Pain and Injury In Writing

I broke a bone in my ankle while on deployment, but that didn't hurt as much as you would think.

Once, as an adult, I was at a gun range and I had a round explode in th chamber of the rifle I was using. I took two pieces of metal into my hand and about 1/3 of my arm was covered in powder burns. Want me to describe that?

POV matters hugely. An example from my bestest unpublishablest novel:

Saint was flat on his back and didn’t know why, only that his legs went from under him and the world shook as if it had collided blindly with something hard. All sound was muffled, far away, something heard under water. You don’t lie on your back when you get hit, you dumb shit, he thought, you get face down, under cover. He opened his eyes and tried to roll over.

The pain came in a rush, from everywhere and nowhere, with its own internal grating noise, a violent flash of colors, a taste of burnt metal, stopping his breath. Searing throbs from his legs made him bite his tongue. He lifted his head to look up. Sweat ran into the corners of his eyes. For a long second the boot with the lower part of the leg still in it, standing upright not four feet away, reminded him of a missed ten pin.

Another example from my second bestest unpublishablest novel:

My foot hit something in the dark and my face hit the earth just at the moment the second shot sounded. Well, at least I think that’s what happened, when I got a chance to examine my face a bit later, after I’d woke up. Waking up at least made me suspect I wasn’t dead. That discovery led to another, a moment later, when I tasted blood and felt the warm smear mixed with grit that seemed to cover most of my face below the nose.

I hauled myself to my feet, but it was dark in every direction and I had no idea where I was or where I should go. I wiped as much of the blood off my face as I could with my sleeve, and tried to blow my nose, but that hurt more than I needed, so I took to breathing through my mouth until my head stopped swimming around.

Think perception, not description.

caw

The type of injury and the circumstances around it would impact how the pain is "experienced."

If you want a very concise example of how to write pain, read Ian Fleming. The one that comes to mind is "Live and Let Die." Two examples: Bond tied to a chair having his finger deliberately broken by one of his captors, and the second of him digging his bare feet into coral reef (and sea urchins) to keep from being dragged by a boat.

As for pain, it all really depends on who your character is. Bear with me on this. Football players (American) endure an extreme amount of trauma every game. When you have grown men at the pinnacle of strength and fitness, each weighing an average of 210 pounds running full steam into each other, that's like being in a car wreck each play. It'd be enough to send us average people to the hospital and get bed-rest for a week or so.
They are able to endure that beating because their bodies are so in shape, and they are conditioned to it.

I'm not saying all pain is mental--it's not--but how a person experiences can really rely on who they are.
Ever hit your thumb with a hammer? Hurts like hell, but carpenters have that happen all the time, and they can bounce back from it much easier than someone else.

Pain endurance is something you might want to think about with your character. Are they a normal, average person who ends up in an extraordinary circumstance or are they a hardened individual, used to physical strain?

If you're talking about something more than a broken bone, then that's different.

Being burned is quite a different experience than having a piece of metal driven through your abdomen.

Is there anyone who has broken a bone *as an adult* and remembers what the pain is like, who wouldn't mind describing it?

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I broke my arm when I was about eleven, but I still remember it. It felt a lot like hitting you toe or your shin pain-quality-wise, but instead of subsiding it stayed on the same pretty high level with pain-spikes when ever I tried to move the arm.

Euphoric Mania said:

Is there anyone who has broken a bone *as an adult* and remembers what the pain is like, who wouldn't mind describing it? I reread my writing all the time, and feel I'm either under- or over-doing it on the description, when all I want is to be accurate.

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As an adult, I broke a bone in my foot. Swelled up big within minutes. But I didn't scream when it happened. It hurt pretty bad, but were it not for the swelling, I don't know if I would have realized how bad the injury was.

