EMS is All Wrong/Brief Hiatus

July is easily the busiest month of the year for me, and I’m overloaded with work until August. Seriously, my next day off is August 6. To keep myself from burning out, I’m going to be pausing from the blog just for a few weeks. I’ll be back August 8, with more Eragon, and at some point, a review of An Ember in the Ashes by Sabaa Tahir. I’ll leave you with just one more post before I go.

When I was thinking about tropes that bugged me, one that immediately came to mind was “We need to remove the bullet!” Because, as a series of disappointing Google searches told me, no, you almost never need to do that. TVTropes does a pretty good job of covering this, though, and I didn’t want to just rehash what they’ve already said. It did get me thinking, though, about other medical emergencies that fiction has portrayed completely wrong.

I’m trained in emergency response and CPR, but I was curious to see what others with more advanced medical training and knowledge thought of, say, the average cop show. I called on my good friend Sam, who works as an EMT in Central New York. That’s Upstate, by the way. There’s a whole lot more to New York than just the city.

Well, the guy who gets paid to save lives had a thing or two to say.

All quotes are taken from Sam’s email to me when I asked him about this.

EMS is almost always portrayed wrong in every respect. They get the ambulance right and that’s about it.

Stable (aka not currently dying) patients never get transported to the hospital with lights/sirens. We rarely transport anyone with lights/sirens because it’s dangerous to use them, especially when not needed.

EKG rhythms are usually never right.No one says stat.

Good emergency scenes are actually very calm.

We never wait for a police officer to bang on the back of the ambulance to let us know when we can leave. The first cop that does that is going to be asked not to hit the ambulance.

CPR is almost always wrong, because of it were right the actors would all have broken ribs.

No bystanders are ever allowed in the back of the rig during transport unless it’s a very small child or the patient is high as a kite and needs calming down.

When I asked if there was anything that was portrayed incorrectly enough so often that it drove him crazy, here’s what he told me:

Everyone dies too quickly. They get shot and only have about 30-45 seconds to talk about how they were only 2 days from retirement or how the main character was like a father to them. 
If that were true, every single person there bled out in 45 seconds. Not really possible unless they all get shot in the heart or rupture a major vessel. If you get shot in the abdomen, you have about 15-20 minutes to make it to an OR before you die. EMS uses “the platinum 10 minutes” to limit on scene time to only 10 minutes for major trauma. ED use “the Golden hour” to get some into the operating room. 

That makes sense to me. If you read news about shootings, they’ll often say something like, “Victim X was shot and died an hour later; Victim Y was shot and transported to the hospital.”

As I’ve pointed out before, even the most fantastic stories need to have some realism, or you’ll get a scoffing reader. Even if your audience doesn’t have a medical background (which is probably safe to assume), why kill off your character so quickly?

Let’s say you want to show how badass your character is and how much pain he can tolerate. Sure, you could have someone try to remove the bullet, but you’ll have more knowledgeable readers rolling their eyes, and potentially spread misinformation to your audience. If your character’s already been shot, they’re already in pain. And those ten minutes it takes to get to the hospital, the hour it takes to die, whatever–for that character, time is going to stretch out and feel a lot longer than it actually is. So they’re already suffering.

If you want drama, why not try to use “the platinum 10 minutes” or “the golden hour” rule to build tension? You need to get the character to the hospital, but you can’t emergency services. Or the ambulance is stopped at a railroad crossing and there’s no way to get around. Or some jackass is trying to remove the bullet and making everything worse. And just because someone gets help in time doesn’t mean they’re going to live.

Plus, if you can confess one deep, dark secret in the thirty second between getting shot and expiring, imagine all the things that might come pouring out in ten minutes, or an hour.

I know a lot of writers have heard the advice, “Kill your darlings.”
But why kill your darlings when you can torture them instead?



