Worldbuilding: A Bloody Mess

How gory should your story be?

“As gory as it needs to be” is a cop-out. Dracula, one of the most horrifying books ever (I rate by books that kept me sleepless with the lights on), has very little blood in it. And that’s a story about vampires. There’s a lot of hinted blood-drinking going on, and one scene with Mina that reads as a vampiric rape, but most of the book’s violence happens off-screen. The horror element is not gore, but the fear and terror of the world you know being shattered, to reveal unclean abominations lurking in the shadows.

Parasyte the Maxim, on the other hand – this alien invasion has blood all over the place. It could have been made less gory; the emphasis could have been more on other characters’ reactions to the slaughtered bodies left in the Parasytes’ wake, and less on the slaughter-in-progress. But that would have lessened the impact of the main character’s situation. Shinichi Izumi is, quite literally, stuck in symbiosis with a shapeshifting alien who missed being a man-eater by inches. And they have to deal with the other Parasytes who didn’t miss, and see a human in the know as a threat to their survival. Staying alive in this setting has a price, and it’s paid in blood.

Rule of thumb, if you’re not doing a story with a horror aspect, you’re probably not using as much blood. Most mystery stories have to start with a dead body, but poison, electrocution, and drowning are just as corpsifying. You may prefer a non-bloody death in a cozy mystery, for example, because it might be passed off as “just an accident”, leaving an excuse for an amateur detective to poke around when the police don’t.

Fantasy and sci-fi… it probably depends on where you want your story to hit on the Sliding Scale of Idealism vs. Cynicism. The more idealistic a story is, the more likely the characters will be able to resolve things without buckets of blood everywhere; and if someone is injured, healing magic/tech can patch them up. The more gritty and grimdark, the more likely you are to have people scarred, losing eyes and limbs, and bleeding out.

(Note: I’d be interested in seeing a fantasy that – along with healing magic – also had some form of our modern “stopgap measures to get someone to the medics alive”. Like tourniquets, gluing wounds together, and expanding sealant to stop blood loss.)

What do you want your reader to feel when people bleed? Sorrow? Terror? Nausea?

Think it over. Hopefully before the plot ninjas swoop in and slaughter a character in a way you can’t write yourself out of!

(Side note: Stitches are aggravating and awkward, and none of the action books I’ve read where a character got stitched up cover just how annoying it is. Realism fail!)

41 thoughts on “Worldbuilding: A Bloody Mess

  1. I broke a toe a couple of weeks ago by stubbing it on my metal bed frame. Yesterday, my mechanic told me that its always worse when something like this happens and you dont even get an adventure out of it. Just the boredom and pain of an ER visit. Also, it really does itch!

    Liked by 2 people

  2. And the level of gore, and way it’s depicted, isn’t constant either. I’ve mentioned this before, but look at the difference between the manga, and the anime, for 3×3 Eyes, or the manga, and the old anime, for Hellsing. In both cases, the manga has lots of gore, but it’s _understandable_ that it does (as you mention for Parasyte), while the anime has more gore _and_ depicts it differently. In both of those anime, the gore is glorified, and it’s clearly done for the sake of “look how much gore we can draw, and how disgusting we can make it”, while in the manga it’s “these are horrible monsters being bloody monsters, it’d break SoD if there wasn’t gore all over the place”. And that difference in how it’s depicted makes a significant difference in the feel of the story.

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  3. Amusingly, D&D actually does have field medicine, at least from 3rd ed on(Heal checks are specifically first aid when you use them in combat and they have magical bandages, which amuse me)

    To be fair, there’s a good chance that the people writing that have never had to be stitched up. Somehow, that’s something I’ve missed(along with broken bones, the only time someone in our family had that involved a gas station explosion.). Now, if you wanted a graphic description of flesh eating bacteria…

    Liked by 1 person

    1. D&D – across all editions, this isn’t a Hasbro issue – suffers from the problem that all damage is hp damage, to be treated by Cure X Wounds or class-based equivalent, so that ‘mundane healing’ is pointless by comparison.