When writing about pain, it might be good to keep in mind that different people handle pain differently. When I was in labor with no meds, I didn't scream. I'm guessing the pain I experienced was probably just as bad as the labor pain that some women respond to by screaming. Instead of screaming, I went into think mode. Thinking that if the pain got any worse, I'd pass out. Thinking that if I'd gone to the hospital instead of working with a midwife at a birthing center, I could have an epidural. Thinking about why I'd chosen the birthing center and the midwife instead of going the hospital route again. And I often go into think mode. (It's even been suggested on more than one occasion that I overthink! Gasp!) Maybe the way your character responds to pain can reveal something about the character?

ETA: Come to think of it , after breaking my foot, I focused less on the pain and more on figuring out how I was going to get home--would I be able to drive myself with the broken right foot?, would I have to call someone to pick me up?, and what would I do the next day? etc. Again, went into think mode. What would your character do in the situation you're putting him in?

I agree that pain is a very subjective experience. Some people have a high threshold, meaning it takes a lot of pain for them to even notice the fact that they're hurting, while others have a low threshold. Some have a low threshold, so they experience more pain than others, but they are able to hide it well, so unless you knew them intimately, you'd have no idea how much pain they were really in.

So you need to think about your character and whether they have a high/low threshold, and whether they scream at the slightest twinge, or if they're stoic through a lumbar puncture. (Just FYI, an LP isn't like on House, where you can hold a conversation while they're sticking a 12-inch needle into your spine. It's bad enough that they make family members leave the room.)

Just FYI, an LP isn't like on House, where you can hold a conversation while they're sticking a 12-inch needle into your spine. It's bad enough that they make family members leave the room

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Actually I had conversation with my patients during LPs. It depends on the patient. Some almost jump out of the bed, some are totally cool with it.

The only way that I know of for describing pain is by comparison, and that isn't very good, because different people experience pain differently. How does it compare with something that most people have experienced.

maggi90w1 said:

Actually I had conversation with my patients during LPs. It depends on the patient. Some almost jump out of the bed, some are totally cool with it.

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Really? When I had one, they forced my husband to wait outside and they warned me it was going to be bad. I was awfully sick at the time, so I don't remember much about it, but I'm pretty sure I screamed. I can't imagine holding a conversation during the procedure! But that goes to show how everyone's pain tolerances and perceptions are different.

In terms of broken bones, there are so many factors involved (even for the same person) the pain can feel completely different. What bone? What type of break? How did the injury occur?

I broke my thumb and it felt just like I bruised it; my skinned knee from the same accident hurt worse. But two weeks later I realised I still couldn't properly grip my bike breaks so I went to the doctor and it was broken. It took about three months for me to be able to grip things properly or make my hand into a fist. It didn't really hurt, but I physically could not bend my thumb into a fist or grab things.

I broke a long bone in my arm, at the time it felt like a normal bruise. By the next day it swelled up with a what felt like a hard lump under my skin and I could barely move my hand. The break was up by my elbow, but the slightest movement of my hand caused jolts of pain along my arm. The pain felt a bit like smashing my funny bone into something (but a stronger feeling of pain), but instead of at the elbow, would shoot along the arm.

I broke my leg with a spiral fracture. It felt as if all the muscles of my leg had been ripped and pulled around my leg. I couldn't walk on it, and the slightest movement made the pain worse. It was a strange pain, not quite like anything else I could compare it to, because there was the twisting, pulled feeling to it.

I chipped part of my kneecap. It swelled to almost twice as large as my other knee, and bruised a remarkable green-purple the lasted for weeks. It had a strange, 'balloon-y' quality to it. I'm not sure how else to describe it. It was as if my knee had been replaced by a small inflated balloon of liquid which every time I twitched, would swish around (thus causing more pain and twitching). It also had this horrible feeling of something that could be popped or punctured. As if the blood, muscle and bone of my knee had swelled up inside the balloon to rupture it from the inside. I couldn't really bend my knee for over a week, and when I could, it hurt so bad I didn't. The pain hurt so much I didn't bend my knee enough while it was healing. So after the bone had healed, I spent a bunch of time in physiotherapy regaining flexibility and use of my knee (which also hurt, but more like an intense stretch pain).

