Five Things Writer’s Need to Know about Being Knocked Out

 

Poor Forrest. Keith Jardine applies fist to face in their UFC fight.

Image copyright UFC.

 

Writer’s love knocking people unconscious. Mostly I mean fictional people, but not always. I’m pretty Matt Wallace wouldn’t hesitate to knock someone all the way into intensive care if the situation arose.

 

Still something I’m sure Matt knows, as I do and anyone who has ever been around combat sports or real fighting for any length of time, is that getting knocked out sucks. It’s not just a slightly inconvenient nap the way many writers portray it, and it’s not a nice gentle way for your hero to take someone out of the fight.

 

If you’re going to write in your protagonist knocking someone cold or getting knocked out themselves here are five things you need to know:

1. It Can Be Fatal

 

A blow to the head hard enough to knock a person unconscious is also hard enough to kill someone outright. A lot of the potential fatality of a strike to the head is dependant on where it lands. You will need an incredible amount of force to knock someone out through the front of their skull but the same blow delivered to the side of the head can cause massive cerebral haemorrhaging*.

 

The same goes for the back of the skull. The skull itself is thicker there than at the side of the head, but it’s also (obviously) where the neck vertebrae connect to your brain. That same knock out blow to the front of the head can separate vertebrae, crack the skull and cause severe brain injuries up to and including sending the recipient of said blow to the morgue.

 

2. Even If It Isn’t Fatal, the Damage Can Be Permanent

 

There’s a very good reason that MMA fighters, Kickboxers and Boxers are forced to take time away from the ring or the cage if they get knocked out. A concussion can be a very serious injury and while mortality rates from the initial concussion are almost zero there are potentially fatal complications that can develop.

 

Even if fatal complications don’t appear, damage from concussions can be cumulative, and anyone who’s seen a punch drunk boxer whose mind and reflexes are going because he’s taken too many blows to the head know that this is a very real thing.

 

Writers tend to ignore these cumulative effects; James Bond got knocked out, gassed out and generally disabled so many times he should have been ended up in a vegetative state instead of spreading syphilis to the attractive female spies of the world.

3. Recovery Is Not Instant

 

This goes for being choked, drugged or pummelled into unconsciousness. No matter how you go out, properly unconscious, it’s going to take you at least a minute to get your bearings properly.

 

Sadly I’ve had ample experience of all three and I can tell you right now that your first thought upon waking up is usually “why the hell am I on the floor?” Then most people, me included, feel sick and dizzy. Depending on how bad the blow, prolonged the choke, or powerful the drugs the feelings of disorientation and nausea can last for hours, if not days. This will hamper your hero’s efforts to do unto the bad guys. The evil doers might be disgusted if your protagonist pukes on them, but they probably won’t be rendered harmless.

 

4. Symptoms Can Appear A Long Time After The Initial Injury

 

Some of the nastier side effects of a hard strike to the head can appear a long time after the person thinks they’ve recovered. This is relatively rare but it’s still a risk, and it can make an excellent plot point.

The main one I’m talking about is something called Second Impact Syndrome. This is where a person gets a second blow to the head before the concussive effects of the first have passed. This can kill someone outright or induce serious bleeding in the brain which results life altering brain injuries.

Pugilistic Dementia can show up years after a fighter has stopped getting into the ring. And in extreme cases a powerful blow can result in a stroke occurring days or weeks after the knockout occurred.          

 

5. Torsion and Impact

 

A knock can occur in two circumstances, at least in regards to a physical blow. The first is just outright trauma. I annoy a man who has a brick. The man belts me in the head with the brick and I take a free trip to the land of the unconscious**.

 

Alternatively, I see him coming, slip the brick backed blow and hit him on the point of the jaw with a left hook***; the force applied to his jaw twists his entire head around and this sudden movement starts slamming his brain back and forth inside his skull. He falls down and I take his brick away.

 

The actual mechanism of this sort of KO isn’t that well understood, and there are competing theories as to why the knock out is so instant. Other theories involve trauma to the brain stem, sudden loss of blood through and the separation of the neck vertebrae.

 

Regardless of why this kind of strike switches out someone’s lights, generally it’s a more survivable injury than pure impact trauma. Not that a punch to the head can’t kill someone (just ask your local Police, they deal with accidental punching deaths all the time), especially if someone with good technique is throwing it.

 

* Haemorrhaging: uncontrolled bleeding. Very bad thing to have happen to your brain.

** ‘Tis a silly place.

*** This scenario brought to you by my rich fantasy life.

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19 Responses to Five Things Writer’s Need to Know about Being Knocked Out

  1. Mel CorbettNo Gravatar says:

    The thoery I’ve heard about a blow to the jaw knocking you out is because the jaw bone hits one of the nerves that goes up to the brain.

    Also, it can break your jaw(think about the the thin part of the jaw pushing against the skull thanks to the impact), which would be pretty inconvenient to your character too. I don’t think many MC’s go running around with their jaw wired shut.

  2. I’ve been knocked out a few times. You can’t wake up and just start gunning people down. Trust me. You’re lucky you know your name when you first wake up.

  3. WadeNo Gravatar says:

    And being unconscious messes with your sense of time. I’ve been knocked out before, as well been under anaesthetic and the gap in your memory is weird.

  4. Becky BlackNo Gravatar says:

    This should be required reading for all writers. Getting whacked on the head is not an off switch for people!

