Need Help - Re: Trauma/Doctor/Gunshot

[RGD.]

Hey Guys -

In writing my third novel, I am having a difficult time finding some information that I need. So if anyone could help out it would be greatly appreciated. Google is not being my friend and medical books are just frustrating for what I need. So here is the deal:

1- The protagonist is going to be shot, from behind, with a 17th century flintlock pistol - close range, 5 to 10 feet - but that can be adjusted for injury survival.

2- I need a devastating injury to the torso that she can survive. Since it is a work of fiction I'll take as low as a 1 or 2% chance of survival.

3- She will need to stay conscious for about 45 seconds or so (again this is fiction so there is some leeway).

4- There will be no hospital, doctor, EMT, paramedic, ambulance, etc showing up to save her.

5- Staunching blood flow on the scene can be done with pressure/herbs so that is not a problem at the moment. Bullet removal (if it would stay in body), bits of clothing, organ damage, etc would be a problem to be discussed.

6- At some point - not sure of time frame - a Dutch nurse will be available to give whatever aid she can with tools/medical supplies available to her in 17th century Japan.

That's pretty much it in a nutshell for the moment. As gratitude for help I'd be happy to send a paperback copy of the book when completed where you would find your name listed as "Medical Adviser" - :)

Thanks,

Ron

[AdamJoshua]

Can't help but want to say good luck and congrats, although to a layman like me she sounds boned. :r

[SvilleKid]

Ron, If I remember past studies, a flintlock causes massive damage vs modern firearms because 1) it was a large caliber (often a .50 cal) projectile; 2) it is a round shot that packs more trauma force because it's not aerodynamic. This type of projectile also tears, which makes wounds much more difficult to simply sew up. That's why there were so many deaths and amputations in the Civil War. Thus, I'd have to assume just about ANY injury in the torso area would be devastating, just due to the nature of the projectile. An injury to any limb would destroy that limb through tissue damage and shattered bones, unless it was superficial, which wouldn't fit your definition of devastating. Thus you are left with a shot thru the torso. The effect of thru-shot that misses any vital organs would still be massive and dramatic, as it would result in heavy tissue damage, possible lead poisoning complications, heavy bleeding and shock which could be as deadly as the actual damage. The shock might not on-set immediately, and could give you the 30-45 minutes after being shot you are looking for. The loss of blood, possible lead poisoning and recovery (in olden days without blood transfusions) would be a lead-in to a medium to long recovery. So, long story short, you don't really need a organ shot to have the damage and time sequence you are looking for. The simple ballistics of a .50 cal ball thru any part of the torso would give you a believable (and well supported by historic events) devastating injury with some possible time before collapse (with assumptions of a strong heroine and a strong reason for a burst of adrenaline to keep her going until blood loss and shock took it's toll.

[RGD.]

Can't help but want to say good luck and congrats, although to a layman like me she sounds boned. :r

Thanks - yeah it does sound bad - just need to figure out how to keep her alive! Didn't think this far enough through when first writing the story.



Also - if anyone would like a free copy of my first book in the series - e-book for either Kindle, Nook, etc - just let me know via PM, text, email, Facebook or whatever works. The title is: Mineko: Book of Sisters.

Amazon link: http://amzn.com/B00F8UEYB8

[RGD.]

Thanks Cliff -

Not that it makes a difference, but it's technically a matchlock instead of a flintlock as I first stated.

As far as the story goes - this scene takes place near the end of the book so I don't need to show/tell that she has survived for another chapter - just need to imply that she does survive regardless of length of recovery.

What I do need to detail though is the damage she sustains and the steps taken to save her. And it's about 45 seconds I need before she passes out as she needs to try a say something . . .

In addition - the shooter does not intend to shoot her at the moment - he does so through muscle reflex. So if a direct shot causes to much damage that I can't make the reader believe that she does/can survive - is it possible that the shot could be fired, hit say a stone column, wall or floor next to her - and she is hit from a ricochet? Did these lead based rounds ricochet at all?

Two pictures that I have included: one is of the weapon itself, a Tanegashima pistol. The second is the typical rounds produced during the Edo period in Japan. The far right round is for a Tanegashima rifle with a barrel of .530. The far left round is for the pistol.

