[The following is an excerpt from the book Maim Your Characters by Samantha Keel] which originally appeared on ScriptMedic: A Medical Consultant for Writers]


An injury plot works on one very simple three-part platform:

A character gets hurt. (The Beginning)

That character gets treatment and begins to feel better, but must navigate the world in a state of partial disability. (The Middle)

Finally, the character settles into their new normal, whether that’s back to a healthy baseline, living with some partial disability, or suffering a total disability of one body part or another. (The End)

Congratulations! This book is done. Go forth and maim your characters!

If only…

The good news is that sticking to this simple structure will give you a perfectly reasonable injury tale.


While daydreaming about smashing a homer at the company softball game, Mary trips over the ottoman, falls, and breaks her wrist. She tries icing her wrist, but the pain just keeps getting worse. (The Beginning)

She goes to the ER and gets X-rays and a cast. Thoughts of the game are replaced with daily challenges: how to button her shirts, how to drive her stick shift, how to type her TPS reports at work. She solves these challenges by asking her wife for help with her shirt, swapping cars for a couple of weeks with a coworker who has an automatic, and using dictation software. (The Middle)

Eventually, Mary’s cast comes off. Her wrist still hurts when the weather changes, but mostly she can ignore it. The softball game is all but forgotten. (The End)

This progression certainly works, although it’s a little dull and, most importantly, it lacks meaning. At present, it’s a plot, but not really a story. Remember, Mary needs to change in some fundamental way for it to be a story with meaning (rather than a series of things that happen).

One way we could add some meaning is defining why the softball game is so important to her. Does she need to redeem herself for a mistake? Does she miss the glory days of her youth? Is she trying to impress her boss – or a potential side lover? (Scandal Alert! Or, a perfectly healthy polyamorous relationship.)

In short: this plot is good, or at least makes sense, but now let’s elevate this plot to the level of story.

In my experience, this is where most injury plots fall apart. There’s a very clear cause – a character is injured, usually shot – but there’s no effect on the person or on the story. It becomes simply a piece of texture, an element of “grit” that carries no weight of meaning behind it.

So we’ve taken a look at the Beginning, Middle, and End of Mary’s broken wrist plot, and touched on why this might matter to her. All of which is great! But let’s break down those three components into smaller pieces that will help us understand the particular quirks of an injury plot.

There are six distinct phases of the injury portion of the injury plot.

Broken down by plot section, these are:

The Beginning:

The Inciting Injury: the moment and manner in which the character gets hurt.

The Immediate Treatment: what the character does in the moment to feel better and avoid further injury.

The Middle:

The Definitive Treatment: when the character receives care which ultimately begins their healing process.

The Rocky Road to Recovery: when the character faces challenges relating to their new disability and how they cope with those problems during healing.

The End:

The Big Test: the moment when a character must overcome a greater challenge related to the global plot – while still recovering from their injury.

The New Normal: when your character’s final degree of disability becomes apparent. They can have No Disability, a Partial Disability, or be Totally Disabled (for the affected body part).

You can see places where the five fundamental elements of storytelling mesh into the injury plot. The Inciting Injury is the Inciting Incident, the Progressive Complications are in the Treatment stages and the Rocky Road to Recovery, the Crisis and Climax parallel nicely with the Big Test, and the Resolution is one and the same as the New Normal.

So why the relabeling? Because it’s easy to get distracted by vague terms. The labels that are injury-specific will help you remember the pieces you need to have in place in order to make sure your audiences find your arc believable.

Let’s take another look at Mary’s wrist fracture, through the lens of the Six Phases:

Inciting Injury: Mary trips over the ottoman and breaks her wrist.

Immediate Treatment: Mary tries to ice her wrist and hopes it gets better, but it doesn’t.

Definitive Treatment: Mary goes to the ER, gets X-rays and a cast.

The Rocky Road to Recovery: Mary’s everyday life becomes more challenging with her broken wrist! Driving a stick shift is out, she can’t even button her own shirt, and she can’t effectively type one-handed. She solves each of these problems.

Big Test: Mary doesn’t have one… yet.

New Normal: Eventually Mary’s cast comes off, and she has a very minor Partial Disability: some lingering wrist stiffness and some aching when the weather changes.

Hopefully the first three phases are pretty clear and straightforward. But I want to talk about the Rocky Road to Recovery for a little bit, because, at least at the moment, it’s the easiest way to touch on the third rail of the story: why the injury actually matters.

Why is it, exactly, that these three tasks are so important to Mary? Essentially, what parts of herself does this injury force her to face?

Buttoning Her Shirt: As it stands, this is just an inconvenience, one that will go away in a few weeks. But what if Mary is very independent, and hates anyone – even her wife – seeing her vulnerable and weak? Why would she feel this way? Maybe when she was younger, Mary had to take care of her aging grandmother, and she always hated buttoning her grandmother’s blouse. She always vowed that she would never get to that stage in her life – and yet here she is. Maybe she’s coming up on a birthday and fearing her older age.

(Note that these concepts are both very natural and very ablist. On the one hand, change is extremely hard, especially where it concerns things we take for granted, such as our ability to do anything we choose. On the other hand, the mindset that becoming disabled is an awful thing implies that the lives of disabled people are awful, which doesn’t necessarily follow. Be aware of what you’re writing as you write it!)

Swapping Cars: Again, this is an inconvenience – until we know why it’s a big deal for Mary. Is she super proud of her ability to drive a stick shift? Is she super proud of her car as a status symbol – and now she’s swapping her this-year’s Lexus for her coworker’s twelve-year-old Civic? What if she’s a neat freak, and the person she’s switching cars with is a total slob? Or, what if she just got her car – by inheritance, and she has conversations with her car as though it’s her lost parent?

In any of these cases, why does it matter?

Typing and Work: Why does it matter so much that Mary has difficulty typing? Is she on the verge of losing her job – hence her burning desire to impress at the softball game? Is it her dream job she’s at risk of losing, one she’s fought to get? Does she feel like an imposter, like she’s gotten someplace she doesn’t actually deserve, and maybe losing the job is some cosmic retribution for her masquerade? Or maybe she’s self-conscious about her voice (why? An utterly embarrassing failure at a school talent show when she was a teen?), and doesn’t want to use dictation software where other people can hear – but it’s the only way to keep doing her work?

As you can see, this is the single best place where an injury plot can teach us about Mary. With just three relatively small challenges, we learn about her grandmother’s illness, her connection with her lost parent, and her sense of being an imposter at a job she doesn’t deserve (even if she does). All of a sudden, Mary isn’t just a woman who tripped over an ottoman – she’s a person, with a story. Maybe we even feel like we know her. Maybe we identify with these pieces of her we’ve discovered through her struggle.

The magic of storytelling is that if what happens to the character matters to the character, and we know why that is, then what happens will matter to your audience as well.


Samantha Keel is a veteran paramedic and author of nonfiction and LGBT speculative fiction.

In October of 2016 her passions collided into a new blog called ScriptMedic, where writers can go to find medical information specifically geared towards them. She’s since cranked out or curated over 2,000 blog posts and helped over 12,000 writers craft better stories with more realistic injuries, illnesses, plots, and characters.

When she’s not writing about her medical passion, she’s spinning her own tales. Her upcoming works include science fiction that orbits around strong, LGBT female characters, but she has a strong interest in most kinds of speculative fiction. 

She lives in ███████, ██, USA with her wife and imaginary pit bull, Steve.

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