Eragon 6-7: Exposition for Two

When you’re writing something that doesn’t take place in the real world, you have to find some way to tell the audience the “rules” of the universe. There are two main ways authors do this: by directly stating what those rules are (The Hunger Games loves this) or Character A telling Character B explaining the rules. In most cases, Character B is some kind of newcomer–like Obi-Wan teaching Luke about the Force, for instance.

Most authors use a mix of both methods, which works well, but I prefer the latter. I think it helps the story flow more naturally, and helps keep the reader in the world a bit more easily. And then there are chapters like this.

Eragon goes into town, and meets with Brom the storyteller in a chapter that is nothing but exposition. Eragon, naturally, wants to learn more about dragons and the Dragon Riders, and has plenty of questions about both. The whole chapter is Eragon asking questions, and Brom giving him the answers. We learn about the history of the Riders, and more about dragons themselves. Even though I generally prefer this method of getting information to the readers, for some reason I don’t like it here. I can’t exactly pinpoint why. Part of it might just be that it feels lazy–Paolini couldn’t figure out how to wedge all this in, so he put it here. Or maybe it’s the length of the chapter that bothers me. It’s pretty long–longer than the last two combined. There’s not a lot of action, just a back-and-forth. I just don’t like large information dumps, and I wonder if cutting out some of the details of this chapter would have helped me like it better. Of course, this is also my second time reading the book, so I already know what Brom’s going to say. Obviously, this stuff isn’t going to be as interesting to me the second time around.

Well, whatever. I didn’t like the way the information was shoved down my throat. I also had one head-scratching moment, wherein Brom describes a war between the dragons and the elves. It was a huge war that left the land devastated, but it only lasted…five years? Okay, that’s a long time for a human war, but we’re talking about creatures that live for centuries. Five years seems a little short.

Moving on to the next chapter.

Chapter 7 is another unevenly short chapter, not quite four pages long. On their way back to the farm, Eragon’s cousin Roran announces that he’s accepted an offer of work in another town. Eragon doesn’t really want Roran to leave, and suggests he wait until spring. Roran disagrees, and says he will be leaving shortly while they’re waiting for winter. Even though this isn’t a book about the division of farm labor, I still need to ask: where the hell are all the farmhands? It’s only Roran, Eragon, and Eragon’s Uncle Garrow working on the farm. How do just the three of them manage to keep it running and productive? How did Garrow and his now deceased wife manage to do it before Eragon and Roran were old enough to help? And for that matter, why doesn’t Garrow have, like, ten other kids to do farm work?

It’s been said that when you’re writing science-fiction, you get one lie, and you have to then work within the confines of that lie. Everything else has to follow the rules. Fantasy, I think, is a little broader, but still follows that principle. f you’re writing about dragons, that’s fine, because dragons are mythological creatures and you can do what you want with them, as long as you follow the basic rules. Things like dragons fly, breathe something dangerous, and could kill you several times over.

Suspension of disbelief is a funny thing. I’m all for dragons and magic–that’s why I picked up this book in the first place. It’s the small, nagging details that bother me. You want to write about a dragon that flies and breathes fire? Cool. Go ahead. But if you’re writing about something that exists in real life, that readers know about, then you have to make it realistic. Realistic details in a fantasy setting make the world plausible. It’s not the fantasy elements that will drive readers away. What will turn them if is when they don’t see the familiar reflected in the extraordinary.

That was kind of an unexpected rant. Anyway, the dragon was finally named “Saphira”, surprising absolutely no one. First of all, she’s a bright blue dragon. Second of all, you know another Saphira was important to Brom, just from the way he said it.

Anyway, moral of the story? It’s cool if your main character can shoot fireballs from his hand or whatever, but if he, say…lived in the 21st Century and didn’t have an email account, I would seriously have to question both the author’s writing choices and their* perception of what is normal in the world.


*Strunk and White be damned, I’m totally okay with “they” as a singular gender neutral pronoun.