      1. *waggles hand*

        Depends on your party composition. I’ve played in parties where divine healing wasn’t really available, because the “cleric” was actually a favored soul of a combat god, and not well-optimized for support tasks.

        Heal check are useful for stabilizing characters as well, if you play with the “0 hp is unconscious, -10 hp is dead dead, and characters that aren’t stabilized can bleed out before the healer gets to them”.

        Also, when your enemy unexpectedly uses poison in combat, and doesn’t carry an antidote that the players can loot from his corpse.

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  4. I actually have that in some of the old stories I still occasionly putter around on! The psychic ability to heal is like all other psychic abilities in that people who have them have a ‘level’ that is their potential maximum (I usually use a 1-10 scale for it) that they will plateau at unless they use some form of enhancers (which all have side effects)

    Now HOW one uses their abilities can be useful, and one character, Walter ‘only’ is a 6 in healing, but he trained to be a doctor and uses the skill with shocking skill and proficiency, able to nearly perform miracles with it

    His fraternal twin sister, Karis-Aria, has the skill on the same ‘level’ for all psychic abilities… but she never uses healing, never trained it… and the best she can do (and has ever managed) is triage work. Patching someone up just enough to get them to a REAL doctor, and if they don’t get to a real doctor odds are high they’re gonna die. The one time she tried to do more than that she did save the person’s life… but left his vocal cords so screwed up (his throat was slashed) that he legit could only ‘talk’ while BREATHING IN (Wally is still not sure how she managed that) and she poured so much ‘energy’ into it that she tricked the guy’s body into thinking THAT was the norm and as a result it resists or refuses ‘repair’

    I’ve got a lot of rules that govern my various types of magic, so while there is ‘healing magic’ it has limitations on it (and there are equivilents of triage there as well… and the elves at least have a ‘you might be physically dead BUT WE CAN FIX THAT IF WE ARE FAST ENOUGH option… thaaaaaaaaaat is tied into their death penalty

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  5. I’ve always wanted to see the fantasy elements interacting with scientific progress.

    “You need the latest treatment, Leeches! We’ll do some nice, healthy bloodletting and you’ll feel much better.”

    “My HP is going down. Also, I have the [Anemic] status which doesn’t appear to have any benefits.”

    “Dammit, again?”

    “Has this ever worked?”

    “Well, not as such… but I have some Snake Oil that will surely do the trick!”

    “Now I’m poisoned. I assume ‘the trick’ in this case is removing witnesses?”

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    1. The canny Earth hero refuses such primitive treatment . . . so the necrotic flesh in his wound isn’t eaten by leeches and thus putrefies, and the infection is never lanced, emptied, and treated with Water of Life, so after a little while amputation is required to save his life.


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      1. Wasn’t necrotic flesh eaten by maggots?

        Leeches are occasionally used to prevent blood clots, but you have to know exactly what you’re going for. Not just “get the blood out.”

        Mostly I’m thinking about how useful it would be to have extra information from magic and [Status] for scientific research. 90% of research if figuring out how to get the information you’re looking for and making sure it’s accurate.

        Liked by 1 person

      2. Maggots. Unless they’re highly unusual leeches. Maggots are the ones you want to eat dead flesh, that actually kill off bacteria in healthy flesh. Leeches are for high blood pressure, draining extra blood from digits before you try to reattach them, and keeping too-stubborn patients in bed.


      3. Yeah, I misremembered which oozy-slimy-worm thing-you use. Thing is, medieval medicine was surprisingly-to-modern-arrogance effective. Going back to the ancient Greeks, physicians accumulated over a thousand years of practical knowledge of what tended to work and what didn’t, even if they didn’t understand why. It was the Renaissance into Early Modern Era into Industrial Revolution period when physicians discarded a lot of ‘old-fashioned superstition’, becoming a lot more deadly to their patients as a result.

        Which didn’t need to happen, because IIRC the first microscopes capable of seeing bacteria date back to the 1500s, so it wouldn’t have been impossible for doctors to look at what they were trying to treat compared to healthy tissue, and observe more closely what worked and what didn’t.


