Alec's Surgery Solved!

[ellenkushner]

UNMITIGATED RAPTURE!!!! not only did my dimwitted online researches & subsequent guesses prove to be unexpectedly right on, but our MD friends Eric & Elka just walked me through the entire accident, diagnosis, procedure & recovery so I can put the details right in my story. We did it on Skype, with lots of hand gestures. I am a Happy Writer.

Many readers will now hate me more than tongue can tell, as I proceed to torture Alec & Richard nearly to extinction. (The guy Alec is working on is but a Simple Villager, not Richard. Tho' E&E pointed out that it's also a lovely way to kill a man with a sword.)

mwa ha.

No, I'm not going to post the new scene* - but here's their description of how the medical bits work:


1) "hook someone in the rib, jam in any little tube – reed or straw – a ton of blood comes out, and all of a sudden – WHOOOOSH of intake of air. adam’s apple will shift to side when lung collapses, because the lung is like a balloon inside another balloon – as the outer one expands, inner one expands too by pressure. If anything comes between the 2 balloons the lung itself will collapse"


2) What they see:

The guy falls from something – he's up & OK for a minute or two. Starts feeling worse, gasping for air as the blood fills the space, becomes harder to breathe, collapse, gasping, w/Adam's apple shifted over. Possible indentation where he fell – bruise. She might feel a broken rib – crunchy! Chest wall moving normally, lung collapsed inside. Pale, turning blue…. (Alec has seen this before in a swordfight: get blade between the ribs, lung fills up - Hey! maybe this is the origin of St Vier's "one blow straight to the heart" - you can't really do it every time - but it's an urban legend that he can.....)

Alec punctures chest w/knife, some blood - inserts reed, pushes it in, big hole, channel blood gushes out in scary way – did he kill him? But then guy takes a deep breath, color returns.

He could stitch the reed in place to hold it there. Close the reed, stopper it w/beeswax, open it periodically to let more blood out. Once inside bleeding stops, lung reinflates, remove reed & stitch closed. More than 1-2 hrs, could be all night… less than 12.

Bandage him up, send home w/rib to heal.

* * *
*I gotta go to Boston tom'w for my Sound & Spirit talk at MGH on Weds. 1pm (wow - haven't been that person in a while!). Must revise this now before I go to bed!

Comments

[ambyr.livejournal.com]

Is it terrible that the first thing that comes to mind when I read this is Steven Brust's Athyra?

[quizzicalsphinx.livejournal.com]

This is the sort of stuff I love to research, but that always makes for awkward conversations outside of other writers ("Do you know you own your dead relatives? They get passed along. Like Grandma's silver." Does not make for good break-room material.). I end up knowing stupid amounts of medical trivia.

[handworn.livejournal.com]

you can't really do it every time - but it's an urban legend that he can

An urban setting that comes up with that legend I'd like to visit.

[handworn.livejournal.com]

Rather like Roman ancestor-masks being borne in for weddings and the like.

[ellen-kushner.livejournal.com]

It's a novel called SWORDSPOINT.

[rikibeth.livejournal.com]

Oh yes, yes you would.

[handworn.livejournal.com]

Realllly?

* looks innocent *

Who wrote it?

[rachelmanija.livejournal.com]

I was going to say the same thing. That was a tension pneumothorax, IIRC, and the kid healer uses a much more complicated set-up to get a chest tube with an underwater seal.

[yaoi-in-exile.livejournal.com]

So glad it worked out! :3 And please: torture away. Torture all you want. Just NEVER stop writing about them!

[royal-spice.livejournal.com]

You may be interested to know that there is just such a scene in the latest Diana Gabaldon book in the Outlander series. The heroine is treating a British officer who her husband shot in the chest. He survives.

[http://users.livejournal.com/la_marquise_de_/]

Yay for resolution.

[belledewinter.livejournal.com]

I seriously cannot wait. ♥

[themaskmaker.livejournal.com]

Ooo! Medical gore....

[crustycurmudgeo.livejournal.com]

Listen, if it's a hemothorax, putting in the initial incision and tube will likely be very messy. When they did it on me, the poor resident got a good shot of blood all over him. I heard the splashes and people moving out of the way then lots of cleaning up. About 1.5 liters worth was in there.

[ellen-kushner.livejournal.com]

Wowza. Glad you made it!

[ellen-kushner.livejournal.com]

Dammit. Oh, well, it's better than tracheotomy.