ER Doctor Breaks Down Movie Injuries

ER Doctor Breaks Down Movie Injuries

Emergency Physician Italo Brown breaks down movie injuries, including 'Scarface,' 'Us,' 'Whiplash,' 'Kill Bill Vol: 2,'Austin Powers: The Spay That Shagged Me,' 'Titanic,' ' John Wick: Chapter 3 - Parabellum,' 'The Campaign,' 'Casino Royal' and 'Home Alone 2: Lost in New York.'

- Hey, what's up y'all?I'm Dr. Italo Brown, emergency physician,and this is "The Breakdown."[funky music]First up, we got "Scarface."- Okay, do you wanna play rough?- Let's play rough.- Okay, say hello to my little friend![booming explosion]- All right, stop.In emergency medicine,we deal with blast injuries all the time.There's things that come from these typesof mass casualty events.The fact that there werethat close to the blastis worrisome to me.Barotrauma to the ears, orpressurized injury to the ear,because it's a tight space, right?And then you've got other things,such as what's flying throughthe air because of a blast?So, shrapnel, matter from the building.Then the body actuallybeing thrown in the airis another degree of trauma.So, imagine being lifted off the ground,and then slammed to the groundwith this tremendous force.I don't know if they wouldeven get back up right away.If not, they'd have their ears ringing.So, all right, we continue.[machine guns firing]All right, stop.I don't see a guy being able to continueto shoot after that, specificallybecause where it hit him.So he got hit left upper thorax area.So, like, left chest,heart, you have lungs.Any time you hit someone center mast,they're gonna have a very poor outcome.- Who'd you think youwere [beep] with, ay?I'm Tony Montana!- He's bleeding a lot.[beeping]Or he shouldn't be able to talk like that.I mean, he's taken at leastfour rounds that I've seen.The first one itself was lethal.So, I don't know how he could continueto have this monologue in real life.I mean, this guydefinitely is not standing.He's gonna pass out at any moment.- You [beep] with the best.[yelling]- That's it.That is it.

[laughing]That is it.It's a wrap.I mean he was talking andthen all of a sudden 50 cent.That's it, just getshit all over the chest.And I was just thinking about,as I'm rolling this in my head,if he is still on cocainehe woulda bled faster.One of the side effects,or the actual main effectof taking cocaine, it's a sympathomimetic,which is like a drug thatboosts all of your senses up.So it would benefit himto have taken cocaine,and to already be in this fightor flight type of scenario.But, if you were hitting a vital artery,I don't know if that would be a real thingto see someone go this far in the fight.- Go ahead, take your [beep].You freak, I'm Tony Montana!Go ahead you [beep], go ahead![shotgun blast]- Stop.Most shotgun wounds are lethal.He gets hit one time.All those other guysshot him about 97 timesand nothing happened, apparently,but this one, it is theone that goodnights him.[cracking wood]Oh.[water splashing]Damn.Poor guy.[upbeat music]All right, next up we have "Us."[moody music]I usually don't trustpeople that walk like that.I just don't do it, [laughing]naturally I don't trust them.She's so fast.[rustling][breaking glass][screaming]All right, stop.

[laughing]That's real.The way that she got stabbedthrough the back of the hand,I would be concerned that after thisshe couldn't make a fist.Very realistic injury.Something that I see extremely oftenin the emergency department.I take my hat off to her to continueto fight after this, it's wow.[tense music][grunting]Not gonna be able to grab that.That's just what I believe.[Laughs] She's not grabbing that.I don't know if she'll be ableto create enough force to hold it.A thumb might be okayunless the blood supplyis compromised, butI'm just watching this,like, no blood dripping behind her.If you've ever seen a handinjury, it bleeds like crazy.I'm talking about it's consistent flow,and if it's an artery,which is what I thinkshe probably had severed,that artery is gonnacontinue to put out blood.Like high output.She wouldn't be able tocontinue this far withoutus seeing evidence of the injury.[suspense music]Mm-mm, surprise.[screaming][wet squishing]Ee!Got her.

[laughing]Whoa.All right.These wounds that go through the abdomen,except for this one, isat the level where I thinkit may have gone throughpart of the diaphragm,and it may even go into the back.So, I mean, let's playa little bit longer.[grunting]Lemme see this, oh, that's it.Yeah, so it's all the waythrough here.