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      4. *Snarl* The loss of knowledge due to throwing things out and “oh-so-educated doctors know best, ignore centuries of experience” was so bad in the arena of childbirth that modern-day midwives (at least in the US, pre-internet) essentially had to reinvent midwifery from scratch when they started trying to get away from the standard practices of the mid century, which included women in labor being dosed with ether to the point of unconsciousness for the duration. Often they’d discover a technique by accident and only later learn that said technique had been used for centuries in X other part of the world. When the almost universal reaction to the fact that I’ve had two children without any pain meds or interventions is shock, something is -really screwed up-.

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      5. To be fair, though, there was a lot of throwing-out of midwife knowledge throughout history and between different cultures. And a lot of it was the lack of “man-midwives” and other males being part of the transmission of knowledge. Any time you tend to lean on a few women for the needs of an entire community, you risk having those few women die without passing important experience on. (Not to mention cliques, that one mentor who is a cracky control freak, etc.)

        The other factor was that, at least in England, there were a lot of 1700’s-1800’s midwives and professional nurses who were hip-deep in the practice of baby-farming (ie, paying money for the removal of your unwanted kids to a wonderful facility for newborns that is guaranteed to kill them off within a year or two). Amazingly enough, midwives who were involved in this murder-business were often alcoholics and often did not wash before undertaking deliveries, and there were other things going on which were pretty darned unsavory, because they didn’t respect themselves after doing bad stuff for a living.

        (And then there’s the elephant in the room of abortion, which was never the safest or most sanitary practice, and which wasn’t exactly guaranteed to make one appear trustworthy when involving medical poisons. And it wasn’t guaranteed to leave the midwives particularly cheerful and sane, either.)

        So there was a legit reason, in some cases, for idealistic young Victorian doctors to distrust midwives and their knowledge, because sometimes they really were dirty gin-soaked murderesses of whole baby farms, and so forth. I mean, geez, the Elizabeth Blackwells and Florence Nightingales of the world did have reason to be anxious to draw a distinction, and not just on the basis of class or education. Of course there were midwives who were knowledgeable and upright pillars of their community in all ages, but it wasn’t everybody. And that’s why the “Ask a Midwife” crew were also so anxious to be seen as professionals with various profession markers.

        Sigh. Studying historical true crime is not one of the most fun things, because you keep running across things that are not very nice, but have a lot of explanatory power of otherwise inexplicable historical prejudices and worries.

        Liked by 1 person

      6. Studying historical true crime is not one of the most fun things, because you keep running across things that are not very nice, but have a lot of explanatory power of otherwise inexplicable historical prejudices and worries.

        For a non-groady example, folks thought cops were thugs and thieves because at the time of Jack the Ripper, they were. The victims’ bodies were looted, and that was normal.

        Which blew a lot of the modern theories that assumed stuff like “the police wouldn’t have stolen stuff from a murder victim” without even thinking out of the water…..

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      7. Oh, and baby farming is the reason why Victorian orphanages were like they were — because they were doing everything they could to get rid of baby farming, which had been horrible; and which not all parents had known was about killing and/or warehousing your kids you couldn’t afford or were too weak to care for, rather than making sure that they were safely being raised by some big healthy farmwoman who liked breastfeeding other people’s kids.

        Since a lot of baby farms had superseded local parish orphanages for at least a generation, Victorian orphanages tended to be big industrial facilities that had been started from scratch, by inexperienced but idealistic persons who were not good at budgets.

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      8. Oh, and I forgot “being the only gynecologist for prostitutes infected with everything, in a time when most of the treatments were toxic stuff like mercury” (which wasn’t anybody’s fault, but definitely made midwifery unfun), and “being deeply involved with child trafflicking into the prostitution industry” (which definitely was the midwives’ fault).

        Of course, with so many unsavory things going on, there were a large proportion of city “midwives” who actually weren’t meaningfully trained in anything at all. They just set themselves up in business with their unsavory connections and nasty treatments, as contractors for brothels or crime syndicates.

