Author Question: Surviving Stab Wounds to the Abdomen

Anonymous Asks:

I have a character in my story who is stabbed three times with a three inch, narrow blade trench knife in the abdomen. I’m trying to avoid the guts or arteries and make it as non-lethal a spot as possible. He is a doctor and also a spy. I would like him to live and make a complete recovery.

He is two hours away from a hospital and has a friend to help him get there. Here are my questions:

1. Would it be feasible for him to live that long while he gets to the hospital for treatment?

2. Would he want to leave the knife in during travel time so he doesn’t bleed to death?

3. Or do I need to rework the scene so he’s closer to the hospital? If two hours is too long, what’s the maximum time he could have in travel before it’s too late?

Jordyn Says:

anatomy-254129_1280This is an example of all things are possible, but not necessarily probable. Of course, people survive devastating injuries every day. Miracles do happen. This is the category I would put your character in to.

The largest problem with him surviving these injures in the length of the knife and how many stab wounds he has. Three inches is long when it comes to knife wounds— particularly if the full length is buried into the abdominal area. We have to operate on a worst case scenario until the patient proves otherwise. Looking at the picture to the right, you can see all that is located in the abdomen and how likely it is that something devastating to this patient would be punctured or nicked.

If you want to keep the scenario as is, then I would have all the punctures be to the lower abdomen and to either side. This could puncture the intestines and bladder. These would need to be surgically repaired, but should be survivable (if the bleeding is minimal) for a couple of hours.

You’d definitely want to avoid the left upper and right upper abdomen which house the spleen and the liver. If these are punctured, your character would likely bleed out within two hours. Also, more midline to the abdomen is the descending aorta (a very large blood vessel), which also would lead to rapid hemorrhage and low survivability.

Leaving the knife in is up to you as an author. I could see his friend doing either thing. In a panic, he removes the knife. Or, maybe he has some medical knowledge where he thinks leaving it in place might be a good idea. I would pick whatever increases the tension for your scene.

Two hours is reasonable if you pick the injuries I describe above. I would caution you, though, to give the reader an image that there is little bleeding and the pain is somewhat tolerable. Rapid bleeding, a hard distended belly, accompanied by signs of shock (rapid heart rate, rapid breathing, sweating, paleness, clammy skin) would be poor prognostic indicators for surviving two hours.

Hope this helps and good luck with your novel!

Can Cadmium Poisoning Mimic Pregnancy?

Laura Asks:

Do you watch the television show Scorpion? If you do watch the show— you may not to read any further as this question may contain spoilers. In a recent episode, a character finds out that she is not pregnant, but instead is suffering from cadmium poisoning, which caused a late period and morning sickness. Is that possible?

Jordyn Says:

periodic-table-42115_1280Well, this is an interesting question. I had to do a bit of digging before coming to a conclusion.

The first research I did dealt extensively with chronic cadmium poisoning in a CEU article published by the CDC. For each of these effects from cadmium poisoning you could probably find research articles supporting and denying the correlation between cadmium and these disease processes so keep that in mind when you read this list.

Chronic exposure to cadmium fumes or dust, in some studies, have been associated with COPD, emphysema, and lung cancer. Animal studies show that exposure raises blood pressure.

The kidneys are the organs most affected by cadmium poisoning and the damage is dose related. Of interesting note was some studies that showed an increased likelihood of kidney stones in populations that had exposure to this heavy metal. Some studies have also shown bone lesions leading to fractures and osteoporosis.

In animals, cadmium in large doses crosses the placenta and led to birth defects, severe placental damage, and fetal death. This, however, has not been proven in the human realm but some studies show women exposed to cadmium may have a higher risk of premature labor.

Surprisingly, in this extensive article, nothing was said about cadmium’s effects on the menstrual cycle so I began to search just for that issue. I did come across this study which showed that cadmium could effect hormone levels involved with menses, but by mildly reducing some that are involved with pregnancy so, in essence, cadmium exposure shouldn’t mimic pregnancy.

All this being said, stress can always alter a woman’s cycle and nausea can be a sign of anxiety, but correlating these with cadmium exposure might be stretching it.

Author Question: What Kind of Trauma Causes Blindness?

Belle Asks:

One of my characters is in a minor plane accident. When you see him next, he is blind. What could cause him to be blind as a result of this accident?

eye-211610_1920Jordyn Says:

A character can lose vision as a result of this accident in one of two ways. Either direct injury to the eyes themselves or injury to brain centers that are involved in the processing of visual information.

Direct injury to the eye could include the eye itself or bones around the eye could become fractured and impinge on certain nerves that could ultimately lead to blindness. You could also have traumatic retinal detachments that if not repaired could lead to blindness.

Many areas of the brain are involved in processing the information our eyes takes in. Any injury to any one of these centers could lead to blindness even though the eye itself looks perfectly normal. This article gives a basic outline and would probably be a good jumping off point for further research. As mentioned in the piece, some of these conditions would be called “cortical visual impairment, cerebral visual impairment, neurological vision loss, brain-damage-related visual impairment, and vision loss related to traumatic brain injury”.

Best of luck with your story!