Video Game Clinic #2: Nathan Drake Gets Shot

Hello! The Video Game Clinic has returned to over-analyse a fresh gaming injury, and this week it’s another swashbuckling adventurer in the form of Nathan Drake of Uncharted fame. Ol’ Nate has taken his fair share of knocks over the four-game series, but the fact is if you’re going to go gallivanting around teeming jungles and ancient ruins, facing up to heavily armed soldiers with little more than a loose-fitting pair of jeans and a cheeky smile, you will undoubtedly get hurt. I’m a fan of the Uncharted games and they consistently deliver spectacular action set pieces, but to do that, they push their luck a bit in the suspension-of-disbelief category. I’m not complaining by any means – there’s nothing wrong with seeing a man fall out of a plane twice and somehow land safely in the desert – and apart from being deliriously entertaining, it gives me plenty of opportunity to take a closer look at some juicy video game trauma. So keep it up, Naughty Dog!

Today’s injury is one that seems unusually common across pop culture in general, and I’ve never really been sure why. It’s the classic shoot-someone-in-the-stomach manoeuvre, perfect for not killing the hero instantly so that they can have a couple more minutes of screen time, just enough to splutter a few heartfelt lines about always being proud of their partner or whatever. You know the kind of scene I mean; there’s probably a YouTube compilation out there somewhere. Gunshot to the abdomen in pop culture terms will either lead to a tear-jerking death, being cradled by a friend or partner, or waking up in hospital a scene or two later and wincing as they try to get up. In reality, it’s an extremely nasty injury that is survivable as long as you get urgent assessment and treatment in hospital, and usually requires an operation within a few hours of the incident. With all that in mind, let’s take a peek at how our charming thrill-seeker Mr Drake reacts to being shot. (Spoilers ahead for anyone who hasn’t played Uncharted 2: Among Thieves.)

Patient: Nathan Drake, AKA “That was close!”

Presenting Complaint: Penetrating gunshot wound to the abdomen, vehicular collision

(The video is not my own. Apologies for the ropey quality).

Nate gets shot (rather coldly) in the lower left part of his abdomen, which in anatomical terms is called the left lower quadrant or left iliac fossa. The only major abdominal organ in this region is part of the large bowel, so if you were to get shot anywhere in the abdomen I suppose this would be the best place (but really it would be best to avoid it altogether if you can). Nate is understandably stunned and staggers away from the advancing soldiers, losing a fair amount of blood in the process. He shoots some conveniently placed gas tanks to cause an explosion, killing his attackers and sending the train careening off the rails and barrelling down the mountainside. The scene fades to black, but fear not…

Nate’s not dead! It’ll take a bit more than being shot and getting thrown around the inside of a train like a tennis ball in a washing machine to keep our hero down. He manages to make it off the train, but he’s been through a hell of a lot.

Doctor’s notes: Let’s break this down. A penetrating gunshot wound in the abdomen is a big problem for a few reasons. First is blood loss: when Nate inexplicably wakes up from his ordeal, he quips, “that’s my blood, that is a lot of my blood”. You may be in the mood for snappy remarks in this situation Nate, but I’d be taking things a bit more seriously if I were you. Without urgent action to stop the bleeding and replace his circulating blood volume, significant blood loss could lead to major organ shutdown and eventually death. I don’t think this train even has a first aid kit, so we may be in trouble here. If major haemorrhage doesn’t get him, it’s very likely that the bullet will have perforated his colon on its way through his body, causing air and other bowel contents to leak into the rest of his abdomen. This is a surgical emergency and needs an urgent operation to fix it – if not, he may die. Finally there’s the inevitable introduction of infection into the abdomen, which in a few hours will cause sepsis; if this goes untreated it will lead to septic shock and, yep, you guessed it, death.

Diagnosis: Nate’s got enough on his plate with a bullet in his abdomen, but he also could be killed pretty easily while being tossed around like a rag doll inside the train carriage as it rolls down the hill. Let’s list his potential medical and surgical issues:

  • major haemorrhage, causing hypovolaemic shock and eventually, death;
  • traumatic bowel perforation;
  • intra-abdominal infection, causing peritonitis and sepsis;
  • any number of high-impact injuries to his head or spine (or really any part of his body) that could paralyse him or kill him.

Real-life prognosis: dead. Dead as a dodo. I really don’t see a way that Nate could survive any of this.

Video game prognosis: “Oh shit, I’m bleeding quite a lot! Better fall out the bottom of this precariously-balanced train carriage, then climb up said carriage, leap to safety, and have a flashback about how I got into this mess in the first place.”

That’s it for this edition of Video Game Clinic, though I’m sure the Uncharted series has plenty more medically-questionable scenarios we can explore in future. I’ve had a couple of suggestions already for the next instalment, and I’d love to hear a few more. I’m having a blast writing these posts, and would love to hear any feedback you have; and really, it’s just nice to hear from people in general. Stay safe out there, and don’t go climbing any train carriages if you’ve been shot in the abdomen. Just go to hospital.

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