3 Things to Know About Harming your Characters by Elizabeth Otto

In my professional life, I work as an emergency medical technician. I’ve been doing this for almost 14 years. Let me tell you, I’ve seen it all. So, when it comes to reading, and I read a lot, I tend to pay close attention to the medical/illness/trauma things a character goes through. I promise that I don’t pick these scenes apart, because I know how hard it is to write about something you’re not familiar with. But, I have noticed patterns over time, of repeat clichés or errors that authors fall into when writing medical scenes or harming their characters.

In real life, it’s my job to save human lives. Since I’m an author too, I consider it my privilege to help other authors do a good job of saving their characters, or kill or hurt them properly. Understandably, it’s difficult to get help with medical questions when you’re in the middle of writing or planning a medical or injury scene, and Google can only get you so far. You want your scene to be realistic and believable, because really, readers pick up on medical things that are too stretched or far-fetched to support the story. Unless the genre you’re writing in allows for outside-of-the-norm medical or super human advances, you should stay as true to human medicine as you can. Of course, there are always exceptions.

But, if you’re going for believable, there are three things you should know about writing medical and injury scenes for your fiction:

1. Fatal, critical and minor injuries/illnesses are not interchangeable. 

Fatal= dead. Whatever injury, illness or trauma you’ve given your character WILL result in his death. End. Of. Story.

Critical=there is hope. Whatever you’ve done to your patient may result in her life being spared IF you medically treat her appropriately.

Minor=suck it up, Buttercup. You’ll live. These are minor illnesses or injuries that require little to no medical attention.

Remember, you can move up, but you can’t always move down. If your character has a minor injury–say a cut on the arm–she may get an infection of flesh-eating bacteria in that cut that gives her a high fever and moves into her muscle, which now puts her in a critical situation. Then, the bacteria moves into her brain and makes her disease fatal. She can’t be saved!

The reverse of this is that you can’t give your character a FATAL injury/illness, like a gunshot wound to the heart, and then miraculously make him get better. Moving from fatal to critical to minor is a cop-out. Unless you’re writing in the fantasy/magical realm, your readers are not going to like this very well.

2. Stay as true to what we know about modern medicine at this time, as possible.

The caveat to this, of course, is if you are writing fantasy, about the future, or are world-building which allows you to step out of modern medicine. Unfortunately, I’ve read too many scenarios where the author of a contemporary, modern-day work, simply stepped away from what is medical reality to date.  

For instance, I recently read a contemporary romance in which an elderly woman slipped into a “diabetic coma.” Her granddaughter poured juice down the unconscious woman’s throat and saved her/ woke her up. Unfortunately, this isn’t how diabetic reactions work, and many readers are going to pick up on that.

Would you ever attempt to pour liquid down the throat of a passed-out, barely breathing person? No. Also, medically, if you are in a “diabetic coma,” you need an intravenous dose of D50 in your vein to, hopefully, get you back. Stay true to modern medicine as it relates to your story. Don’t reach too far, because your readers will catch on. If you don’t know how to solve or fix a medical situation you’ve put your characters into, ask someone who does.

3. Make your character’s reactions believable 

If you shatter your main character’s arm in a high-speed car chase/accident, he’s not likely to use that arm to punch/beat up the perp. I don’t care how macho he is. Adrenaline will only get you so far.

Often, I read about characters that are ill or hurt, and they fall into cliché after cliché:

I have a fever, therefore I’m going to thrash about and spill all my dirty secrets while talking in my delirium. I’ve seen a lot of high fevers in my career, and this honesty-diarrhea never happens.

I just got the side of my head beat with a baseball bat, but I’m a tough cop so I’m going to hold off on this concussion, run a mile to chase the perp, bring him down AND show up for work the next day, with a smile!

I know the house we were in JUST exploded, and we were thrown fifty feet into the hard-packed ground, and we’re very shaken up and bruised and have burns everywhere, but dammit, let’s have sex! 

Before you get too sensational in that reach and stretch to wow your reader and play on their emotions, put yourself in the situation that your character is in and ask yourself, “How would I respond to this in real life?” If you wouldn’t lie in bed with malaria for two weeks, puking until you’re a dehydrated skeleton, and then jump up on day 15, feel great, go back to work AND have sex with your dream partner, neither will your character. Granted, we want a little sensationalism because it’s fiction, and because we can get away with it, but there’s a fine line between adding meat to the story and pulling the reader out of it.

If you have trouble navigating that fine line between believable and sensational when it comes to medicine, pop over to Twitter and join me, @EAOtto, on the hash tag #traumafiction. I’m always available to help with your medical and injury questions, and if I don’t know the answer, I’ll find someone who does. Now go injure someone! I’ve got your back.


Eizabeth Otto

Elizabeth Otto grew up in a Wisconsin town the size of a postage stamp, where riding your horse to the grocery store, and skinny dipping after school were perfectly acceptable. No surprise that she writes about small communities and country boys. She’s the author of paranormal romance, and hot, emotional, contemporary romance, and has no guilt over frequently making her readers cry. When not writing, she works full-time as an Emergency Medical Technician for a rural ambulance service. Elizabeth lives with her very own country boy and their three children in, shockingly, a small Midwestern town.

Elizabeth’s current release, TEMPTING THE COWBOY, is pulling all the heart-strings while flaming the heat!

Connect with Elizabeth on her website, Twitter and Facebook.


Tempting the Cowboy by Elizabeth Otto

After taking a job on a quiet Montana dude ranch, ex-cop Rylan Frederickson finds herself surrounded by unbelievably sexy cowboys. Too bad the one she wants is her boss…and the single dad of a four-year-old. It doesn’t matter anyway, because after a recent tragedy, there’s simply no more room in her heart.

Letting a new woman into their life is the last thing Cole Haywood wants for him and his daughter, Birdie. But as Rylan’s presence at Paint River Ranch breathes new life into his family he can’t ignore his growing attraction.

When the sparks between them turn into fireworks in bed, Rylan’s torn between the family she’s lost and the one she may have found. Now she must decide if something that feels this good is worth the risk.

Buy ‘Tempting the Cowboy’ at AMAZON or BARNES & NOBLE

As a child Angel Leigh was quite often found curled up with her nose buried in a book. By her teen years, she was writing as much as she was reading. ...
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  • October 17, 2017
Boy, I hope this author doesn't watch anime or read manga. Characters get gut-stabbed and leave the hospital within the day in that genera