Ron

http://rgdillon.com/wp-content/uploads/2014/03/tanegashima_pistol.jpg

http://rgdillon.com/wp-content/uploads/2014/03/t-rounds.jpg

[8zeros]

Looks like the smallest ball is about .25 cal, then.
I don't think that would be too devastating. Probably not going to penetrate through most of the time. Cliff may want to re-scale his comment.

[SvilleKid]

Smallest round would cause less damage, musch less likely to be lethal unless it hit an organ. Shock less, so more chance to survive a thru-shot, with the 45 seconds you need if hit in the side by the pistol round. It also has a better chance of bouncing off a rib and tearing a big gash in the front and side, but not fatal (but really gory and lots of blood and sewing up needed to repair. Anything that hits an organ, or stays inside the body has a strong chance of death in that era due to lack of antibiotics. Treatment even for surface damage like a hit and glance off a rib.

Accidental misfires more likely with matchlocks anyway. A spark drops from the lit "wick" into the powder pan before gun fired, or the holder brushes up against an edge with the wick and drops a spark off into flashpan. Any numbers of ways these guns could misfire. That small of a round, shock would be heavier for a hit on a strong bone than it would for a soft-tissue thru-and thru. And a glancing blow with lots of surface damage has the potential to bleed heavily, and cause her to pass out after a short time (especially combined with shock).

You probably want to research the muzzle velocity of the gun verses a modern .25 cal. Modern .25 cal isn't usually a killing round for a single shot unless it hits something really vital. And can actually do little damage. I had an appraisal client once that was a former bouncer at a bar. He took 6 shots to the body from a customer, still got to the guy and broke his neck. Granted, he was a big guy. But I also had a teacher in high school that moonlighted as a waiter at a swanky hotel restaurant at night. He got into a gunfight over tips after hours. Both guys had .25's and both took at least six hits at close range. Both eventually died, but was from organ damage, not the size of the rounds. Again, these were more aerodynamic rounds that would be more likely to leave less damage than a round shot.

To get heavy damage without death (in that era), you might need to consider a gun with a heavier caliber round. Don't know if that's workable in the story. But I'd say the smallest round would need some creative liberties due to smaller size. as for a ricochet, if it tore ball into a jagged projectile, more surface damage possible, but you'd lose velocity, less impact shock. BUT.... Medical shock probably kills more people than actual injuries. And effects of shock not really understood and classified (as we know it today) until the last 50 years or so. Medical shock requires fast treatment to avoid death and that treatment wasn't known in the era of your setting. BUY, you could easily work the modern treatment methods into story, done by pure happenstance (or common sense). The delay in treatment for the 30-45 minutes could be almost fatal, and result in a long recovery and near death consequences. I think a gory surface wound, with the followup shock factor is the closer to actual truth. Lack of modern medicine and surgery methods just works against shots that hit the torso and the organs involved and the victim still survive.

[SvilleKid]

Ron... I did a little research,

http://samuraiantiqueworld.proboards.com/thread/27/tanegashima-bullet-sizes?page=1&scrollTo=27

I'd say the pistol probably shot a 1 monme round. A 6 monme would be .62 caliber, and around 360 grains (a typical .45 acp is only 250 grains!). However, note in the chart that due to rounding to the nearest whole number (as the Japanese did), you could have up to the equivalence of a .38 caliber round still classified as a 1 monme, which would still work for that pistol. At .38 caliber and a grain weight of almost 150, this is almost a good .357 mag round size. Now you ARE talking about a bullet that could pack enough punch to do a good bit of damage. A glancing shot off a rib, major skin rippage, broken or cracked rib (survivable) and a good shock factor, both physical force and from a trauma shock standpoint.

And this is considering only a 1 monme size. The reference above says most pistols were 3-4 monme. So you can factually justify about any amount of damage you want with these bullet weights. (note that a 3 monme is equivalent to a .50 caliber round with a grain weight of right at 200..... strong stopping power)

[bighairlogo]

Not sure if this helps but if your looking for someone to survive being shot in the 1700's when black powder gets wet or even damp not all of it will go off, reducing velocity significantly. Even really high humidity can cause this in a flint lock.

[Ashcan Bill]

From what I've read, back then you were just as likely to die from infection as from the wound itself. The ball itself was filthy, usually greased with lard or whatever, and it would go through clothing thus introducing bits of what the victim was wearing into the wound as well. That doesn't help much though, does it?