        So you have the legit midwives, the semi-legit midwives, and the total criminal midwives working side by side, without there yet being any professional markers to distinguish them.

        Liked by 1 person

      9. So anyway, if you think Victorians are being ridiculously prissy, there’s something they are revolting against from previous generations, and sometimes it’s something terrible.

        Another major factor was the fracturing of European culture, knowledge, and education by the Reformation. Once you can’t have anyone in Europe attending Bologna or Paris or Oxford, you end up with medical developments not getting out to everyone. And since Bologna was the big university for women physicians and gynecology, that was a big problem. The destruction of nunneries meant fewer educated women in England, and the witch panic meant that a lot of women had to watch their step. A lot of the gynecological manuals were seen as “Catholic books,” too.

        And of course, lots of epidemics in the Early Modern Period, which meant lots of dead midwives and physicians.

        So there’s knowledge transmission problems all the way down, and a lot of them affected physicians too. It’s just that there were also a lot of experimental advances at the same time, which spackled over some of the knowledge gaps.

        Liked by 1 person

  6. Current work in progress?

    Well, it is a Castlevania crossover, and I’ve been tempted to do an omake every chapter that is a bad end for events in the chapter, with a different character in each omake taking on Dracula’s role in certain of the Castlevania games. As in, some hero shows up in the throne room, there the character is, and fight. Complete with goblet of blood thrown to the ground. Of course, that was before I realized that the most extreme bad ends involved the evaporation of planets.

    There is also a use of ‘Water of Life’ to create artificially some of the qualities that some kinds of vampire possess.

    Most relevantly, SAO canon is that the survivors were fed by IV, not feeding tubes. I’ve been learning about effects of IV, and hope to show those accurately for the survivors. Including, Nerv gear would apparently not prevent the elevated blood rate, etc, from serious CNS excitation, so some of them should have some significant bruising and other immediate consequences.

    Okay, some of the characters are going to driving cars with untreated but minor bomb injuries, etc…

    Blood is definitely important, but it doesn’t feel like a real gore fest. Except for a subset of the folks with supernatural enhanced constitutions, I think I’m going to be relying more on stress and other long term things than injuries; serious injuries should put most of the characters down for the remainder of the plot, rather than slow someone down who is still active.

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  7. Stitches ITCH. But attempting to do anything about that hurts, and doesn’t fix the itching. And also there comes a point where it is far enough along in healing that you don’t consciously feel them, until something jostles or brushes or pokes them. At which point, suddenly you’re aware that you have them again, and it hurts again. Oh, and also, moving and having them tug sucks. Fun times.

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  8. Side note: Stitches are aggravating and awkward, and none of the action books I’ve read where a character got stitched up cover just how annoying it is.

    The closest I’ve seen is “they itch.”

    Which is also used for any injury when it’s healing.

    *looks down at various scars*

    Haven’t ever had an itch from healing, although I understand the theory is the nerves are slightly injured. Sometimes scabs, after everything is healed and they want to come off.

    Related: cuts on hands can and do come open, using paper cuts as a comparison is totally legit for those who haven’t had them.

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    1. I can state that some injuries do itch while healing, even when not scabbed. One that I remember being exceptionally itchy was a case where I fell and scraped my arm pretty badly… but it all was sub-surface bruising rather than “skinned elbow” like I would have expected from the cause of the injury. At first, it looked like a the scraping I expected, except upon feeling it, it hadn’t actually broken the skin. As it started healing, first I got streaky bruises where all the “scrapes” should have been, at which point it became exceptionally itchy. Later, the bruises spread out and it became one large bruise, and then after that it leaked blood through the skin and formed scab, despite there being no sign of the skin actually being broken (either to sight or touch). It only finally stopped itching after all of that was cleared up.

      Also, answering the point about stitches: that depends a lot on the quantity and location of the stitches, and the spacing and type of nerves in their vicinity. It’s related to the test where you poke different spots with a feather and see which ones itch, and which ones tickle, and how close the location the itching feels like it’s coming from is to the actual location touched. When I had stitches on the back of my hand (boxer’s break, needed a pin, so they had to cut it open and then stitch it closed again), the stitches only itched during the part of the healing where the wound was still leaking and dried blood was getting caught in them. When I had stitches on my fingertip after getting it crushed open, those stitches itched the entire time they were in.

