Medical Bloopers: Don’t Try This At Home

When Mel Gibson slaps his dislocated shoulder back into place in any of the Lethal Weapon films ad nauseum, I always cringe.

I don’t cringe because it’s painful, which I assure you it would be. But because, reducing a dislocation that way, a real person would inevitably fracture the humerus, the long bone of the upper arm. Sure, some people can pop their shoulders in and out of joint voluntarily. Their ligaments are loose. They need only to relax their muscles to slip it back in, no force or loud crack is necessary. However, everyone else needs sedation and medical help to reduce the joint, sometimes anesthesia and even surgery. No one can violently slam the ball of the humerus into the joint without injury, though it’s become a staple of action movies.  Blame me for being a retired physician and picky. A novelist friend reminds me that fiction is telling the real truth with imagination, but I find myself often challenged to suspend my education along with my disbelief.

One of my favorite authors, I’m sorry to say, wrote a recently published scene where his detective protagonist listens to a Medical Examiner who ought to be relegated to making house calls on Fantasy Island.  Unlike a Coroner, who may or may not be a medical doctor, the M.E. is always a physician.  He or she methodically examines human anatomies, perhaps several a day, taking them apart like dismantling broken clocks.

Two medical examiners looking down at operating table
Do these glasses make us look smarter?!
To summarize this Medical Examiner’s report to the detective: Three hollow-nosed 9mm shells were removed from the body. The first shot entered the chest, piercing the right ventricle—that’s the pocket in the heart that pumps returned venous blood from the body to the lungs for aeration. This first bullet exploded the heart, continuing on its path until embedding in the fourth thoracic vertebral body, though it did not fracture it (break the bone). With that impact, however, the victim’s spinal cord was severed, causing paralysis of the legs. He, therefore, fell onto his back on the floor. While he lay paralyzed, this M.E. says, the next two shots pierced the right and left lower sternum (the breastbone). They each struck a lung, but did not exit the body. The bullets were trapped by the musculature of the back. Death occurred within a minute of the first shot.

So what’s wrong with that?  And where’s Waldo, and who took the cookie from the cookie jar, while you’re at it? Good mysteries are, of course, based on questions, but the evidence provided to the reader shouldn’t be so questionable, and if you think through it, some of these issues don’t require a medical degree to wonder about.

We’re told that the bullet which struck the spine at T-4 without breaking any bone also “severed the spinal cord.” What’s up with that? It couldn’t touch the cord nestled inside the vertebrae if it didn’t even fracture the spine, right?  So how did it damage the cord enough to paralyze the victim and drop him to the floor?

It couldn’t have.

Anatomical diagram of spine

Thoracic vertebral bodies sit in front of the spine shielding the cord. Further, they are bound together with very strong gristle tissue. They cannot be significantly moved or dislocated without tremendous force, something like being run over by an army tank.

You can contuse the cord and lose function, but our questionable Medical Examiner said “it severed the cord.” I must assume an M.E. making a visual inspection knows the difference between a contusion and a laceration. I also assume three beers is my limit, but once I pass that number, I can’t remember whether I’m right or not.

Suppose, somehow, the force of the bullet’s impact could injure the anterior cord that’s behind the vertebral body at this level. Unfortunately, the motor power to the legs at T-4 runs at the very back of this cord, furthest from the vertebral body being impacted by the bullet. These back-seat nerves alone could not have been contused without taking out the windshield and steering column, too. As described, it is anatomically impossible for this victim to have suffered a laceration of the cord and lower body paralysis. Oh, well.

9mm bulletsWe’re also informed the murderer used 9 mm hollow-point shells. These cartridges usually are packed with enough powder to blow your doors clean off. So why didn’t the following two bullets to the lungs make it out the victim’s back to deform against the floor or even pierce it? The magic bullet in Dallas’s Dealey Plaza went a few hundred yards and then through a skull, a neck, a chest, an arm and into a leg. Okay, I’ll suspend my disbelief on that one for national security, but . . . 

The investigator hypothesizes the victim quickly reached over to grab and hide an ejected shell casing in his mouth prior to dying.   People with exploded hearts die extremely quickly from lack of oxygen to the brain. People who are also paralyzed from the waist down with exploded hearts can’t move very well to grab leftover ordnance, because their lower body is a dead weight and their brain is dying. Every muscle’s cramping from lack of oxygen. If you have ever run too far and too fast for your conditioning, you know what I mean. The movement required to chase rolling shells with three gunshot wounds to the chest would be extremely painful and unlikely, especially while dragging dead weight as your exploded heart isn’t pumping, 

You see my problem?  You may encounter similar issues, because crime novels are set in every area of the country and every occupation, especially involving medical, scientific, legal, and law enforcement professionals.  Sometimes knowing a subject too well interferes with the fun of the ride.  But when (fictional) death’s on the line, medical information at some level almost has to be provided.  I still enjoy this award winning crime novelist’s work, but I wonder, to paraphrase My Cousin Vinny: Are the laws of physics suspended in your novels?  Certainly the laws of physicians are.

