens. It’s a little slice of living on the edge. 
I’ve been tossed out into white water several times. You know what– you cannot anticipate it. One minute you’re in the boat. The next, you’re wet and cold and wondering what the heck just happened. 
Isn’t this so much like death in our lives? We really do not know when that moment will be. Are you prepared? Can you ever be prepared?
Thoughts?
This week’s posts will be spent answering an author’s questions about medical treatment of patients who have been in a motor vehicle accident. 
Another one of those unexpected things.
Have a great week of unexpectedness. 

Author Question: Police Death Notification

In my writing life, I’ve met some fantastic police officers. My own brother is a county sheriff close to where I live so I use him a lot for questions. I’ve also gotten to meet many other great police officers and one was very helpful in giving me a detailed SWAT scenario for my most release, Peril.

Darcie sent me some police type questions and I passed them along to Seargent S. Tarr and he provided the following insight.

Darcie asks:

What I learned so far is that if my Main character (Kelley)’s parents’ bodies were found along a hiking trail near Glenwood Springs, the Denver Police would visit her house to break the news since Kelley lives in the Denver area.
Sergeant Tarr: Yes, if a person is found to be deceased the next of kin is notified by the jurisdiction that the person’s family is located. They would usually send a marked patrol unit and a victim advocate. We call it a death notification. Sometime the coroner will also go if it’s in the same jurisdiction. 
Darcie: That leaves me now with, since at first this appears to be a hiking accident, where would the bodies be? Coroner? 
Sergeant Tarr: It doesn’t matter if it appears to be an accident or not. The coroner would handle the investigation into the cause of death and police in the manner (like a homicide, scene traffic accident, suicide etc..) So it would be a joint investigation regardless. The only time the coroner and law enforcement don’t do an investigation is if it happens in a hospital or in the care of medical staff. So the coroner would take the body and most likely perform an autopsy. Would be very uncommon for them not to. The coroner would then rule on the cause of death ie: natural, suicide, accidental, etc.. 
Darcie: Would there be an autopsy? 

Sergeant Tarr: An autopsy would be performed by the jurisdiction that the death happened. The pathologist could be from Denver. I know for example that the pathologist from Fort Collins comes down to Denver to conduct autopsies. The Arapahoe examiner has also traveled to other coroner’s offices to assist. 

Darcie: Would Kelley have to go ID them even though they had drivers licenses etc on them?

Sergeant Tarr: This depends on if a positive ID can be made with the id or not. Like if their face was ripped off, sorry to sound crude. They can also put their fingerprints through AFIS to see if they can get an ID that way also. Sometimes the family has to ID the body if no positive ID can be made. It is usually the last thing done. Once the coroner releases the bodies it would be picked up by a funeral service. They would transport the bodies back to Denver for the funeral arrangements.

The Death of Dr. Mark Sloan

Ahhh… Grey’s Anatomy Fans.

I need your help . . .

This may seem funny coming from a medical expert like myself but . . .

I. Have. No. Idea. What. Mark. Sloan. Died. Of?

Anyone know?

The tumultuous end of last season– the plane crash with almost every major character on the plane left us in doubt as to who survived and who didn’t.

At the beginning of the current season, it’s assumed Mark Sloan is dead. But then, he’s not. But then, he is.

From a medical standpoint, I do give Grey’s credit for showing some true aftermath of the crash. A renowned neurosurgeon who no longer has full function of his dominant hand and can no longer do surgery. Kudos. The post-traumatic stress aspects that had one character going through some fairly severe post-traumatic stress. Honestly, how Christina is still walking upright . . . you know after the whole gun situation too when she had to operate on Derick with a weapon to her head.

Really…

The confusing thing about Mark Sloan’s death was the ACTUAL cause of death was never mentioned. He had a major chest injury. We know that. He was coherent and talking after the crash. Good! But then, his happiness at Seattle Grace is noted to be “the surge”– which I guess is to equate with a real thing that can happen when a terminal patient has a period of lucidity in order to say good-bye.

But what would have been terminal for this doctor? His heart was too weakened by the crash he wouldn’t live? Hmm… how about a heart transplant? Vasoactive drips? An LVAD device?

To confuse matters more– he signs a 30-day DNR order where if he hasn’t fully recovered, they are to discontinue life support.

But, he still has the breathing tube in his mouth at the end of 30 days.

And here is my teaching point at the end of all my musings. Generally, a ventilator dependent patient (or one who isn’t recovering quickly) is typically taken to surgery and a trach is placed somewhere between 7-14 days (sometimes sooner.) A trach is easier to take of and a more secure airway. Having an endotracheal tube in the mouth and through the vocal cords for that long can cause damage.

So keep this time frame in mind fellow fiction authors.

And please . . . someone tell me . . . what did Mark Sloan die from?