by Jason Swink

Since my first day of med school, I’ve provided family and friends with untold joy. This has come in the form of pointing out medical errors found in books, movies, and TV shows. Every story, it seems, either shows an astonishing lack of realism or attention to facts. My wife and kids tell me they are infinitely grateful for the interruption of any show they watch, and especially for the correction of falsehoods. After all, I say,  what is more important than being entertained?

Exactly—being right.

Here are a few ways to avoid having medical professionals make fun of your novel.

Know your equipment

A big medical flaw I recently saw was from a book that was made into a television series. (I won’t name it because the author is a former Navy Seal, and he terrifies me. And maybe he didn’t write the TV show.)

In this story, a gun battle occurs in an MRI suite. Now, guns and some bullets contain steel, which is ferromagnetic. An MRI machine creates one of the most powerful magnetic fields on earth and would interfere with said gunfight.

Years ago, while performing an MRI-guided breast biopsy with substandard equipment, my biopsy device locked up, trapping the biopsy sample within. I grabbed a pair of pliers to free the precious tissue. In the heat of the moment, I forgot the giant freaking magnet twenty feet away, and the steel pliers were nearly ripped from my grasp. Fortunately, I have the reaction time of a hummingbird and the strength of a brown bear. Or maybe the other way around. In any case, I kept the pliers from rocketing at the patient, but it took a lot of effort.

Bottom line: No way you can aim a Sig next to an MRI scanner.

Calculate the outcomes of injuries

One of my favorite screwups in books is when a character gets clocked in the face and breaks his nose. Somehow, the fictional nose never starts gushing blood. But that’s what generally happens when a real snout meets a fist, or a baseball bat, or a steering wheel.

Next, and this is one hundred percent of the time, the movie victim with the broken nose will grab the displaced shnoz and click it back into place. Like it’s made of Legos. Click. Problem solved.

I’ve interpreted a million maxillofacial CTs and nasal bone x-rays, and when the nose is broken, it’s broken. As in, bones are fractured and splintered and displaced.

If you’ve never broken a bone, you may not know that bones are loaded with nerves. When broken, bones hurt. So, if you grab an extremely tender handful of bone splinters and yank them back to midline, you’re going to pass out from the pain, and probably break the bones some more.  They certainly don’t click back into place and stay there.

Same with shoulder dislocations. When a shoulder is dislocated, it’s almost always an anterior dislocation. This means the head of the humerus is dislocated forward from the normal position. (Unless they were electrocuted, but that’s a story for another day.)

In the movies, the injured party simply runs into a wall and knocks the humerus back where it belongs, nicely seated in the glenoid fossa. Think Mel Gibson in Lethal Weapon. Click. Just like Legos. Once his shoulder has been reduced by slamming into a wall, he’s ready to fight more bad guys.

Uh, no.  The humerus is held in place by a variety of soft tissues, including the glenoid labrum, the rotator cuff, and some other physical components. When you dislocate the humerus, that non-bone stuff gets jacked up. So, even if you don’t have a fracture, you’re bound to have lots of soft tissue injury.

You aren’t going to be fighting bad guys for a while. Not even if you’re Martin Riggs.

Understand gunshot injuries

When a person is shot with a gun, whether it’s through the abdomen, or chest, or wherever, sometimes the focus is whether the bullet is still in a person.

“It was a through-and-through,” they reassure whoever.  “Everything is okay.”

No. Everything is not okay. You just got shot in the chest. If the bullet went all the way through you, it probably broke ribs, tore through blood vessels, and most definitely collapsed your lung. You aren’t going to be fighting any bad guys with a tension pneumothorax. You need a chest tube in place until all the holes heal up, and the lung can remain inflated on its own.

If the chunk of antimony-lead alloy ripped through your abdomen, you probably tore up some bowel, more blood vessels, maybe some solid organs. You have fecal matter leaking into your peritoneal cavity, forming abscesses, and trying to kill you.

You need a surgeon and a ton of antibiotics.

Okay, sure. there are absolutely miracles where a bullet or knife or tree branch penetrates some poor person’s body and somehow manages not to damage anything crucial.

But it’s definitely better (for the victim, and for your reputation) if a bullet hits a rib and stops in the subcutaneous tissues of the chest wall, rather than passing entirely through the body.

Do your homework

None of this is meant to point fingers. All writers are guilty of flying through the process of writing about technical issues in which we aren’t experts. I’m sure I’ll get nasty emails from lawyers, neurosurgeons, and FBI agents when my books are published. All we can do is try to be careful and thorough, and sure, at some point, you have to stop researching and just write.

But first?  Run some of the more technical stuff by an expert. Their advice can help everything click into place. Like Legos.

Do you need medical answers to resuscitate your novel? Let’s talk about it on the Career Authors Facebook Page.




Jason Swink is a former chemical engineer and standup comic-turned physician and author of medical thrillers. He lives in Kansas City with his wife, four daughters, and two dogs.