Violence 101: A Primer for Writers

posted Dec 15, 2015, 10:27 AM by Martin Roy Hill   [ updated Dec 15, 2015, 10:36 AM ]

Not only do I write mystery thrillers, I am also an avid reader of them. Too often, however, I read books where the author has researched all kinds of minutiae except the effect of violence on his or her characters. I call this The Mission Impossible Syndrome, named after the Tom Cruise movies in which his character is repeatedly blown up without repercussions. Obviously, the writers and directors of those movies never heard about primary blast injury or traumatic brain injury. Therefore, I offer my rules for writing about violence.

First, allow me to present my bona fides. I have been a medic of one sort or another in three branches of the military. Most recently, as a medical service corps officer in a component of the California National Guard, I helped train combat medics for Iraq and Afghanistan. I've also served as both a wilderness SAR medic and a tactical medic as a reserve sergeant in my local sheriff's department, and an EMT on a federal Disaster Medical Assistance Team. In my day job—the one that pays the bills—I am a U.S. Navy analyst in combat casualty care.

Here are my rules for writing about violence in my novels:

Rule 1: Injuries have permanent consequences. Of course, this is obvious if the injury involves an amputation. But even those injuries that are not immediately obvious to the onlooker are life changing. In my alternate history short story Hitler Is Coming, the former OSS agent protagonist, Paul Klee, was shot in the stomach during WWII. As a result, eating is something he no longer enjoys because of digestive difficulties. In my novel Empty Places, protagonist Peter Brandt suffers crushing headaches as a result of a head injury received covering the proxy wars in Central America in the 1980s.

 Rule 2: Understand ballistic injuries. A ballistic injury is a penetrating wound caused by a bullet or a piece of shrapnel from an explosive device. There are two types of ballistic injuries, low and high velocity.

A low velocity ballistic injury is one caused by a relatively slow moving projectile. Bullets fired from pistols are usually low velocity projectiles. Some rifles fire low velocity rounds, particularly older weapons that use black powder. These rounds move relatively slow compared to high velocity projectiles, and often do not pass through the body.

However, that does not mean they aren't dangerous. The bombs used in the Boston Marathon attack were packed with low-yield explosives which threw out low velocity projectiles. The black powder rifles of the U.S. Civil War fired low velocity rounds—namely the minié ball—that caused horrific injuries. The relatively slow-moving minié ball would shatter bone lengthwise on impact necessitating an amputation.

High velocity wounds are a product of modern warfare. They are caused by ammunition originally developed for use in military rifles such as the AK-47 or the M16 and its variants, or by shrapnel projected by high-yield explosives (see below). Such projectiles travel at near supersonic speed.

When a high velocity projectile enters the body, it creates two cavities. One is the track it takes through the body. The other is a created by the projectile’s shock wave. This one is larger, but temporary. However, because of this shock wave effect, when a high velocity projectile exits the body it leaves a massive hole with a great loss of tissue. This is the wound that causes most of the bleeding, not the little entry hole. These wounds are crippling, sometimes permanently so.

Rule 3: Understand blast injuries. There are four types of blast injuries—primary, secondary, tertiary, and quaternary

Primary blast injuries are caused by the effect the pressure wave (aka blast wave) of a high yield blast on the human body. Modern military explosives such as C-4 or PETN usually cause high yield blasts. They create a super-sonic pressure wave in all directions. A body too close to the blast can be torn apart by the pressure wave before any shrapnel can reach it. At greater distances, the blast wave can rupture hollow organs like the stomach or bladder, or tear solid organs from their foundations, resulting in death from internal bleeding even if there is no external wound. Victims of bomb blasts have to be observed and re-evaluated for some time after the blast exposure. They can appear fine at first, then fall over dead thirty minutes later.

Secondary blast injury involves penetrating injuries from shrapnel hurled outward by the explosion. The shrapnel can be fragments from the casing of the explosive charge, or items embedded inside the bomb such as ball bearings or nails. Penetrating injuries can also be caused by items in the surrounding environment hurled about by the force of the blast. These can be both low- and high-velocity projectiles.

Tertiary blast injuries result from victims being thrown by the force of the explosion into solid objects such as a wall, or being struck by an object thrown by the blast force, or from the collapse of a structure caused by a blast.

Quaternary blast injuries are caused by burns or inhalation of toxic products created by the explosion.

 Rule 4: A blow to the head is no simple matter. We've all read hardboiled detective stories where the hero is repeatedly knocked out with a blow to the head, usually from a pistol butt. A little while later, he gets up, rubs his head, and carries on like nothing happened. If I were writing that scene, the hero would wake up, puke his guts out, experience disorientation, and probably end up in the hospital.

Such a blow, in fact, could be life threatening. A blow to the head with a metal object like the butt of a pistol can result in a skull fracture or a contrecoup injury, in which the brain literally bounces around inside the cranial cavity, resulting bruising and swelling of the brain. It can also cause internal bleeding of the brain.

 Both internal bleeding or bruising can cause an increase of pressure inside the skull that could cause the brain to herniate, resulting in death. Depending on whether the bleed is fast or slow, the victim could die in minutes or days if not treated.

A simple concussion is nothing to whistle at either. A concussion is also called a mild traumatic brain injury or mTBI. Sounds a lot worse like that, doesn't it? In fact, mTBIs are considered the signature injury of the Iraq war. The big problem with concussions is that once you've had one, you become more vulnerable to future mTBIs. We've all heard the term "a punch-drunk boxer," right? That means someone who has taken too many blows to the head and suffered a permanent mild brain injury. If you read the sports news, you know professional football players are now known to suffer a number of neurological problems in their later years, probably due to repeated head blows during their careers.

Rule 5: Violence is not easily forgotten. Unless you've sealed yourself in a cocoon for the last half dozen decades, you've heard of post-traumatic stress disorder (PTSD). People who endure and survive horrifying events—whether they involve combat, terrorism, or a natural or manmade disaster—will never be the same again. Even highly trained soldiers and law enforcement officers experience PTSD after traumatic events.

Today, the military recognizes you don’t need to experience combat to develop PTSD symptoms. The key phrase used today is “combat and operational stress.” It might be a new phrase, but our fellow writers recognized this problem decades ago. The TV show China Beach, which ran from 1988 to 1991, and Shirley Lauro’s 1992 play, A Piece of My Heart, both dealt with the lingering effects of the Vietnam war on noncombatants such as doctors and nurses.

If you have a character who survived a horrifying experience in one novel, but in the next is perfectly unaffected by it, you have failed in your character development. In Empty Places, for instance, Peter suffers guilt and terrible nightmares stemming from the event that led to his head injury. In my forthcoming sequel to Empty Places, called The Last Refuge, the violence he endured in the first book only ads to Peter’s ghosts. Peter is trying hard to give up smoking, but the recurring nightmares he suffers make that difficult. Hence, he keeps what he calls his “nightmare stash” of cigarettes in his nightstand drawer for when the bad dreams scare him awake.

Understanding the lasting effects of violence on the human body and how it affects the mind and soul of your character can make that character more realistic and sympathetic to your readers.