    I heard of a real case once where a woman claimed a man had broken into her home, knocked her out and when she came around, had kidnapped her baby. In fact she’d murdered the baby, disposed of the body and come up with this intruder story to try to cover her tracks. But the police knew she was lying simply because of her claim to actually remember the man coming in and hitting her. If she’d really been out for as long as she claimed from the blow, she’d be lucky to remember anything for the previous twenty-four hours, never mind right up till the moment she was knocked out. She’d clearly picked up her knowledge of what happens when you’re knocked out from watching TV and it proved her undoing.

  5. AndrewNo Gravatar says:

    That’s an awesome story Becky thanks for posting that :)

  6. AndrewNo Gravatar says:

    I;ve found that occasionally I get a flash of something coming back to me (this is a year or more later) but it’s unbelievably jumbled and non sensical, like a half remembered dream on the night after eating a lot of cheese.

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  8. DaveNo Gravatar says:

    I think you meant to use the plural “writers” and not the possessive “writer’s”.

  9. KevinNo Gravatar says:

    I’ve never been knocked all the way out, but did slam my head on the floor hard enough to do the wobble dance and see everything look a freaky shade of blue. It does indeed suck. I had to stay home in bed the whole next day because moving made me almost throw up from the nausea. I also don’t remember seeing the end of that class, even though I was awake during it…

    Definitely changed how I think about impacts to the head. I’ve become much more protective of my brain, and my characters’ brains, since then.

  10. AndrewNo Gravatar says:

    Hi Kevin, thanks for commenting on this it’s always good to get other people’s experiences and views on the same topic.

  11. JonathanNo Gravatar says:

    Just wanted to say thank you for this Article it has been a big help. I’ve never really been knocked unconscious myself and sounds like if I had I wouldn’t remember much of it anyway.

  12. ArianwenNo Gravatar says:

    A man was recently killed by a punch in the face: his head twisted so far with the blow that his aorta (I think – might have been the vena cava) tore. He died before the ambulance arrived.

    Re. less serious head blows, I think sometimes people don’t know whether they’ve been hurt or not. I jumped into a door-frame once and the next few minutes are kind of fuzzy. It could have been simple disorientation or I might have passed out for a few seconds.

  13. Julie ANo Gravatar says:

    I wonder whether what happened to me was a knockout/concussion or just a really hard knock to the head. I had smoked some weed, felt hot and went out to get some air. Almost immediately, I felt desperate to sit down and so I got myself into an unsteady squatting position. I’m not sure what happened next but I do remember “dreaming” of this bright white flash on the right side of my vision. What I do remember is waking up on my side and wondering for what felt like an hour why I was lying down. At some stage, not sure if it was simultaneously or what, I became aware that people were shouting, and I realised they were trying to get my attention. I then felt a blinding pain in the right side of my head, so bad that I nearly started crying and I honestly wondered if I’d been shot (stupid but I had never felt such pain or confusion). I started panicking and wondered if I’d been robbed (I wasn’t). Every time I tried to stand, the only thing I can compare my difficulty to is the feeling you get when you stand up too fast, only much more intense and for a lot longer and it was impossible to fight – it had me back on my bum every time. My biggest craving was to fall asleep but my friend refused and kept asking me questions – at one point she asked me to follow her fingers but it just made me feel nauseous and stressed out. After an unknown period of time I could finally walk (slowly).
    I thought I was concussed but after what everyone has said here, maybe all I had was confusion. This happened last week (hence my sudden interest in this subject) but I didn’t go to the hospital because I was a) abroad and b) didn’t think it was that serious as it righted itself relatively quickly – apart from a very sore jaw that has slowly been getting better and a sore spot where I hit my head that stopped hurting a day or two after the incident, I had no other problems and I think I can remember pretty much everything bar how I actually hit my head – I’ve deduced that I lost my footing when squatting precariously and fell over sideways very very hard. Any thoughts on what I described?

  14. AndrewNo Gravatar says:

    Are you abroad right now? Actually never mind, wherever you are go and see a Doctor. I have no idea what happened to you but it my experience that bright white flash was either an impact (someone blindsided you for no reason) or a small brain hemorrhage.

    Either way you need to get it checked no matter what. It could also have been a bad reaction to the weed, although I have never heard of that particular set of symptoms.

    Just one last time in case you were wondering: GO TO A DOCTOR! Now if you can, as soon as possible other wise. Probably you are fine. I hope you’re sine, but get it investigated anyway.

  15. Julie ANo Gravatar says:

    Well that’s pretty much told me! I feel a bit silly now, it’s actually obvious that I should go and get it seen to. I returned home a week ago so hospital related matter should be easier (although I still should have gone to a hospital out there) but hopefully everything is fine. Thank you for your help

  16. AndrewNo Gravatar says:

    No problem, sorry to come across so tough but I wanted to be sure you were OK in as much as I could. I hope everything works out!

  17. elijahNo Gravatar says:

    i was wondering if you knock someone out by suffocating them will they know yoou did it when they wake up

  18. AndrewNo Gravatar says:

    If they saw you then yes they’d remember, there’s a moment of confusion but your memory is unaffected.

  19. JonNo Gravatar says:

    I am writing a novel and one character used a large rock to hit another on the head and knock him out. I’m glad I found this article because I can make it more realistic. Thanks.

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