Have you encountered murders that seem to be impossible, or so unlikely you couldn’t enjoy the story?  Do you wonder about the reality of frequently portrayed methods of injury and death?  Has your own knowledge as a specialist been offended by an author you love reading (anyway)?

I’ll be glad to know I’m not alone.

Images courtesy of Spine Universe and An Nguyen Photography

Dr. Lewis Preschel a.k.a. Madison Muttnick M.D.


  1. Michael Terreri

    Well done, Dr. Muttnick. I enjoy your criticism almost as much as your fiction. Keep on.

    Michael Terreri

  2. Laura K. Curtis

    I love this! I hope you dissect many more “medical mysteries.” There’s no excuse for sloppy research, and I am always fascinated by stuff (like medicine) I know nothing about.

  3. Jill

    Can’t wait to read more from you!

  4. Cindy Dunn

    Thanks for the analysis, Doctor. I hope you (or the Mad Mutt) are available for consultations as I may need your expertise one of these days…

  5. JFN

    Accuracy is of utmost importance. It is what separates the amateur vehicle of literature from the pro.
    Do not apologize for knowing the way it is. Keep your stories accurate. Make it your mission

  6. jill preschel

    Accuracy is the most important!! I agree

  7. Harvey Self

    This is amazing thanks for sharing this blog I have become a fan of your blogs now. This blog is so interesting and informative.

  8. Mr John

    This is very informative and interesting for those who are interested in blogging field.

  9. gutter leak

    Thnaks for Shaering it

  10. Joseph Engle

    Thanks for sharing this amazing article, it is a very informative post good work keep it up.

  11. custom painting from photo

    If you’re looking for a way to immortalize your loved ones’ special memories, look no further than Our personalized portraits are the perfect way to capture your loved ones in all their glory. Check custom painting from photo. We offer a wide range of high-quality frames and sizes to suit any need and budget.

  12. Better Pets Life

    Do you want a white fluffy dog? Let’s be real, large dogs aren’t for everyone. The terrifying image of a gigantic fluffy creature charging at you in a show of enthusiasm is one that probably resonates with a lot of people. If you fit this description but are determined to get a dog anyhow, there are now a number of smaller dog breeds available.

  13. Embroidery Digitizing

    Our best embroidery digitizing company know how to properly digitize a logo based on factors such as fabric, textures, sizes and threads. Most of our staff has been trained in graphic designing or applied art and have an artistic vision to convert your artwork into beautiful embroidery.

  14. Better Pets Life

    The majority of people who own dogs for better lives are aware of the obvious benefits of doing so. However, many of us still don’t know that cuddling with an animal can also be good for our physical and emotional well-being. Only recently have researchers begun to systematically examine the advantages of human-animal relationships.

  15. Logo Design Company

    American Logo Developers is a company that offers you the best logo design services, including online logo creation. We strive to develop great logo designs for small companies and enterprises all over the world. We only give the greatest creative designs for brand identities since we have an experienced staff of designers.

  16. 2d animation design

    2D animation design has gained immense popularity since when it was first introduced. Today it’s primarily deployed in 2D animation studios for creating advertisements, marketing videos, animated movies or cartoons, corporate presentations, and video games. Besides being adorable, 2D animations tend to capture audiences through their auditory, visual, and kinesthetic aspects.

  17. White Transgender Woman

    Our embroidery digitizing know how to properly digitize a logo based on factors such as fabric, textures, sizes and threads. Most of our staff has been trained in graphic designing or applied art and have an artistic vision to convert your artwork into beautiful embroidery.

  18. Romance Books With Trans Characters

    Great post dude.

  19. Top Happiness And Prosperity

    Nice men.

  20. High School Experience Book

    Keep sharing good content.

  21. Fiction Books With Moral Lessons

    Well done.

  22. Mbs Taxes

    Dan Mossberg, the founder of MBS TAXES in Lawndale, CA, and LA South Bay area is qualified to manage your accounting responsibilities.

  23. Embroidery Digitizing

    Great post dude.

  24. Surgical, diagnostic, drug, equipment, device, and system failures, infections, falls, and healthcare technology are examples of medical errors. In outpatient settings, missed diagnoses or medication-related injuries are frequent.

  25. Digitizing Services For Embroidery

    Digitizing services for embroidery refers to the process of converting a digital design or artwork into a format that can be read and stitched by an embroidery machine. The digitizing process involves breaking down the design into individual stitch patterns, specifying the type of stitch to be used, and assigning colors to the various elements of the design.

  26. Jorge Dan

    Thanks for sharing.I found a lot of interesting information here. A really very thankful and hopeful that you will write many more posts like this one.

  27. business “contributing writer”

    Fantastic article. Your works are distinctive, easy to understand, and contain informative and inspiring material. Keep up the fantastic work!

Comments are closed.