One factor in the severity of wounds from muzzle loaders was the amount of powder the gun was loaded with. You could either intentionally or unintentionally "short" the powder load, decreasing the velocity of the projectile. This was sometimes done in duels, sometimes nefariously, to increase the chance of survival. I would think a "short" load hitting a bone would be survivable, barring infection.

And if it's a fictional book, while you want to be as historically accurate as possible, you still have artistic license to work with. While gun enthusiasts go nuts over obvious errors in firearm depictions in literature, I've never heard any critiques on wound survivability (and I'm a member of several firearm forums). Who's to say who could survive what, even today. On rare occasions, you just get lucky. ;)

[Don Fernando]

can't help you with the trauma, but can help you with the Dutch if needed

[RGD.]

Great! This information really helps and that’s a good chart and info on the web page there. I literally have hundreds of pages of research.

The important thing here, for me, is that the reader believes that she can or will die at any minute – then we save her. I did work a little more on the plot/outline – the nurse (surgeon’s assistant) will actually be on the premise and so the time for her to actual help could be reduced. Protagonist #2 will need to kill two others in the room (one will need to be questioned quickly) before she can reach our heroine, Protagonist #1. With her skill set, it won’t take that long to make quick work of them. Probably reduce the time from gunshot to nurse in the 15/20 min range.

I don’t have to go into very much detail about the pistol – just a cursory explanation. It has to be a pistol though because firearms are the only thing that scares her due to the unknown factor – as mentioned in the first two books. But I also have to make believers of those who know a little something about firearms.

So – as you mention I think for now, a shot from the rear, an upwards angle (she is suspended by her hands with ropes) – striking the ribcage, bone breakage, and then exiting out the front side. Lots of blood, no bullet/lead poison, silk and cotton fragments to be removed, etc etc. Think I can work with that. Of course, if anyone else has some ideas – I welcome them!

Thanks Cliff! :tu

[AdamJoshua]

Smallest round would cause less damage, musch less likely to be lethal unless it hit an organ. Shock less, so more chance to survive a thru-shot, with the 45 seconds you need if hit in the side by the pistol round. It also has a better chance of bouncing off a rib and tearing a big gash in the front and side, but not fatal (but really gory and lots of blood and sewing up needed to repair. Anything that hits an organ, or stays inside the body has a strong chance of death in that era due to lack of antibiotics. Treatment even for surface damage like a hit and glance off a rib.

Accidental misfires more likely with matchlocks anyway. A spark drops from the lit "wick" into the powder pan before gun fired, or the holder brushes up against an edge with the wick and drops a spark off into flashpan. Any numbers of ways these guns could misfire. That small of a round, shock would be heavier for a hit on a strong bone than it would for a soft-tissue thru-and thru. And a glancing blow with lots of surface damage has the potential to bleed heavily, and cause her to pass out after a short time (especially combined with shock).

You probably want to research the muzzle velocity of the gun verses a modern .25 cal. Modern .25 cal isn't usually a killing round for a single shot unless it hits something really vital. And can actually do little damage. I had an appraisal client once that was a former bouncer at a bar. He took 6 shots to the body from a customer, still got to the guy and broke his neck. Granted, he was a big guy. But I also had a teacher in high school that moonlighted as a waiter at a swanky hotel restaurant at night. He got into a gunfight over tips after hours. Both guys had .25's and both took at least six hits at close range. Both eventually died, but was from organ damage, not the size of the rounds. Again, these were more aerodynamic rounds that would be more likely to leave less damage than a round shot.

To get heavy damage without death (in that era), you might need to consider a gun with a heavier caliber round. Don't know if that's workable in the story. But I'd say the smallest round would need some creative liberties due to smaller size. as for a ricochet, if it tore ball into a jagged projectile, more surface damage possible, but you'd lose velocity, less impact shock. BUT.... Medical shock probably kills more people than actual injuries. And effects of shock not really understood and classified (as we know it today) until the last 50 years or so. Medical shock requires fast treatment to avoid death and that treatment wasn't known in the era of your setting. BUY, you could easily work the modern treatment methods into story, done by pure happenstance (or common sense). The delay in treatment for the 30-45 minutes could be almost fatal, and result in a long recovery and near death consequences. I think a gory surface wound, with the followup shock factor is the closer to actual truth. Lack of modern medicine and surgery methods just works against shots that hit the torso and the organs involved and the victim still survive.


