Getting it Right: Dying (part 1 of 3)

by Carolyn Steele

So, your character has to die. You want to get it right but, short of hanging around mortuaries and hoping the smell doesn’t put you off your lunch, death isn’t that easy to research. Watching old episode of House will just lead you into the traps that have medical types throwing their stethoscopes at the TV screen, so here is a short series of tips and pointers for getting fatality right.

Episode 1: Sudden Death

Murder: People with life-threatening injuries rarely scream, yell or writhe in pain. Non-fatal injuries are agonising but if you’re dying, you barely notice the pain at all. All your senses dull, everything looks and sounds fuzzy, and pain recedes too. Your character will quieten, they may see blood and wonder where it comes from. They might lick their lips, or try to, as thirst sets in. They may cough or vomit blood, depending on the internal damage you create, but not for long. Your character turns pale as the cold sweat sets in, the body’s reflexes begin to shut down and they lose consciousness. Breathing becomes rapid and shallow before it stops. This is shock.

With any physical injury, most people die of shock…the body’s reaction to blood loss and physical trauma. Even a relatively minor wound, a broken bone, say, left untreated for long enough can kill, and it’s the shock that does it.

But: shock is not having had a bit of a fright, that’s hysteria and the only way to die from it is if you get extremely annoying.

Do you want to shoot your victim? Decide where you want the bullet to end up. If it is to remain in their body, then the wound will be the classic little round hole that CSI types dust for gunpowder residue. If you want the bullet to be found in a wall, doorframe, shattered window, it has to exit the body from somewhere. It may not go straight through, it can ricochet off a bone at any angle you like. Give thought to the internal damage it does on the way.

But: there won’t be two neat little holes. The entry wound will be bullet-shaped, yes, but the exit will be a big mangled, bloody mess. It’s often missed by rookie cops and paramedics, so if you want to drop your first responder in the mire, missing the exit wound is a great tactic.

If you choose to stab your hapless character, bear in mind that it’s harder than it looks for the average, untrained killer. Most angry knife-wielders do no more than superficial damage, cutting around the face and chest. An assailant with no anatomy knowledge will be most successful by puncturing a lung, since it’s well-nigh impossible to stab someone in the heart. Punctured lungs are dramatic, the wound will actually breathe. Each time your victim inhales, the wound sucks air. Breathing out, the wound expels bubbly blood. With the right care, this person can be saved but the treatment is pretty counter-intuitive; unless your plot involves an ambulance on stand-by or your victim is a paramedic, your assailant can safely leave.

If your murderer is a trained assassin, the quickest, quietest option is a slice through the femoral artery in your victim’s inner thigh. Spurting blood will hit the ceiling and it’s all over within minutes.

But: it is really difficult to slit someone’s throat. Noisy, messy and only happens in movies.

Illness and Accident: Your character has to die without an assailant. Accidents can happen out of the blue but illnesses need to be a little predictable, a few clues sprinkled in the text, or it feels like a plot copout. For realistic warning symptoms, heart attacks and strokes work best. Especially if you ramp up the stress as well. You can predict a heart attack with repeated bouts of ‘indigestion’ type pain. And this is one victim who is allowed to be terrified! You can predict a stroke with sudden headaches and, believe it or not, nosebleeds. These both remain common killers, despite often being treatable with rapid professional help.

But: if your scenario involves your character being bundled into an ambulance with paramedics performing CPR, please let them die. CPR is effective in a scant 7% of cases, anyone who knows their stuff will chuck your book at the wall if you allow it to work. Incidentally, CPR as we know it wasn’t invented until the 1950s and not widely taught until the 1970s. If your tale is set any earlier, most resuscitation attempts would be an anachronism.

That stuff is ok for older characters but how do you kill a youngster? Whatever you want to set up, drink, drugs, road accident, head injury from a fight or fall, some sort of suicide attempt, it’s the unconsciousness that does it. Anyone left unattended will die from their compromised airway within minutes, sometimes from airway occlusion as the throat muscles relax, often from inhaling vomit. It’s quiet, undramatic and truly tragic, since that life is saveable if anyone knows their stuff. If your character has to die like this, make sure no-one nearby has taken a first aid course.

But: nobody ‘swallows their tongue’.

Finally, a big but: this one bugs every medical person, every time. All dying and dead people go through the same colour stages (pale, grey, blue at the lips, blue all over, drainage markings after several hours) except carbon monoxide victims. Their skin is always bright, cherry red. They look really well, if a little embarrassed. So, if you put Dad in the car, in the garage, with a hose from the exhaust poking in through the window, he will still look alive when he’s found. If you want one character to walk into danger to save another, it’s worth you knowing this but not telling your hero, but, for the sake of my blood pressure, please don’t turn Dad blue.

Next Time: Narrow Escapes.

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Carolyn has been a paramedic, first aid trainer and palliative care worker. She has watched countless people die, although to be fair, mostly the ones she wasn’t tasked with saving at the time. One day there will be a book about death, people don’t talk about it enough, but currently her narrative non-fiction is more about life…and some odd ways to make a living. Her first book, A Year On Planet Alzheimer, is available at Amazon in both print and Kindle format. Her forthcoming book Trucking in English is currently being podcast, in 10 minute espisodes, on her blog and on iTunes.

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