magibrain

So, What Happens In Burma has this exchange:

Peter: In the last year, it was held in a secured vault at a state mining facility, under army guard, in the middle of a jungle.
Neal: Not exactly a prime location for a college kid to just walk in and grab it.
Peter: No. The mine is in the Mogok Valley.
Neal: You can get there by a helicopter or a seven-hour jeep ride over some nasty terrain.
Jones: You just know these things?
Neal: Yeah, that's why they keep me around.
Peter: Mm.
Neal: You'd need some muscle, a cargo plane, and a few grand in bribe money just to get started.
Peter: You would?
Neal: And who knows what else? Because I've never considered stealing gems in Burma.

(Emphasis added.)

In Forging Bonds, when Mozzie walks in with the information on Kate's whereabouts, Neal is doing some red-ink work on a map. The conversation there:

Neal: Hey. Rubies in Burma. I'm gonna need a bush plane to get–

–and then he sees the look on Mozzie's face and asks him if his pigeon died.

( Tongue-in-cheek examination of probably-unintentional canon implication. )

Trauma is a surgical disease. It is cured with bright lights and cold steel.

I can't remember where, when, or how I first came across a series of posts on Making Light called Trauma and You, but I am forever glad I did.

Trauma and You, despite its CYA-ish disclaimer (I am not a physician. I can neither diagnose nor prescribe. These posts are presented for entertainment purposes only. Nothing here is meant to be advice for your particular condition or situation.) does a pretty good job of walking you through a trauma scene – what you're going to see, what's going on behind the scenes (or under the skin), and what you should be doing about it. It provides mnemonics, statistics, and instructions, and if you're the kind of person who likes doing terrible things to your characters and having them patch themselves or each other up, it's a really great reference on how they should be going about that "patching up" thing.

But I think half the reason I keep coming back to it is that, even though some of the medical conditions described are enough to make your skin crawl (there was a meta-blog post elsewhere on the site, wherein one of the posters summed up the author's usual contributions as Long, bloodcurdlingly detailed advice from James D. Macdonald about what to do in event of some dire emergency (heart stops, house floods, leg falls off, children attacked by whale, etc.) Posters stunned into silence. Long, contemplative pause as commenters look thoughtfully at own houses, children, legs, etc. Timid, Piglet-like question. Terrifyingly learned and hope-destroying reply.), the post is often just fun, in a snappy, sardonic, and... occasionally hope-destroying way. Because you get advice like the ever-quotable [...]make sure the scene is safe. There is something over there that munches people. You are a people. Don’t get munched yourself. If you do get munched what you’ve accomplished is this: you’ve incremented the patient count by one and simultaneously you’ve decreased the responder count by one. On a scale from good to bad this is bad. Or the sheer pragmatism of When you’re dealing with trauma, your life is pretty easy. You have 1) Things that’ll kill your patient in the next five minutes, 2) Things that’ll kill your patient in the next hour, 3) Things that’ll kill your patient today, and 4) Things that you don’t really care about.

Trauma and You is broken up into five informative posts, with a couple of Final Exams at the end:

1. The Basics. So, what’s trauma? It’s the physical world impinging on your tender body. Not to be confused with biology happening (in the form of bugs and germs), or chemicals (poisons, overdoses) happening, or your body breaking down and wearing out and going mysteriously wrong. No, this is more the Force of Gravity sort of stuff.


2. Shock. Now it’s time to have our little chat about shock. Shock is what kills people. Shock, dear friends, is what will eventually kill you, personally. The only question will be how you got into shock to start with.


3. Sticks and Stones. You can have a lot of fun memorizing bone names. (For example, the mnemonic for the bones in the wrist is “Some Lovers Try Positions That They Can’t Handle” for Scaphoid, Lunate, Triquetium, Pisiform, Trapezium, Trapezoid, Capitate, Hamate. (You can have even more fun memorizing the names and functions of the twelve cranial nerves, but that’s for another post.)


4. The Squishy Bits. When crush injuries were first identified (in the trenches of WWI and the London Blitz of WWII) they ran around 90% fatal. Nowadays with fast and efficient EMS they’re down to 50% fatal.


5. Burns. The amount of smoke inhaled is the number one predictor of mortality in burn injuries, way ahead of the age of the patient or the surface area of the burn. Continue to be suspicious with someone who has escaped from a fire. Sometimes the symptoms of smoke inhalation don’t appear for hours or days.

While I usually have to consult additional resources for various fictional traumas – like this shockingly relevant article on gunshot wounds to the chest, one of my major pieces of research for Misfire – and while I have no illusions that I get everything right when I do write about trauma, the Trauma and You series is almost always my first click, and I know there's a level of verisimilitude in my writing that wouldn't be there without it. Highly recommended.

Also highly recommended: a strong stomach when it comes to various traumatic medical things. Like amputation. And degloving.

Seriously, though, I could have gone my entire life without learning about degloving.

(Crossposted to my srs journal.)