what kind of injury....

AllanR

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The setting is the mid 1980's in Medellin Colombia.

I'm looking for a type of injury (from a fight, --gun, knife, or hand to hand) that would be severe enough to require someone to be flown from South America to North America with little delay. Even if they had access to the best local medical offerings of the time.
Would be a plus if the character was dicey at the Colombian hospital, but I don't want the character to go to coma, and I want the injured character to talk in the hospital and sit on the plane (maybe they could be on a stretcher and be reclined taking numerous seats)

Bullet beside the heart? --Heart transplants were just starting to be regularly successful at this time, but if the character needs a new heart right away, would they be conscious?
Swelling in the brain from a bat to the head?
Poison or infection from a cut?
 

K.S. Crooks

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The issue I see with your premise is wanting the injury to be severe, but needing a 4-24 hour flight (depending on where on each continent you want them to travel). Also add in the change in air pressure that could affect the person's condition. Poison may be the way to go. You could have the person given a sedative and/or covered with ice during the flight to decrease their heart rate.
 

Montero

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Question to check - do you know for sure that Colombian hospitals were that poor?

If someone has taken a severe bat to the head they won't be talking, or probably aren't talking any sense.
 

AllanR

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but needing a 4-24 hour flight
I was thinking total travel time in the twelve hour range (Medellin to Cartagena, Cartagena to Toronto)
Question to check - do you know for sure that Colombian hospitals were that poor?
The rich hospitals were high quality, that's why I am looking for a more specialty injury to require the transfer.
 
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Wayne Mack

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Probably any sever trauma would justify moving a patient from a more rural hospital to a larger one after the patient is stabilized. Consider having a secondary reason besides the injury as the rationale for the patient being sent to North America. Perhaps embassy involvement, threats from locals, insurance coverage?

Some injuries to consider would be fractured ribs and a collapsed lung or a skull fracture. A bullet near the heart or spinal column might justify specialized surgery. Having a heart transplant would require suitable donor and would likely take the character out of the story unless he or she were to return a year after the fight. Amnesia might justify returning the patient to his or her home settings for recovery, but it feels a little bit overused.
 

alexvss

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The setting is the mid 1980's in Medellin Colombia.

I'm looking for a type of injury (from a fight, --gun, knife, or hand to hand) that would be severe enough to require someone to be flown from South America to North America with little delay. Even if they had access to the best local medical offerings of the time.
Would be a plus if the character was dicey at the Colombian hospital, but I don't want the character to go to coma, and I want the injured character to talk in the hospital and sit on the plane (maybe they could be on a stretcher and be reclined taking numerous seats)

Bullet beside the heart? --Heart transplants were just starting to be regularly successful at this time, but if the character needs a new heart right away, would they be conscious?
Swelling in the brain from a bat to the head?
Poison or infection from a cut?
As Wayne Mack pointed, I find it hard to think of anything but insurance coverage or a political disturbance (which Colombia has a lot btw. You definitely could explore that). You’ve put yourself to meet two different conditions at the same time: a) an injury that is not urgent enough to kill, and the character must be able to stay awake and sit down; b) said injury must be treated in a specific location because Colombian hospitals don’t have the expertise. You see, those two conditions contradict each other. Maybe the character receives urgent attention in a local hospital, but then goes back to his country? Or the hospitals are full because of the insurgencies of narcos/communist rebels (happened a lot at the time. It could be the M-19 group or Pablo Escobar).

Maybe we should wait for the Chronners with medical (and Latin American history) education.

I just thought of something. A chronic disease. Something that doesn’t manifest often, but when it does, it needs attention from an expert. Maybe the injury triggers it. But beware: said injury should appear in the story before lest it will look like deus ex machina.
 

Swank

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Bullet lodged in spine or CNS. This wouldn't require immediate surgery but would require cutting edge scanning and techniques like you'd find in a US research hospital.
 

AllanR

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Poison may be the way to go.
Hmm, I'm thinking of a poison like what is in the Destroying Angel (Amanita bisporigera) --that takes a day or two to dissolve one's liver. The character might meet the conditions of being conscious and time urgent if they need to do a live organ donor liver transplant using a sibling (who is in NA) as the donor before the liver shuts down.
 

paranoid marvin

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I'm not sure that you have to be medically 100% accurate, as long as what you write is feasible. Does anyone really remember what medical facilities were like in the US or Columbia 40 years ago?

If I were to read in a novel that a patient had a bullet lodged near to his spine/brain/heart/other vital organ, and needed to be transported to a North American hospital which had the best medical equipment and surgeons in the world? I wouldn't question it. Sounds plausible enough to me.
 

Montero

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If you have a character who is the driving force on the transfer, stating that no hospital in Colombia can cope with that injury, that would be a further cushioning - because it is not the writer saying it is impossible, it is a character - who might have been right, or might have been wrong.
 

Swank

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If you have a character who is the driving force on the transfer, stating that no hospital in Colombia can cope with that injury, that would be a further cushioning - because it is not the writer saying it is impossible, it is a character - who might have been right, or might have been wrong.
If all you need is character bias, then a hangnail and American chauvinism would have been sufficient.
 

THX1138

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Most, if not all gunshots or knife wounds would be treated there in SA. Poisons and infections most likely treated there in there SA as well.
Maybe a bullet lodged into spine might require a flight to the US. But then again, it's a bullet lodged in the spine. the landing could cause more or even permanent damage. All depending on how you write how the patient is being transported while in flight. (Strapped down while wearing a spinal brace and sedated.)

Infections most likely would be treated there (SA) because they would have the antibiotics for that strain.

It would also come down to who this injured person is? A government official? A spy? Someone important must likely.

Just one posable scenario.
 
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KiraAnn

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This is off to me. It would have to be a VIP to be flown anywhere from Columbia in the mid 80's. Or a covert ops agent, perhaps, someone higher up than 007 who would just be written off.

And if it is that urgent to get him in Toronto, why not stop somewhere closer like the Miami area, or Tampa, or Birmingham (AL) or Nashville. The latter two cities have top ranked medical schools/hospitals.
 

AllanR

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It would have to be a VIP to be flown anywhere from Columbia in the mid 80's.
I chose Cartegena to Toronto leg only because I know a regular commercial direct flight existed at the time. In the 80's, Cartegena had about 50k tourists from Toronto every winter. There would have also been a regular flight to Miami from numerous Colombian cities as well, probably from Medellin itself (Miami was the hub for all areas of Latin America at the time.)

I was thinking Toronto as the character in question is Canadian. Miami would be three hour or so shorter flight and if I use Miami, it could be one flight instead of two even shorting the travel time.
 

Yozh

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Maybe not something specific about the injury itself, but other surrounding circumstances make this reasonable. For example, years ago I was working overseas and developed an infection that could have been treated in country, but would have required putting me up in the capital city hours away where I knew no one, maybe for weeks. It happened that my organization had a doctor in country at that time who was coincidentally flying back to U.S. headquarters the next day, and so the organization offered me the option to fly back with the doctor and get treatment in U.S. in a city I’d lived in for years. Of course I took the flight to U.S.
 

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