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Killing a character (or not?) - a medical question
So, I tend to let the logic of circumstances and characterisation lead the plotting of my stories. It can surprise in that way. And it's surprised me now to find that a beloved character may be dead by the end of this story I'm writing. In fact, I can't see any way round it.
Here's the situation: two teenagers, a boy and girl. They grew up friends and he's always been the kind of kid who acts before thinking (usually doesn't think at all, to be honest). She's always been the feisty one, hitting back if need be, giving as good as she gets. Now they're older and he's joined the wrestling team -- the perfect activity for him. Much stronger and some ways more aggressive. They're down at the national park where they've always played (a big place in Tennessee -- real location). He wrestles her to the ground, no harm intended, gets her in a choke hold. She can't fight back. Before he realises what he's done, she's unconscious.
From research I've done, unconsciousness is a given in this situation. When the boy sees she's unconscious, he goes into flight mode and leaves her. There are a few possibilities now, and research hasn't led me to anything conclusive: she's either going to come round from her blackout, or she's going to slip into a coma (possible, but I don't know the exact circumstances -- period of time without blood/oxygen supply to brain -- where coma becomes likely), or she'll die there and then (sadly, I've seen this in a video of that African American man who was wrestled to the ground by police and put in a choke hold by one officer). But I haven't found any conclusive information about the prognosis for someone who does end up in a coma; or even the amount of time someone can be in a choke hold before either of these outcomes happen (it seemed to happen quickly, though, in the terrible incident between that officer and the suspect who died). It may depend on underlying health, even age. I'm just not sure.
There is another friend on the scene (the protagonist of the novel), who doesn't step in even when he sees the girl struggling before she blacks out (he's afraid of the one who wrestles her to the ground); and though he does run for help, he has a long way to get out of that forest. So there's going to be a significant delay in medical attention.
Is there anyone here with a medical background who might give some insight? Or who knows someone? Or a place to ask? Many thanks.
Here's the situation: two teenagers, a boy and girl. They grew up friends and he's always been the kind of kid who acts before thinking (usually doesn't think at all, to be honest). She's always been the feisty one, hitting back if need be, giving as good as she gets. Now they're older and he's joined the wrestling team -- the perfect activity for him. Much stronger and some ways more aggressive. They're down at the national park where they've always played (a big place in Tennessee -- real location). He wrestles her to the ground, no harm intended, gets her in a choke hold. She can't fight back. Before he realises what he's done, she's unconscious.
From research I've done, unconsciousness is a given in this situation. When the boy sees she's unconscious, he goes into flight mode and leaves her. There are a few possibilities now, and research hasn't led me to anything conclusive: she's either going to come round from her blackout, or she's going to slip into a coma (possible, but I don't know the exact circumstances -- period of time without blood/oxygen supply to brain -- where coma becomes likely), or she'll die there and then (sadly, I've seen this in a video of that African American man who was wrestled to the ground by police and put in a choke hold by one officer). But I haven't found any conclusive information about the prognosis for someone who does end up in a coma; or even the amount of time someone can be in a choke hold before either of these outcomes happen (it seemed to happen quickly, though, in the terrible incident between that officer and the suspect who died). It may depend on underlying health, even age. I'm just not sure.
There is another friend on the scene (the protagonist of the novel), who doesn't step in even when he sees the girl struggling before she blacks out (he's afraid of the one who wrestles her to the ground); and though he does run for help, he has a long way to get out of that forest. So there's going to be a significant delay in medical attention.
Is there anyone here with a medical background who might give some insight? Or who knows someone? Or a place to ask? Many thanks.
Comments
Either way, the choke-hold-gone-too-far situation is what he gets into. I realised I'd foreshadowed that anyway much earlier, and it just seems exactly what he would do. Remember some kids like that at school...
Questions for a medical person are:
1) How long usually before she'd become unconscious?
2) I know having blood and oxygen supply cut off can lead to a coma from my research, but what circumstances can lead to going from a temporary blackout to coma?
3) What are the chances of survival if such a coma occurs? What sort of permanent damage can occur if any?
And any other specifics that might happen. All this taking into account it will take at least 20 minutes for the one kid to get help, leaving her unconscious, and then significant time for paramedics to arrive.
If your friend can help that would be great.
So far I've found articles about abused women being choked for a couple of minutes and blacking out, and telltale signs such as reddening of the eyes and affected quality of speech (temporary). And seen a news article about a child who was choked and slipped into a coma (but no real details about what leads to a coma, and no follow up article to say what happened to the child). And as I already said the incident with the police officer who held a suspect in a choke hold resulting in death (which seemed to happen in a very short time span).
So a few different potential scenarios but no clarity, as yet, on which might occur in my scene.
Lung capacity will be different on someone who is smaller than someone larger, which might effect how quickly they pass out.
Someone who runs regularly would probably last longer than someone who doesn't...
Why don't you send the questions by email to your own Dr?
Hopefully these are the kinds of questions a specialist can clear up, Carol. I did wonder if age is a factor. The boy who accidentally strangled himself on bag strings and slipped into a coma was 4 years old. Again, nothing in the article suggests a prognosis or what happened to the poor boy in his case.
If I'm told that my character is likely to regain consciousness, or slip into a coma but survive, then great. But if I'm told chances of survival are zero, I'll go with that outcome. Don't want to force an outcome that's unrealistic.
I think it is feasible for the victim to come round* or not, depending on what you want.
This is not my area of expertise though.
*I've heard some lecturer's party piece was to cause students to collapse through the carotid sinus reflex.
One was due to a severe head injury, if that helps?
Most people, I suspect, will believe that a short blackout would be something your female character can survive unscathed. If the story you want to tell requires her to slip into a coma or even die right there on the ground, you'll need to emphasize the length of time she spends in the choke hold, how roughly the guy pulls her about, etc. She might also hit her head on a rock or something as her releases her.
You might need to brush up on the medical terminology if you wanted to include a scene where a doctor explains what happened to the girl, for authenticity's sake. But often such scenes only seem to exist to show off the research the writer has done and can be tedious if not done particularly well.
I've moved on with it already, though. But thanks.
A blackout was never really an option (no problems resulting from one of those) because it wouldn't create the incentive for my protagonist to act the way he does (I can't go into detail more than what I've already said). So it was either coma or death. I didn't exactly want to lose this character, but if that was the only logical outcome... Could have changed the setting to somewhere closer to a telephone (time period means these kids don't have mobiles, like every teen probably does today -- not that they'd be guaranteed a signal), but the forest setting is important, too.
Having said that, I believe, having read a couple more medical articles by doctors who specialise in these matters, it's plausible that she would survive and go into a coma (which she would also survive, but would probably suffer memory loss of the events leading up to it; much like my brother does when he's had a hypo). The delay in medical attention and being left alone at the scene could risk her choking on her own tongue if she's lying on her back (which she won't be) or on vomit/mucus. But I think it's safe for me to have her slip into a coma and none of these potential threats happen before medical assistance arrives.
And yes I'd even thought, a couple of days ago, that she might hit her head on a rock, because swelling that pushes down on the brain stem (reticular activating system) causes coma. Great minds, Danfango
Definitely won't get into any medical jargon scenes. It wouldn't be relevant to the story I'm telling.
I do like getting my facts straight as much as I can. Some might call me pedantic
If someone is knocked out by a blow to the head, how long can they stay unconscious without treatment and come round relatively unharmed?