This is actually what I was thinking, less of a high caliber pistol more of one of the old single or dual fire small concealable pistols, two fast shots from close range, one in and maybe one that hits a bone, you could make it more interesting by having one of the rounds close to the spine, too close to remove, the embedded shot could add an element later in the story as well, "an old injury".

[RGD.]

Not sure if this helps but if your looking for someone to survive being shot in the 1700's when black powder gets wet or even damp not all of it will go off, reducing velocity significantly. Even really high humidity can cause this in a flint lock.

Good thing to keep in mind - Thanks. In this case, they are indoors and we really don't know the condition before hand.

Ron

[RGD.]

From what I've read, back then you were just as likely to die from infection as from the wound itself. The ball itself was filthy, usually greased with lard or whatever, and it would go through clothing thus introducing bits of what the victim was wearing into the wound as well. That doesn't help much though, does it?

Actually it does help. This is something that the nurse may know or discover when she treats the wound(s).



One factor in the severity of wounds from muzzle loaders was the amount of powder the gun was loaded with. You could either intentionally or unintentionally "short" the powder load, decreasing the velocity of the projectile. This was sometimes done in duels, sometimes nefariously, to increase the chance of survival. I would think a "short" load hitting a bone would be survivable, barring infection.

And if it's a fictional book, while you want to be as historically accurate as possible, you still have artistic license to work with. While gun enthusiasts go nuts over obvious errors in firearm depictions in literature, I've never heard any critiques on wound survivability (and I'm a member of several firearm forums). Who's to say who could survive what, even today. On rare occasions, you just get lucky. ;)

As the story focus is not so much on the weapon itself - but the fact that one is used, aside from the type, I don't need to worry about powder loads. I do wish to avoid critique from gun enthusiasts - so the least amount said - the better! :)

Ron

[RGD.]

can't help you with the trauma, but can help you with the Dutch if needed

And I might need to take you up on that! I have a 13 year old niece who absolutely loved the first book (she did not know that I wrote it) who is playing the part of the Dutch nurse. Currently she is researching her part for dress, mannerism, hair/eye colors, languages spoke, etc.

My niece is a very smart girl - she recently took her SAT's - so no doubt her research will be pretty thorough - but I might have other questions so I'll keep you in mind.

Thanks!

Ron

[Remo]

For the sake of Ron's book, I will be happy to shoot one of you guys with a matchlock/flintlock and we will get a detailed account :r :tu

[RGD.]

For the sake of Ron's book, I will be happy to shoot one of you guys with a matchlock/flintlock and we will get a detailed account :r :tu

:lr:lr:lr


Ron

[Remo]

:lr:lr:lr


Ron

I am here to help bro! :tu

[Don Fernando]

And I might need to take you up on that! I have a 13 year old niece who absolutely loved the first book (she did not know that I wrote it) who is playing the part of the Dutch nurse. Currently she is researching her part for dress, mannerism, hair/eye colors, languages spoke, etc.

My niece is a very smart girl - she recently took her SAT's - so no doubt her research will be pretty thorough - but I might have other questions so I'll keep you in mind.

Thanks!

Ron

just shoot me a pm or an email (ferdinand (at) sigarenliefhebber (dot) nl when you need the help

[AdamJoshua]

I am here to help bro! :tu

Rather get shot than buy anymore of those poker chips :sl


You could make it a custom made two shot pistol, after the first shot no one expects the second shot and BAMM another round down range. lol

I do know a girl that is on one of those life flight crews, helicopter crew, in Florida, I can shoot her a facebook message and see if she or one of her crew can help, they must know about serious trauma care, considering their job.

[Lockspur]

I'm thinking a pocket pistol would be more feasible for an accidental discharge. It's concealed from the public, but the shooter would still have purchase of it given the overcoats of the time. That being said, you're probably looking at a .36 cal ball round.

A torso wound would not end well. But if that round has to travel through an overcoat (the shooter) and then possibly the overcoat/petticoat then corset of the victim, I would say cavitation might be non-lethal. The bullet's deformation as it travels through cloth barriers would cause it to tumble with an unpredictable trajectory. Now. Weather conditions. Is it raining? An umbrella could be a convenient barrier (rods or support pieces taking the hit) that might be a pivot point for the readers' belief in the severity of the wound. Heck, an iron eyelet of her corset would make a decent impact point. Taking some of the silk lace with it into her wound...making it easier for extraction later.