None of my breaks have been that severe, so in terms of pain they haven't hurt as much as some soft tissue injuries or serious burns (those really hurt), but the specific feeling in the injury in all cases was completely different because they were all very different types and severity of breaks.

Euphoric Mania said:

Sure badwolf, I'll take that description too, as there is some use of firearms in a lot of what I write.

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Sorry for the late reply, I had a busy weekend.

The story about my ankle is less impressive than you would think. Towards the end of the deployment, we were getting bored so we decided to do flak runs with our body armor and plates, which weight about 15 lbs. One day everything was fine, the next something was "wrong", I could feel it. So i just stopped doing flak runs, figuring my ankle would heal but it still hurt so when i got back from deployment i had it checked out and then found out that I had the broken bone.


Once, while I was at a civilian range, I was using a new rifle, new to me anyway. A round jammed in the chamber so i decided to do remedial action to clear the jam. Well, i did the remedial action wrong and the round exploded in the chamber.
At first i was just stunned for a bit, because you don't expect something like that to happen. Then i felt that my arm was "wrong" and when i looked at it i saw that my hand was covered in blood and my arm was burn from fingers to elbow. At this point, nothing really hurt so i grabbed a golf towel i had next to me and covered the blood so i could get to the hospital.
I was with my father and nephew, i explained what happened so we packed up to go. Being a civilian range at a public park, i decided to inform the person running the range about what just happened. They didn't care so we left for the hospital.
I was never really in much pain while waiting two hours in the ER before being seen, the nurses were rude and condescending and when the doctor showed up he was in and out as fast as could be. The only real pain i had was when they gave me Vicodin, which i then discovered i was allergic to.
My hand ached for months afterwards, and still does time to time. The worse part of that day wasn't the injury itself but the way other people acted towards me.

I broke my collarbone on a ski trip one time, if that'll help.

The weird thing is, it didn't hurt all that much at first - I thought my dizziness and nausea were the result of a concussion. But I had a little voice in my head going "Don't move your arm. DON'T." I, being an inquisitive dummy, decided to do just that to find why I wasn't supposed to. Rotating the arm forward wasn't so bad, but moving it out to the side was impossible - I'd got my elbow half an inch away from my body when the pain became too much to handle. It was like the break point midway between my shoulder and my neck was being stabbed with something superheated. I didn't end up screaming or anything, which I think confused the people I was with - one of them optimistically suggested that I might have "just" torn something - but it was clear that my arm wasn't functioning properly.

The people who came out to administer emergency aid did a slightly inadequate job of getting my arm in a sling, and I wound up having to support it with my other arm to avoid getting jostled around during the snowmobile ride to the first aid cabin. Holding it steady was enough to eliminate the pain, although I don't know how normal that is - there's a history of ludicrously high pain tolerance in my family, and I know the nurses were surprised when I opted to walk myself around the hospital rather than being subjected to a wheelchair. Unexpected jostling was really my worst fear at the time, as any motion I wasn't prepared for would recreate the initial stabbing sensation in full. Overall, it didn't hurt unless I was moving it in a way that could damage it further.

Sleeping was hard, though. I don't sleep well on my back, but it was the only way I could while I was injured; and, since collarbones are connected to shoulder blades, sleeping on my back also stressed the injury somewhat.

Two weeks later, when the bone had mostly finished mending, I discovered that my shoulder was also sprained from the incident, leaving it hypersensitive to just about everything - touch, movement, loud noises. That was actually worse than the break, I think. It definitely had a longer-lasting effect; my collarbone mended leaving only a small bump, but my shoulder routinely cracks quite painfully.

And then a couple months later I severely sprained my ankle and didn't get it checked out. I probably broke something in it, actually - although it was okay to walk on for the hour or so after I'd injured it, it swelled up quite badly and I couldn't put any weight on it by the end of the day. Luckily I had a three-day weekend during which I could recuperate.

blacbird said:

POV matters hugely. An example from my bestest unpublishablest novel:

Saint was flat on his back and didn’t know why, only that his legs went from under him and the world shook as if it had collided blindly with something hard. All sound was muffled, far away, something heard under water. You don’t lie on your back when you get hit, you dumb shit, he thought, you get face down, under cover. He opened his eyes and tried to roll over.