Eragon 4-5: How to Write Your Dragon

Remember when I said that the chapters in this book were really uneven, length-wise? Chapter 3 was 16 pages of exposition, backstory, and stupid names. Chapter 4 isn’t quite 3 pages long, and so short it would hardly be worth mentioning, if not for one event in it.


That’s right, the dragon finally hatches, and I remember the reason I started reading this book in the first place. So far I’ve found it cliche and unintentionally humorous, but maybe things will change from here on out. Maybe, with the dragon in the picture, things will get better from here.

Let’s read to find out. Moving on to the next chapter!

What I like about this is that it actually goes into depth about Eragon’s thought-process when it comes to keeping Saphira. He has to take into consideration how he’s going to take care of a dragon, how he could hide it, and even if he should keep it. It takes him a couple pages figuring out his rationalization to keep the dragon, despite all the reasons he shouldn’t. You know, like Galbatorix (I hate typing that name) swooping down to kill him and everyone he loves. So that’s decidedly a “con”. Pros of raising a dragon: IT’S A DRAGON!

If I were Eragon, I would totally risk keeping a dragon. Saphira’s the best part of this book! You have no idea how much I love dragons, guys. If someone offered me a billion dollars or a dragon, I would take the dragon. Especially if it was an intelligent one that you shared a mind-link with! And if a dragon egg hatched under my watch, you can imagine I wouldn’t be calm about it. Which is why I’m a little disappointed that Eragon is so cavalier about this.

Let me put it like this:

Remember when you were a kid, and you loved dinosaurs? You read books about dinosaurs, you drew dinosaur pictures, you collected dinosaur stickers, you loved to hear stories about dinosaurs. You were probably sad that there aren’t any dinosaurs anymore, and wouldn’t it be great if they came back?

Well, suddenly, a baby dinosaur hatched in your bedroom, and it’s the first dinosaur to be born in millennia. What do you do?

You’d probably freak out, for a start. Maybe wonder if it’s a prank, or if the dinosaur is real. After all, there haven’t been any for millions of years. My point being, you would not be calm and rational, and you wouldn’t accept it right away that suddenly you have a long-extinct creature in your bedroom.

Eragon doesn’t for a second doubt that it’s a dragon, that it’s real, and that he was meant to have it. Remember, dragons were supposed to be wiped out by Galby (I refuse to write “Galbatorix” one more time) hundreds of years ago, but Eragon doesn’t have any trouble accepting that this mythical, should-be-extinct creature, is in his bedroom. His calm reaction is just so unnatural.

The rest of this chapter is Eragon learning more about Saphira, and it’s pretty disappointing. In fantasy and science-fiction, characters experience things that we, in the real world, will never get to do. That’s a big part of their appeal. We’ll never be able to fly on the back of a dragon or shoot fire from our hands, but through books like this one, we can imagine what it’s like. Which is why Paolini’s vague descriptions of Eragon’s interactions with Saphira are so annoying to me. For example, he tells us that Eragon played with the dragon, but doesn’t say what that means. Were they playing fetch? Hide and seek? Chasing mice? How would an intelligent creature with abilities different than ours (and a newborn) react to her rapidly expanding world? How does Eragon respond to her actions? There’s a lot of possibility to show us some exciting (and adorable) stuff, but it just gets glossed over.

I want to play fetch with a baby dragon so badly.

Eragon 3: This is a Joke, Right?

It is truly shocking how little I care about the goings-on in Carvahall, Eragon’s village. Since I’ve read Eragon already and know what’s going to happen, there’s no tension in this chapter anymore. I wonder if this is one of the reasons I never read this book twice, despite how much I enjoyed it the first time around. So far it’s the longest chapter in the book, and it’s nothing but exposition.

Before I get into that, though, I want to pick apart the text.

“He helped himself to a piece of chicken, which he devoured hungrily.”

Does anyone else see what’s wrong with that sentence?