As for organs. Why not kidney? We've got two. One can go and no one would be any the wiser. You might have to address whether sepsis is a factor in her prognosis, however.

[RGD.]

I do know a girl that is on one of those life flight crews, helicopter crew, in Florida, I can shoot her a facebook message and see if she or one of her crew can help, they must know about serious trauma care, considering their job.

:tu

Ron

[Lockspur]

And if that doesn't work out, a friend of mine is a former EMT and is an expert on the Black Plague...and quite the writer. :) And is hot.

[RGD.]

I'm thinking a pocket pistol would be more feasible for an accidental discharge. It's concealed from the public, . . .

Thanks for the comments/notes/suggestions! Everything helps.

Just to expand a little more - when I say "accidental discharge" what really happens is this:

Our protagonist is an assassin who has been captured by a powerful daimyo who actually needs her alive for information that she has. Being a daimyo, his pistol is really just an ornate piece and not something someone would use in battle - more prestige than anything, but he is waving it around to threaten her.

The scene takes place in a large room within an estate home of the time period. Her hands are bound by the wrist, the rope is secured to an overhead beam.

The person who is trying to save/rescue her sends an arrow into and through the daimyo's throat - which in turn causes a reflex, tightening of the fingers, thereby firing the weapon and striking her.

Her clothing is a simple cotton pants and tunic with a silk and cotton kimono. Typical 17th century Japan clothing for middle class.


Thanks!

Ron

[Lockspur]

Ah, well then, I'm out. My Japanese expertise lies in the epic consumption of raw fish.

However, I mentioned this to my friend and here is her response. Bear in mind, her expertise is in 16th century diseases.

I can pass that and some possible avenues to follow from there to medical treatment progression
That's about all I can offer. Other than go for sucking chest wound. All you need is something flat that a seal can be made with to stop it.
It will leave the chest cavity full of fluid, but could do with something stuck in to drain, herbs, etc to heal and pass through rough fever and infection.
Could be glossed over if taken from the point of view of the victim in and out of consciousness.

Hit the wake ups with the hard facts of treatment easily talked about in layman's terms and then defined later when the crisis is passed. Bullet could lodge in a rib bone and stay in place. Poetic

[RGD.]

And if that doesn't work out, a friend of mine is a former EMT and is an expert on the Black Plague...and quite the writer. :) And is hot.

:tu Actually in my second book - I do have a person who dies from the plague in Oslo.

Ron

[RGD.]

Ah, well then, I'm out. My Japanese expertise lies in the epic consumption of raw fish.

However, I mentioned this to my friend and here is her response. Bear in mind, her expertise is in 16th century diseases.


Very helpful - tell her "Thanks" -

Ron

[AdamJoshua]

Her clothing is a simple cotton pants and tunic with a silk and cotton kimono. Typical 17th century Japan clothing for middle class.


Thanks!

Ron

Wait, she's clothed? I'm out.

:lv

[SvilleKid]

Something to consider, if you need more damage, early muzzle loaders were often double-shotted, meaning they put a little extra powder in, and loaded two balls in the same load. Because these guns did not have rifled barrels, they were not very accurate, and double-shotting the load gave a greater chance to hit your target. So, it you need a shot to hit your victim, and another to do additional action of some sort (on same general trajectory as first bullet), then you also have the option of including a double-shotted load! Good luck! BTW, I'm NOT a medical doctor, but I did stay at a Holiday Inn one time.

[RGD.]

Something to consider, if you need more damage. . . . BTW, I'm NOT a medical doctor, but I did stay at a Holiday Inn one time.

Noooo - I believe we have enough damage with a shot to back, bouncing off the rib cage and leaving a sucking wound out the front. Plus I forgot to mention that she has heavy scar tissue across her back from abuse as a teenager - not sure how that plays in but will research it.

For the past several years she is all I think about 80 to 90% of the day. From research to writing to publishing, etc - so I have grown quite fond of Mineko. I just couldn't bear to have her killed off now. Plus who knows - might be a fourth book in the saga down the road.

You know, when I am writing it often helps me to use audio or visual aids. Makes it easier to describe facial expressions, movements, injuries, etc. That said, I have used a very specific model for Mineko. So if she was a real person - this is what she would look like -

Ron

http://rgdillon.com/wp-content/uploads/2014/03/Mineko-Rina1.jpg