Tuesday, November 30, 2010

From Rebecca - Let's Shoot Someone

Let's say I wanted to shoot someone (just for fictional purposes, of course). I'm thinking in the abdomen. Serious wound. Doctor arrives (no hospital). Quick surgery. Where should I shoot him? Assuming the doctor gives him some morphine before taking out the bullet, how long would he be out? How soon before he could drive a car? walk?

Wow. Not being a doctor, I have no idea. So I outsourced this question to my friend and invaluable critique partner, former Vietnam nurse Sharon Wildwind, author of Some Welcome Home and First Murder in Advent, and Poe’s Deadly Daughters blogger. Sharon wrote:

You can't do surgery on a serious abdominal wound by just taking the bullet out. There have been so many advances, that what I describe below might go quicker and easier in a major trauma center, but if there was no hospital available and the surgeon was having to do it "the old-fashioned way," I've outlined what he would have to do. The abdomen is crammed full of really useful things like liver, kidneys, intestines, etc, so it's almost impossible to have a serious abdominal wound without lots of things being damaged. Unfortunately those same things tend to bleed a lot. Sorry, but this is going to involve some yucky details
Step 1: open up the abdominal cavity wide enough to get both hands in. Hold it open with retractors.
Step 2: put clamps on everything that is bleeding.

Step 3: sluice out the abdominal cavity with sterile water and suction and look for any smaller spots that might be bleeding.

Step 4: maybe get an x-ray to see more than you can with the eyes or feel with your hands. Laproscopy (tube with a camera on the end) might also be used to locate bleeders.

Step 5: work one area at a time repairing every tear. Livers and spleens don't repair easily, though now I believe there are glues that are being used on livers. If the spleen has been damaged, remove it. Also, as long as you're in there, remove the appendix because once someone has had major abdominal surgery, they will have scar tissue and you don't want to have to go in through that scar tissue at a later time just to take the appendix out if appendicitis develops.

Step 6: spend a lot of time on the intestines because even a small hole that isn't repaired can cause bowel contents to leak into the abdomen and produced peritonitis. If the intestines have been damaged in multiple places, do a temporary colostomy so that fecal matter will be drained out before it passes over the healing areas.

Step 7: oh, yeah, take the bullet out.

Step 8: sew everything up in neat layers, inserting tubes and drains as you go.

Serious abdominal surgery can take 4 to 12 hours. Step 8 alone can take an hour or more.

That’s all she wrote, and it sounds pretty serious. As for how long he’d be out, I’m sure that all depends on how much morphine the doctor gave him. How long it took to resume normal activities like walking and driving would depend entirely on where he was hit.

Lisa Black is a full time latent print examiner/CSI and the NYT bestselling author of the Theresa MacLean series, including Takeover, Evidence of Murder and the recently released Trail of Blood. Please visit her website at http://www.lisa-black.com/.


Sue Ann Jaffarian said...

I found all that detail truly fascinating. Though it doesn't sound like anyone going through it is going to be up and running anytime soon. Now on to breakfast!

Meredith Cole said...

Wow. Thanks for the information, Lisa. And I hope that helped your, um, book Rebecca! I assume it's not a vampire getting shot...

Rebecca Cantrell said...

Thanks, Lisa! Lots of great details there! Please also thank your friend. I very much appreciate it!

In the movies, you just shoot
'em and they're doing aerobics the next day. How could the movies LIE? :)

Maybe I'll shoot him in the leg or someplace more generous.

It's not a vampire, sadly, Meredith. Then he'd have magical healing properties that could take as long as the plot needed. *sniff*

Lisa Black said...

You have to shoot them in the shoulder. Everyone on TV gets shot in the shoulder. They're up and around in 5 minutes, and it doesn't mar their face.

Rebecca Cantrell said...

I shot someone in the shoulder in the first book, so I need another place to shoot them that's life threatening but then gets them up and around in a day or two (unless they die). I don't care so much about this guy's face, but I broke his nose and two ribs in the last book, so I need variety there too.

I used to think I was such a nice person...

Rebecca Cantrell said...
This comment has been removed by the author.
Anonymous said...

Hi, Rebecca,

Legs are good places to shoot someone, relatively speaking, of course. I'd recommend a through-and-through wound in the fleshy part of the back of the lower leg, or a off-kilter shot into the thigh,which misses all of the major blood vessels, bones, and nerves.


Rebecca Cantrell said...

Thanks, Sharon! Maybe I'll just have to go for the thigh then. Lots of blood, pain, gore. What's not to like?

Kelli Stanley said...

Wow--thanks, Lisa!! Fascinating stuff!! :) What caliber are you planning to shoot this poor sucker with, Becks?