April 1, 2022

*Content Warning: descriptions of physical injury and trauma*

There aren’t many things that can jar me out of a good story. For the most part, my willingness to suspend my disbelief is quite high, and I don’t usually get upset when something seems a little off. I just roll with it.

But then my lung collapsed, and everything changed.

A lung collapse, or a pneumothorax, is when air from the lungs enters the chest cavity. It can happen without any known cause (primary pneumothorax), due to stress from lung disease or lung irritants (secondary pneumothorax), or from sudden injury (traumatic pneumothorax). Essentially, it can happen to anyone for any reason, making it a universal injury for the human species. When it does happen, the lung tissue is punctured or torn, allowing air to escape and cause steadily worsening pain, oxygen shortage, and low blood pressure, until it eventually kills you. 

In short, it fricken sucks.

Now, I’m not putting down the idea of injuring characters for plot points, tension, and development. I like reading and writing whump as much as the next person, and I think it’s quite common to see non-immediately-fatal injuries in stories. Our MC needs to get hurt, but we don’t want them down for the count, nor do we want them to have so small an injury that it’s not cool enough. So, there are the convenient injuries: biceps, ribs, calves, ankles, wrists,  shoulders or lower sides if we’re getting really crazy. All areas that have just enough anatomical wiggle room for the reader/viewer to be able to suspend their disbelief that it would not much hamper the MC in the immediate moment or at all for the long term. 

Apparently, the lung collapse is on that list, too.

Before my lung collapse, I never noticed this. Whump scenes were just another part of the story, and I paid no never mind to the specifics of the injury. After my lung collapse…pneumothoraces were everywhere! Police dramas, superhero movies, space operas, period pieces, rom-coms. Lungs giving out left, right, and center! 

In all these stories, the characters usually suffer from a traumatic pneumothorax. They are shot, stabbed, blown up, or otherwise injured to cause one or both of their lungs to be punctured or torn, thus leading them on the slow march toward death by internal suffocation.

Except none of these characters in stories ever die from their lung collapse, despite not receiving treatment right away (if ever). In fact, most act like they don’t even notice it happened. They’re still running, and fighting, and speaking. You know what you can’t do when your lung collapses? All of those things! The sheer pain of it would force most people of the human species to have to sit down and try not to move for the foreseeable future. Beyond that, every time you breathe, it 1) hurts, and 2) gets worse, so therefore 3) hurts more. You want to live to see a surgeon: breathe as little as possible as shallowly as possible. You know what requires a lot of deep, heavy breathing? Running, and fighting, and speaking!

When your lung collapses, you are not suffering from a small injury with minimal, easily overcome pain. You are actively dying in slow agony. I just watched a show where the character is informed by his medical tech that he has a collapsed lung, and he says it’s just “a mild inconvenience” before proceeding to give a rousing speech to rally the troops at the top of his voice.

Excuse me, sir? Mild inconvenience‽

I had to pause the show and take a few breaths (the irony!) before I could shrug off this blatant disregard for injury accuracy. It harkens to the Black Knight from Monty Python in absurdity. “Major organ failure? ‘Tis but a scratch!”

I have learned that I can no longer suspend my disbelief when it comes to pneumothoraces. I know the consequences of them too well now. It is a life-threatening and life-altering injury. Trust me, action hero shenanigans were off the table for the better part of a year when mine happened. No worlds were being saved during that time.

Writers and creators of stories, I am begging you: make sure you understand the weight of the consequences of pneumothoraces. Whump to your heart’s content, pop all the lungs, but then make sure to lay your characters low, make them bedridden, give space for their pain, their suffering, their inability to do much of anything until fully healed. Don’t erase the trauma for brief, superficial, inaccurate tension.

Your characters are not the Black Knight. And a lung collapse is not just a flesh wound.