[laughs]I don't have to tell youthis, but for it to go frontto back it's possiblyaffecting spinal nerves,she's not gonna be ableto walk or move anythingfrom that level below.I'd be more concernedabout, at that angle,what part of the heart did she hit?I think she may have justsevered her aorta, maybe.[whistling]Don't believe it.That diaphragm, I thinkshe pierced through it.So I don't see being able to even makethe motion to breathe in and then whistle,because that rod wentstraight through both.[gurgling]The asphyxiation with the handcuffs,that's pretty brutal, man.I got a problem with moviesthat have this, like,sound of crunching.It's not, like, thateasy to go through allof those structures and thenall of a sudden magically gettwo vertebrae and just [crunching].I don't know if that happens like that.So, I think that the crunch is more likelyfrom something more anterior,in the front of the neck,not so much posterior.[jazzy music]All right, the next moviewe're gonna see, "Whiplash."- [Female Voice] Turn 200 feet.- [Pianist On Phone] Are you driving, man?- No.- [Pianist On Phone] Whatthe hell was that noise?- Okay, look, why don'tyou just tell Fletcherthat I'm coming, you [beep].- Stop, there's a lotof lessons to be learnedjust from this part.Motor vehicle accidents,like, one of the top,the leading causes ofdeath in young people.He's talking on thephone, totally distracted,driving a car, and they'resetting it up just likeit happens when it comesinto my emergency department.[Horn blaring][glass Crashing]Oh my gosh!

[laughing]I'm sorry, yo.I worry off the top about him being thrownand jostled in the car.The car flips.You've got an entiredifferent set of thingsthat you're worried about.Loss of consciousness, head injuries.So his head struck something in the car.Glass broken, that's projectile.If the car is basically bentin on the side by the driver,his lower body is entrapped.[panting]He's lucky.I mean, this is what I'm talking about.This is a super common thing that we getThey will bring us someonewho was in a rollover accidentand they come mangled.I mean, seat belts areextremely helpful in tryingto reduce injuries like this,but that type of decelerationor quick shearing force,if it wasn't an airbag that hit him,or the steering wheel that hit him,then it may have been theside of the car itself.Like a coup contrecoup isthe phrase that they use.Which basically is likesome cool French wordwhich means that the head strikeson one side of the impact,and then the oppositeside will also impact.He may have struck something on one end,and the force threw himin the opposite directionand then struck the wall of the car again.That boy is on a mission.

[laughs]I would not be getting up out of the car.A lot of times what happens onthe scene is someone will getup and then they go down immediately.Because they didn't realize that they hada intracranial bleed.You think everything iscool, and then you go down.We call that a lucid interval.- [Man] Are you okay?- Yeah, I gotta get my sticks.- [Man] No, no, no, no, no,no, stay away from the car.- I would definitely notrecommend standing straightup vertically, walkingaround because I'm worriedabout him having bleedingthat's not visible.I'm worried about hisneck having an injuryand a vertebral misalignment.Do not move, but if you're worried aboutthe vehicle blowing up, man, crawl.Lieutenant Dan it out.

[laughs]Just get out.Get out, man.[jazz music]The body woke up and said, "Wewere just in a car accident."Yes, you were, andthat's why I don't thinkhe could continue the performance.He would have difficultytrying to hold the sticks,that match grip wouldn't be as easy.Him trying to, like,keep along with things,and hear things, all thosesenses could be compromisedby pooling blood inside the head.Next up, "Kill Bill: Volume 2."Awesome.