The pain came in a rush, from everywhere and nowhere, with its own internal grating noise, a violent flash of colors, a taste of burnt metal, stopping his breath. Searing throbs from his legs made him bite his tongue. He lifted his head to look up. Sweat ran into the corners of his eyes. For a long second the boot with the lower part of the leg still in it, standing upright not four feet away, reminded him of a missed ten pin.

Another example from my second bestest unpublishablest novel:

My foot hit something in the dark and I my face hit the earth just at the moment the second shot sounded. Well, at least I think that’s what happened, when I got a chance to examine my face a bit later, after I’d woke up. Waking up at least made me suspect I wasn’t dead. That discovery led to another, a moment later, when I tasted blood and felt the warm smear mixed with grit that seemed to cover most of my face below the nose.

I hauled myself to my feet, but it was dark in every direction and I had no idea where I was or where I should go. I wiped as much of the blood off my face as I could with my sleeve, and tried to blow my nose, but that hurt more than I needed, so I took to breathing through my mouth until my head stopped swimming around.

Think perception, not description.

caw

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Unpublishable? Damn. That's some fine writing.

Anyhoo. I broke a vertebra and severely injured my back after a (horse) riding accident. My first thought was, KILL ME NOW SOMEBODY PLEASE KILL ME NOW NOW NOW! The pain was so intense, I simply could not handle it any longer. So, like the birdman sayeth, perhaps more perception (and reaction) than description.

When I was 12, I twisted a knee after I fell when skiing. I was screaming and moaning, and people who were watching were laughing and coming very slowly to help me.

In the elementary school, a 14 year old girl dislocated her shoulder. She was crying and screaming. I was near and I was thinking there was no need to scream so loudly and to be so annoying...

As a medical student I saw how a female doctor gave a local anesthesia to a young soldier who needed his ingrown toenail to be cut. She cut too early and the soldier, who looked quite brave, was twisting his whole body but the doctor was quite amused. I wanted to punch her into the face.

I agree about what was said above: think perception, not description.

Following a good thread here.

And PastyAlien is right. Love both of those passages, blacbird.

I was just thinking that trying too hard to describe the pain is pointless. The injured party should simply scream and writhe as much as the injury permits.

Another facet that maybe no one has mentioned yet - I broke my toe a few months ago, and apart from the sharpness of the pain, one of the most immediate sensations was not just my foot itself but my head - I immediately panicked and knew it was broken straight away. It was the ringing and pulsing in my head from the panic that was most memorable, thinking "oh shit, I've just broken my toe. Holy crap what do I do? I don't even want to look" etc. I think that's what set my pule racing - the panic, more than the actual pain.

Also, I broke my collarbone when I was a teenager but I also blacked out (don't actually know exactly what happened even still) so can't remember what the break felt like!

A couple of comments:
1) I broke my leg when if was in my 40s. Very little pain at first. Pain and swelling later. As long as I kept my leg elevated and ice on it, I was OK. I was camping and it took two days to get to a doctor, but it was fixed and healed just fine.
2) Show, don't tell. Describe how your character is acting. Don't try to describe the pain. Your character can complain about the pain, "This is nothing to joke about, you idiot. This hurts! Shit, I can feel my broken leg all the way up to my hip. Maybe there's something else wrong."

I suppose you'd want to describe the pain rather than the extent of the injury. Like the others said, the pain level can vary depending on the threshold. In my case, a broken toe felt like a force field of awfulness surrounded my foot, pulsing like a giant zit. You could find something mundane, and multiply it a hundred times?

For instance, a scrape feels like a burn, and a break feels like a deep ache in the bone.

Readers would probably not be interested about how "exactly" the pain feels. Everyone knows that, and even if not, you probably do not want to make readers "feel the pain" but to show how the sufferer reacts to pain.

Boron just said it about as well as it can be said.

caw