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      1. Orajel or topical painkillers, as long as it doesn’t touch the wound or stitches.

        Also, keep a close eye out for infections. Not trying to make you paranoid, but that can be a reason for pain and inflammation.

        Also, if your doctor says it’s okay, Mr. Peroxide Spray Bottle can be your friend. Walmart sells hydrogen peroxide in brown spray bottles, and it’s great, even if it makes me feel like I’m gardening. Just make sure you don’t get any peroxide in your hair, unless you like being artificially blonde.

        Liked by 1 person

      2. Oh, and don’t rub or apply crystallized honey on anything, even in a story, unless you’re being cautionary.

        I mean, crystallized honey does not help your wounds heal in any kind of a good way. Sure, there’s no infection, and yay for fighting infection. But crystals are sharp, at least on the very small level!

        I once did this on a little road rash thing. And it does not look super good, even on the tiny little scar scale. Do not recommend, would not do again.

        Make your characters heat the freaking honey (or sugar) until it’s a clear-consistency liquid. Then they can use it to prevent infection. (And even as a liquid, IIRC, sugar is more crystallish than honey, unless you heat it and break some bonds.)

        Liked by 1 person

      3. I once did this on a little road rash thing. And it does not look super good, even on the tiny little scar scale. Do not recommend, would not do again.

        Why am I not surprised that you– or pretty much anybody here– 1) tried a classic wound treatment 2) in a relatively low risk manner?

        Liked by 1 person

      4. Of course, in pre-modern settings, you are going to have wrap up any honey/sugar-treated wounds, because otherwise you would attract insects that like sugar, as well as the meat-loving flies previously attracted by blood.

        Of course, the covering thing is one reason you see pre-modern people covering wounds with olive oil or butter — it got rid of access to a lot of germs, and smothered the aerobic bacteria. If you treated and cleaned the wound with wine before putting on the oil and then wrapping the wound, as was often done in the Greco-Roman world, you got rid of a lot of the anaerobic bacteria also.

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      5. All of mine have been c-section stitches, so the usual stitch issues weren’t there– no stretching against the stitches/staples, the butterfly stitches (think bandaids that do the same thing as a stitch, for those not familiar with them– really good home option), etc.
        Made it hard to identify any weeping from the wound, much less tell if it was clear (healing) or not (infection), and the bikini-cut means that there’s no good way to get a clear view of those to see red. The touch-for-strangely-hot works for everything at least. Tends to become a nervous tick, though, which can make it hard to remember to disinfect your hands solidly…..

        I’ll try to limit my fussing at you, you already know this stuff, and even well meaning fussing can be draining to the fuss-ee. 😀

        Liked by 1 person

  9. I found the following online:

    It’s only germane to the topic at hand because it’s writing help.

    It’s bilingual calligraphy. Read in one direction, it’s Chinese. Turned sideways, and it’s Arabic and with the same meaning.


  10. Depends on the situation. If you’re trying to track what is believed to be a monster then you need to know how it kills. Or if something is out in the woods killing off pets, you need to be able to tell what it is by how it’s killing, that way it can be taken care of, depending on how big it is, before it starts to go after people. Or if you’re out in the woods and you stumble on a kill, then you need to be able to tell how fresh it is, and if you should be worried. Some of the creatures that I’m working on are a lot like birds, and feeding time comes up a lot. It’s pretty gory, they hunt in groups, and don’t like waiting for their prey to die. They subdue it and then start feeding. The dominate female prefers to eat the still beating heart, and their feeding methods are somewhat ritualistic.

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      1. I’ve also seen a video on Youtube. A Golden Eagle caught a pigeon. The pigeon kept trying to escape, but it couldn’t get away. The Golden Eagle started plucking the feathers from it, going right for the white meat. It was still alive.


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