[laughs]Awesome.If you're trapped inside a coffin,oxygen is gonna be an immediate concern.I think that you'd onlybe able to survive likea matter of minutes in this situation.Her core temperature might bea little bit elevated tryingto figure out what's goingon in this situation.The cool thing about peoplewho are this highly trained,sometimes they're able tolower their heart rate,and lower their body temperature,their core temperature.So that's like upper echelontype of warrior stuff.She might be able to do that.I still don't see that giving hera considerable time advantage.You can't make more oxygenexist in this space.The fact that you're re-breathingcarbon dioxide would makeit a little bit less likelyfor you to do this typeof focused activity.Mm-hm, good one-inch punch.Nice.And pause.Trained boxers or trainedfighters know exactlywhich knuckles to strikewith and how to limitthe likelihood of a fracture.Any other random person ofthe street who is tryingto punch their way through a coffin,one, I don't think they'dbe able to get that far.Two, they're definitelygonna break a hand.I'd expect them to havefractures of the ring fingerand the pinkie fingerbecause they don't know howto throw a punch properly.Whereas her, she probablyhas probably already hadso many fractures thatthe bone itself is formedin a certain way to bestrengthened so thatshe wouldn't fractureher hand that easily.[wood cracking][grunting]Another thing thatdoesn't make sense to me.She's deep underneath the ground, right?So dirt's coming in, not air.There's just more dirt, so I don't knowif you get a great benefit of oxygenfrom having more minerals dropped inside.I don't know, but.And then the broke hand reachesthrough the earth.

[laughs]Fo sho.[gasping]Yeah, that's probablythe most realistic partof this whole thing is how much she wantedthat oxygen when she got up out,'cause I know that sisterwas struggling down there,so congrats to you.All right, so the next movie,"Austin Powers: The Spy Who Shagged Me."- Come right over here.- Okay, yes I can do that.[music drowns out muttering][laughing][screaming]Fo sho.Pause!

[laughs]Um, this is like a veryclassic injury, right?It usually means that theperson can't move their limbsbelow the level of the injury,and has some sensory deficits.So I'd like to see what happens as far as,like, how they display that.- Prepare to die, Powers![screaming]- Clearly, they didn't care.

[laughing]- Use the machine gun!- No, no![machine gun firing]- What a minute.

[laughing]Okay, so it wasn't enough thatshe got a knife in the back.- Say goodbye, Powers!- I'm sorry, this it'sher facial expressions.Unfortunately I've neverbeen in this situationto know exactly how this plays out,but any high powered weaponlike that has the abilityto make bullets go through bodies.So I'd be worried that Austinwould have taken at least two.She's still going.- Use the bazooka!Wait a minute.

[laughing]Go back.[winding]You see how she has no injurieson the front of her body?Yeah, that's nah, nah.[screaming]- No!No!- Wait a minute.[rocket exploding][screaming]Now she has the injuries again.To even try to talk abouthow realistic it is,I feel foolish, but she tookan RPG right on straightto the body and Austin's untouched.Nothing fazes my man.I think that that's funny.Real life, we know what would happen.I love the fact that'ssitting here still talkingto him while they fall.Just a little char, you know.She's just a little singed.[crashing]Hm, yeah, she's definitelygone after that fall.And he might actually have an injury, too.That's probably one of themost misunderstood things.People think that if I fall,try to land on my feet.You'll end up with a lot ofcompression fractures that way.Bilateral ankle fractures.The vertebrae itself from the axial load,or the load of the forcegoing down onto the vertebrae,or come up from theground that you land on.I would probably try mybest to fall on, like,one part of the body.And try to make sure thatyou don't hit your head.So those are the areas thatI'd be most concerned about.The next movie we'regonna watch is "Titanic."[shivering]- It's getting quiet.[distant shouting]- Just gonna take a couple of minutes to--- Man, he took one for the team.- The boats organized.- All right.- I don't know--- Pause.I know where this is going.Basically, someone is gonna freeze.Honestly, two people should freeze.What you're dealing with in hypothermiais essentially like bloodflow that is no longer goingto areas where it needs togo to keep the tissue alive.When the body goes into this mode,it's trying to conserve as much heatand as much blood flow as possible,so it'll divert it towards vital organs,like the brain and the heart.But the extremities, they get frostbite,and eventually you have completedisruption of the tissues.And they may not be viable after that.[distant calling]- I don't know about you,but I intend to providea strongly worded letterto the White Star Lineabout all this.- I'm glad he's still talking.I'd be worried about the quiet people.He has uncontrolled shivering.The other things that I thinkis a little bit unrealisticis he's able to continueto think things through.Like that mentation is something that goeswhen you're startingto be more hypothermic.So the fact that he'stalking is a good thing.I just don't know if he'dbe able to move as freelyas he's moving now if it's that cold.This is what I was talking about.This face right here.I'd expect that face a lotearlier on if it's that cold.The mental status isstarting to wax and wanebecause the only thing that'sbeing perfused, really,is parts of the brain,and now that's going.I would also worry about isthe heart rhythm regular?When you start to dropthe core body temperatureto this level, your heart is freaking out.At 28 degrees Fahrenheit,I just think that you're gonnastart to freeze a lot sooner,five minutes max, definitelynot an hour in this water.[gentle music][water lapping]- I'll never let go, I promise.- Let's him go.She's should let him go.Cold-hearted, like, literally.And this is the last thing that I would dois roll into some water.I just don't see her having full actionin those extremities.[blowing whistle]If she was able to withstandthis tundra-level cold,maybe she could blow the whistle,but nah, I just don't...Definitely not loud enoughto get the guy to come back.Up next, we have "John Wick: Chapter 3."- What are we going to do about John Wick?[suspenseful music]- He knows it's coming.- Oh, he has to die.[gun firing]- Pause.