I’ve taken enough creative writing classes to know that you should (a) avoid adverbs and (b) use verbs for description.

I love how Stephen King put it in his memoir, On Writing:

“I believe the road to hell is paved with adverbs, and I will shout it from the rooftops. To put it another way, they’re like dandelions. If you have one on your lawn, it looks pretty and unique. If you fail to root it out, however, you find five the next day…fifty the day after that…and then, my brothers and sisters, your lawn is totally, completely, and profligately covered with dandelions. By then you see them for the weeds they really are, but by then it’s–GASP!!–too late.”

One or two adverbs here or there are okay. Too many, though, and they become annoying and repetitive, and make your writing look lazy and weak.

And this ties into into (b) use verbs for description.

Don’t get me wrong, adjectives are great. But verbs are better.


“I don’t like it,” she said in a soft voice.


“I don’t like it,” she whispered.

They both mean the same thing, but the second sentence should feel stronger and put a more immediate picture in your mind than the first. If it didn’t, I’ve clearly done something wrong here. Like adverbs, adjectives can get ungainly when they’re overused. Don’t use two words when one will suffice.

If you haven’t figured it out yet, my problem with the above sentence is two-fold. Obviously, I don’t like “hungrily”. But it’s also redundant. If Eragon is “devouring”, he’s clearly hungry; there’s no need to say he devoured something “hungrily”.

“Eragon devoured the chicken.”
“Eragon hungrily ate the chicken.”

Either of these would have been better than what we got.

I just spent way too much time picking apart one sentence that’s probably gone unnoticed by most readers.

As for the rest of this chapter, it’s mostly just exposition. A good portion of it is just the villagers talking about how much they hate the Empire. I think it would be better if it was done using more dialogue and didn’t rely on the narration so much, but it also seems to repeat itself a lot.

The most important part of this chapter comes at the end, when Brom tells the story of the Dragon Riders. They were a group of Mary Sues humans and elves who rode dragons and kept peace throughout the land. So, you know, Jedi, but with dragons. As you might imagine, some tragedy befell them, and now the Dragon Riders are no more. Or, as Brom tells it:

“‘Some saw his abrupt rise as dangerous and warned the others, but the Riders had grown arrogant in their power and ignored caution. Alas, sorrow as conceived that day.'”

Hahaha! This is another case of flowery words backfiring. “Conceived”? Really?

“Brom, how did the Riders fall?”

“Well, Eragon, when a Dragon Rider loves arrogance very much, they conceive sorrow!”

The story is about a Rider named Galbatorix…

…yes, that’s his real name. Not a name that he took after going crazy and becoming evil. Sigh.

Galbatorix’s dragon was killed, he went crazy, and the Riders refused to give him a new one. Now, Brom talks a lot about how cunning Galbatorix is, and how skilled he was with magic and a sword. Basically, a real bad-ass. When he goes to overthrow the Riders, though, he can only do it with the help of an accomplice, Morzan.

“‘Galbatorix convinced Morzan to leave a gate unbolted in the citadel Ilirea, which is now called Urû’baen.'”

Two things here: First, all of those names are so cringe-worthy. The dragon Galbatorix steals is even named “Shruikan”. You know, “shuriken” spelled wrong.

Second, Brom spent so much time telling us how dangerous Galbatorix was on his own, I’m kind of finding it hard to believe that all he needed was a gate left open instead of melting the lock with magic, or blasting it open, or disguising himself as another Rider. Once Shruikan is all grown-up, Galbatorix and thirteen other defectors kill the other Dragon Riders. Vrael, leader of the Dragon Riders, fights Galbatorix, but…well, this is the part where I nearly threw the book down with rage.

“‘As they fought, Galbatorix kicked Vrael in the fork of his legs. With that underhanded blow he gained dominance over Vrael and removed his head with a blazing sword. [. . .] And from that day, he has ruled us.”

A crotch shot?