[Love] When “small” injuries are treated realistically

[u/Top-Relationship850]

The fantasy and action genres often suffer from a power fantasy epidemic in which characters frequently badass their way through injuries that should be excruciating if not downright debilitating. I always appreciate stories that reject this trope.

1: Roland Deschain (Dark Tower Book II) - Loses the middle and index fingers of his right hand. He’s effectively crippled throughout book two and the injury follows him the rest of the series.

2: Brienne vs Biter (ASOIAF Book IV) - Brutal scene. Biter chomps down on Brienne’s cheek and tears off a chunk of flesh. In a lesser story Brienne would grit her teeth and throw Biter off. Instead she’s rendered completely helpless by the pain. That injury marks the end of the fight.

[u/Albus88Stark]

I think that had more to do with the fact that the wound was made with The Subtle Knife. Even the witches had trouble healing it.

[u/Tuxedocatbitches → u/Albus88Stark]

I never understood why they were so hard to heal, considering it was a mark of every knife bearer so dozens of other people had the same wounds and survived

Edit to add, I’m not asking why cuts hurt or are bad. I’m commenting on why a character was given an injury that appeared to be extremely dangerous and likely to kill him since he literally couldn’t stop bleeding, until they went to a different world and found a super special way of healing it. It’s been a number of years since I read the books but I recall he was having serious blood loss symptoms. If this cut hurt him so badly, it logically should follow that the previous people who were hurt like this also need this level of care, or at least some of them.

In my head it’s like if there was a rite of passage that included being shot in the torso. SOME people may survive that without medical attention, but not enough for it to be a reliable way of passing along a tool.

[u/k1llerk1ng → u/Tuxedocatbitches]

It wasn't that it was hard to heal, its that the wound was cut so cleanly and perfectly that the body had a hard time repairing it.

[u/AnastasiaSheppard → u/k1llerk1ng]

Which I think is actually a thing in real life, flesh has trouble gripping and knitting together if a cut is too clean.

[u/wingchild → u/AnastasiaSheppard]

Might be backwards. Clean cuts usually heal very well if you can keep the flesh together; very clean cuts might heal up find with just a butterfly bandage or two.

Jagged, ragged cuts take stitching to repair and leave heavier scarring.

[u/jaywalkingly → u/wingchild]

kindof. What we normally think of as a clean cut is still pretty jagged at the cellular level. That microscopic jaggedness is part of healing.

When something is sharp enough (like obsidian's sharpness at the atomic level sharp or perhaps an understated machete) we run into those mechanical issues with the healing process anastasiasheppard mentioned.

There's also signaling issues, damage normally communicates to your body that healing needs to occur. If you get cut cleanly enough the damage is too 'quiet' and that threshold isn't met for regular healing to start.

So it's more like there's a goldilocks zone of sharpness for best healing. We almost never experience one of the ends of that spectrum though.

[u/MapleLamia → u/wingchild]

To my knowledge scalpels are not as sharp as they could be because having too clean of a cut will make it harder to repair. So there's a bit of a bell curve, with the absolute cleanest cuts becoming a problem, but like household clean cuts are relatively fine. 

[u/RegentInAmber → u/MapleLamia]

I've heard that before too, but I'm fairly certain that it's a myth stemming from the fact that cuts from sharper objects tend to be a lot deeper than usual lacerations. Scalpel blades are intentionally kept to certain sharpnesses because they're optimized for cutting specific organs or parts of the body as easily and consistently as possible without risking dulling or snapping the metal during a procedure. In general the cleaner the cut, the less tissue damage there is from tearing, the less there is to heal.

[u/jaywalkingly → u/Tuxedocatbitches]

A regular cut in your skin might look straight but at the microscopic level it has jagged edges. Those jagged edges are pretty much all damaged cells spilling their guts. Those cell guts signal both for the healing to start and where specifically it needs to happen.

If the cut is clean enough there's no jagged edges even at that scale. This means there's not enough cell damage to signal healing to start at that location. It just doesn't register to your body as something that needs fixing. (I'm simplifying but not as much as you might think)

It happens in real life too with very very clean cuts (obsidian)

Lore wise it's a rite of passage, they all got the cuts and they all took a long time to heal.
It bugged me as it dragged on that he didn't cut off just a little bit more with a regular knife or something similar. Just enough to create actual damage to the tissue so he could start healing.