Should Characters “Dig Out” Bullet Injuries?

A_bullet_in_the_base_of_a_brain,_viewed_through_x-ray._Photo_Wellcome_L0000624Photo via Wikimedia

TLDR: No.

Not having been shot by a gun (thankfully), I’m a little naive in the department of gunshot injuries. However, a Facebook conversation the other day brought up the topic of characters treating gunshot wounds. Books, movies and TV shows will often depict a character “digging out the bullet” before wrapping up the wound.

This makes for great thematics, but I always doubted the practicality of digging out the bullet first. It turns out I’m right (self-high five), according to one of my favorite sources for ditch medicine, theLiving Ready Pocket Manual: First Aid (disclaimer: we publish this at my work, and you should go buy it right now).

The author, Dr. James Hubbard, MD, recommends forgetting about the bullet until the wounded person (or character, in this case) can get to a hospital for proper assessment and treatment. Instead, focus on stopping the bleeding (apply pressure/coagulant), treating the wounded for shock (keep warm with blankets) and monitoring symptoms for relaying to a real doctor.

Hubbard has this to say about “digging out the bullet” ahead of real medical treatment:

In most circumstances, you don’t want to remove an implanted bullet. It’s almost impossible to find, and it may actually be corking up a big blood vessel.

Thousands of military members live with shrapnel in their bodies every day. Unless there’s initial infection from the wound itself, the body adapts to most metal without much serious problem.

The exact thing happened to Dick Moonlight, novelist Vincent Zandri’s PI character. A shard of bullet left over from a botched suicide attempt remained in the titular character’s head, causing him to black out at inconvenient moments. It’s suggested the doctors can’t remove the shard without killing him. Moonlight may be a work of fiction, but that’s pretty close to reality.


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The Writers Guide to WeaponsThe Writer’s Guide to Weapons: A Practical Reference for Using Firearms and Knives in Fiction (Writer’s Digest Books) comes with everything but the ammo. Pick up a print or digital copy from these fine retailers:

One thought on “Should Characters “Dig Out” Bullet Injuries?

  1. Yeah, but don’t buy into the doctors too much. There are some real and good reasons to pull bullets, glass, and other things out, especially in certain situations. Not suggesting a civilian in normal living conditions somewhere in public with access to medical care. But when they started making fun of Rambo for pulling out a knife in the middle of the Vietnam jungle, maybe not doctors, but people listening to the words of doctors turned the realism idea upside down, which happens a lot. Criminals, even innocent people on the run, in a lot of stories cannot go to the hospital. There are some funny things that are said about medicine in movies, which realistically usually comes down to, “We’re the doctors and your not allowed to take out the bullet or do anything medical, realistic or not.” In the 911 world, the recommendation, the standard and easily made stereotype of modern medicine is to get there, get care, and let them take care of it, whether that will make sense, or the character will be unable to do the job, in a given story. Caution. Medical reality and situations also vary. That’s why a guy can get shot in the throat and the bullet pass through all blood vessels unharmed, and be called medically impossible. Bullets especially are, to quote one doctor, magic in the human body. This relates also to how easy and difficult it is to kill people and how it varies.

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