Plausibility Question

Sat Nam! (Literally "Truth Name"--a Sikh greeting)

I knew a man who was shot in the throat while in the merchant marines. Yes, he lived. He could speak, but only barely. Was never told what they did to keep him alive.

But I can confirm that it's possible to damage the larynx without damaging an artery.

Blessings,

Siri Kirpal

It's plausible to me. Your scene reminds me a little of the movie Revenant where the MC's receives a truckload of wounds from a bear, including one in the throat.

You can probably find a number of stories from the old west about wounds and how people treated and recovered from them.

I think it borders on the plausible; but, I suggest you wait until some of our medical experts chime in and address the the rather blatant issue of infection. The propensity for infection-related issues is huge. On the other hand, that may spark some imaginative lingering after-effects, no?

Maybe the interloper has a flask of corn-mash moonshine on him? Boondocks/frontier disinfectant?

A friend of mine helped me butcher some Rex rabbits after my cervical dislocation attempt failed, and I was upset because I wasn't giving them a clean death. Her preferred method was severing their jugular. It took two of us, one to hold the rabbit down, one to use the knife. I felt bad about giving her the bad job when they were my livestock, so I tried--- and I failed again, even with a freshly sharpened knife. One of the differences, of course, is that rabbits have fur--- but the point being, it was actual work and effort to get the blade to slice through all the layers it needed to.

I've never tried harming a human. But I'm curious, with all the forces moving in the various directions, whether there would be sufficient force to actually sever his vocal cords, rather than just bruising his larynx.

In the 1980s I knew a prison guard that this happened to after being attacked by an inmate. Survivable, but one hell of a scar, almost ear to ear. I never got the whole story so I cannot guess how deeply the wound penetrated.

I’m an otolaryngologist head and neck surgeon.

The mechanism of injury sounds very unrealistic. Vocal folds are protected by heavy blocks of cartilage (thyroid cartilage literally forms a shield around the VFs).

And they are in the same plane as most knife injury trajectories, so are usually spared.

So yeah, sounds like cool drama but not very plausible... and I’ve seen concrete cutters vs necks

However, fiction hardly ever gets medical facts right, so go for gold.

Wouldn't a hard blow to the throat bruise or harm the larynx enough to limit or destroy speech capability?

Lochnivar said:

Thanks all!

I'm not a slave to hard facts, it's fiction after all, but I do value plausibility to a critical mind.

What if I changed this into a cut that turns into an infection that destroys the larynx? It's not an integral part of the story, but it is a major tool. I can cut it, but I'd like to keep it if I can keep it plausible.

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Do you need the character to lose their voice or just get their throat cut?

Destroyed larynx = no airway = death, so that doesn’t work.

The larynx’s main function is airway protection. Voice is secondary.

Cobalt Jade said:

Wouldn't a hard blow to the throat bruise or harm the larynx enough to limit or destroy speech capability?

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Yep - you could get a laryngeal fracture that significantly alters voice, but you need a higher force injury. The mechanism above doesn’t really work for that

Don’t really know how you would destroy a larynx, like I said, it’s pretty well protected. Unless you go for a stab wound through the cartilage (significant force), and someone then does an emergency tracheostomy on him?

Lochnivar said:

The MC's throat is going to swell up, swell shut. The newcomer is an old wilderness man and quickly places a few sticks in the wound to prop open the throat so that the MC can keep breathing. He then goes to the riverbank to find a few stones to use as a cold source to reduce the swelling. After a few days, the swelling has subsided enough to sew up the makeshift trach, minus the MC's voice.

Barring any concerns of infection, that much is probably certain, how plausible does this basic premise seem?

Thanks for your answers.

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In addition to the aforementioned problems with the injury itself, if you're going for a situation where a tracheotomy is necessary not only for survival of the initial injury but ongoing survival after that, sticks and stones aren't going to cut it for first aid. AFAIK a drinking straw or similar tube has been used in emergency first aid situations where a tracheotomy's necessary and there's no medical equipment available, but the procedure was carried out by someone who knew emergency medicine. Also, I'm not 100% certain if I saw that done in a documentary or a work of fiction.

If the guy's gone down to the river to get stones to reduce swelling, bear in mind that if the throat closes completely, the patient's got about 30 seconds to one minute of being conscious (will be desperate to try to breathe and may do more damage clawing at his throat) and will be brain dead within about 13 minutes. Cold stones aren't going to do much. They might reduce swelling near the skin but they're not going to open the throat up again. A tracheotomy's necessary and a tube is necessary to keep the tracheotomy incision open and clear of blood.

Bear in mind that there'll be lots of bleeding, so blood will be going into his trachea which will complicate things. I'm not a doctor of any kind so I don't know how doctors and paramedics deal with this but it further illustrates that propping the wound open with a stick and going to get cold stones to reduce the swelling isn't going to work.

Having a permanent hole in your throat is a thing. I can't remember what medical conditions necessitate living with a permanent tracheotomy hole in your throat, but at a guess, cancer that affects the throat. You won't be able to speak with this because the air goes in and out of your throat, rather than through the larynx. Your vocal cords only work because of air going through the larynx. No airflow = no sound. Also bear in mind that these are people who've had access to a high level of care in modern hospitals with specialist doctors. I wouldn't find it plausible that someone could survive this without the same.

Anyway, PK Torrens knows far more than I do about this, but even without being a doctor I find the whole scenario - the injury and the treatment after the injury - implausible enough that I'd stop reading the book.

Best advice is to start with what outcome you want and research backwards from that - if you want someone that's got a hole in his throat that he breathes through and can't speak, find out what medical conditions and treatment results in people having to live with that and work that into your character's backstory. But the backstory needs to involve a decent hospital and specialist doctors.

OP, feel free to PM me if you need further help. I only sometimes drop by this sub-forum

If you need him to lose his voice, what about a botched hanging? I haven't researched this myself, but there's a book by a well-respected author who is known for her research and accuracy, where a male singer (late 18th century) is abducted and strung up because of a misunderstanding. The rope was new and stretched just enough to let the guy touch the ground with his toes, so he didn't die. But by the time he was rescued, his throat was badly bruised and swollen. He couldn't talk for a long while (I want to say months?) He had to do a lot of vocal exercises to regain control, and even still, his voice sounded different. I don't recall if he was able to sing afterwards, but I'm thinking not. Or at least, not with the same skill.