Have you ever read a book where the main character was injured so badly that it was a miracle they survived?

Not only did they survive, but they thwarted the villain, saved the townsfolk, and won back their love. All while bleeding profusely. All while running around on a fractured ankle. All while nursing a significant head injury.

It sounds far-fetched, but it happens. In books, in movies, in TV shows. We’ve all seen characters come back from injuries that should have killed them, but didn’t. It’s usually used as a plot twist or a moment of triumph. When they’ve been injured so severely, though, that moment of triumph can turn into a moment of laughter or disbelief in the eyes of the reader. Instead of being glad the hero returned from that fall off a cliff, they’re ready to put the book down because it’s just not plausible.

Injuries are a realistic part of stories, especially books with action, horror, and thrillers. While some liberties can be taken, if you’re ignoring the extent of an injury because it messes with your plot, rethink what you’re doing, and keep track of everything with this checklist.

The Injuries ChecklistResearch It

When adding injuries to your characters, research goes a long way. Not only will it help you plan how an injury can occur, but it may even lead to a plot twist in your book, so do your homework on everything.

Look into the side effects of an injury. A head injury can cause many issues, but so could a paper cut. If one happens to a character that doesn’t stop bleeding, it could be a sign that they have an underlying condition.

While researching, make yourself a note file of healing times. A character that cops a black eye in the morning that’s gone by the time they go to the big dance that evening isn’t realistic. Bruising takes a few days, and broken bones, weeks, even for something as small as a pinky finger. If a severely twisted ankle happened to your sprint star main character on a Saturday, they still need to be hobbling around the next Saturday, not at the big track meet winning races as if nothing happened.

Open up a new notebook or digital file and add the following headings:

How the injury occurs.Injury side effects.Healing times.

As you research, make notes under your headings so that you have all the relevant info to add to your story as you write.

Keep it Realistic

We’ve all seen those slasher films where someone is stabbed so many times there’s no way they survived. Yet, it gets to the final act, and up pops Mr. Pin Cushion as if his gaping wounds are a knick that can be held together with a ripped shirt until the day has been saved. He’ll then drop by the hospital on his way home, but not before saying his trademark quip.

In reality, he shouldn’t be breathing, let alone talking. This isn’t realistic. That character is dead.

If you find yourself with injuries that are too much, scale them back. Your characters can still get injured fleeing the serial killer, but a sprained ankle is better for clamoring over downed logs in the creepy woods than a shattered ankle that would realistically have them curled in a ball, delirious with pain, no matter how much of their backstory you dedicate to their do-anything fighting spirit.

Add the following to your checklist…

Research, plot, and write the injuries as realistic for the situation.Log It

If you’re a note taker, planner, or working with a series bible, this will already be on your to-do list. If it’s not, put it on this checklist and log…

Who was injured.When they were injured.Where they were injured.The severity of the injury.The consequences of the injury.

These are just a few basics to log, but you could go further and include wider questions, such as how long they’ll be injured for, when the injury needs to be healed by, who injured them, and why, and so on. It all depends on the story you’re telling, so go with what works for you and add your extra questions.

Record The Reactions

Another item to add to your checklist should be the reactions of your other characters to any injuries. After all, if a friend turned up with a jagged cut across their cheek, or skin blistering with burn marks, you’d be asking them questions, right?

Having the other characters in your book ignore or gloss over what is an obvious injury can pull a reader out of your story, so make sure a reaction is recorded.

It’s also a good idea to temper the reactions to the injury. A minor cut can be reacted to with the helpful offer of a Band-Aid. Treating the same small injury with a character calling an ambulance isn’t the way to go.

Acknowledge any significant/obvious injuries with character reactions.Keep any reaction or solutions to those injuries realistic to the type of injury.

By now, you should have a checklist of headings/questions ready to be answered, which will eventually look like this…

The Injuries Checklist (example)

How the injury occurs.
Carla is being chased, first in a car, then on foot. In the car chase, she bangs her head against the steering wheel. During the foot chase, she falls and twists her ankle, and severely injures/cuts her arm. Injury side effects.
The head injury causes bleeding and pain. The ankle injury, pain, and limited mobility. The arm is also bleeding, and the heavy fall has likely broken a bone and caused Carla’s arm to become almost useless. Healing times.
Adults recover from head injuries in two days, but can have symptoms for up to ten days. A twisted ankle can take weeks, and a severe arm injury can be three months if bones are broken.Research on the injury.
How much blood loss does there need to be to cause lightheadedness and confusion? (Losing more than 30% of your total blood volume.) Will a light head injury cause memory loss? (Yes). Will a hard fall shatter bones in a wrist? (Yes, if the fall involves an outstretched hand.)Where the injury fits in the plot.
When Carla’s stalker catches up with her after a cat-and-mouse game.What type of injury is realistic for the situation?
A head, ankle, and arm injury is realistic for a car accident and a heavy fall on concrete. Who was injured.
Carla, the main character.When they were injured.
Chapter six, with the consequence of the injuries plaguing her for the rest of the book.Where the character was injured.
Injured on their forehead, right arm, and left ankle while driving through the old industrial area shortcut.The severity of the injury.
Enough to impair a quick getaway. Would need medical care from professionals.The consequences of the injury.
Carla can’t escape someone chasing her, which could lead to her capture. Her bleeding could leave behind a trail, giving away her location, and causing secondary problems like being lightheaded.Other character reactions to an injury.
Carla makes a video call to her friend, Jenny. Jenny is horrified when she sees the blood from Carla’s head wound, and that she’s struggling to move, and begins to panic/cry.Other character solutions to the injury.
Jenny’s solution is for Carla to hide somewhere dark and where any blood trail can’t be seen until help arrives, and for Carla to use her cardigan to stem her bleeding.

By using these headings as your starting point, and adding all the info that’ll help you answer the questions they ask/raise, you’ll nail the type of details that make a book believable, interesting, and enjoyable for readers. Your characters might not have fun with the injuries, but you can, so go with it, and add this checklist to your writing arsenal.

If you want more checklists to tick off, check out the Writing and Editing Checklists and the free companion ebook, Authoring Checklists.

— K.M. Allan

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