[laughs]If you watch the movie,you know that he's gotthese special liners inside of his jacket.It's possible that hemay be able to sustaina couple shots like that from a handgun.Even his reaction is real, like,to double over after those shots.We watched a couple other movies,they didn't even get fazed by being shot,whereas he, in thismovie, like, doubles over.I think that this is realistic.- Sorry, Jonathan.- Winston!- I don't see any other way.[crashing][grunting]- All right, pause.So, can we rewind thisa little bit?

[laughs][reminding]So, one...Two...Three...Four... stop.Man!All of those different hitsmeans that he had blunt traumain each of those locations.- [Interviewer] My initial reaction was,"Oh, he's breaking his fall by--"- No!The fall is breaking him!His ribs rapped on the bar at one point,another part of his hipstruck the dumpster,and then finally head and shoulders.So, you're talking aboutvessels still shearingbecause they're stopped abruptly.You're talking about bones that haveto deal with that force,and they're not made tobend and be malleable.You might fracture the skull,but you could also causethe brain to jostle.It's so many differentinjuries in this scene thatI don't even think that I could just startto enumerate them off the bat.He's John wick!I mean, at the end of the dayyou know he's getting back up,with a broken pelvis andspine all out of whack.Up next, "The Campaign."- I have the faith in me!- All right.- Mitch, I could do this forever.These snakes love me.[chomping]- Done.- God damn it!

[beep]- Okay, so people own exotic animals,and I've seen everything from snake bitesto gila monster attacks.Common location... actuallycommon mechanism, you know,someone handling thesnake, trying to act cool,and then all of a suddensnake goes snake on themand that's what happens.- Oh the [beep] [beep] serpent bit me.Staple my [beep] to my [beep]and then do sit-ups, it hurts.- Sir.- That's kinda realistic.Once you get bit it's everycurse word in the book.I would be worried aboutthe person who talks, talks,and then all of a suddenstarts to just trail off.Because that means thatthe effect of the venomis starting to take hold.- [Cam] I can't feel anything.- Yeah, here comes the neuropathic stuff.- Hey, you okay?- Yup!

[laughs]- Cam, come on, we gotta go!- I love how they change to fish-eye lensto basically simulate that he is altered.And that's realistic.Other things that would happen,he may fall and have a seizure.If you have recentlygotten bitten and you startto have this altered mental status,you may run straightthrough a window like that.I don't think that that'scompletely unrealistic.The next movie, "Casino Royale."[tense music]He just got poisoned,and because he's James Bond,the car is tricked out with defibrillator.Like a AED right there in the dash.Pause.I don't know what that is.It looks like he's trying tocapture his pulse, or a rhythm.I mean, if I'm looking forsomebody's heart activity,I'm gonna place leads around the heart.I don't think that this isrealistic unless he's tryingto put an IV access into his body.- 007, stay calm and don't interrupt,'cause you'll be deadwithin two minutes unlessyou do exactly what I tell you.- He's starting to sweat,we call is diaphoresis.Now this is what I was talkingabout as far as you haveto place somewhere on thebody those leads in orderto effectively distribute a shock.- Ventricular tachycardia, digitalis.- So, pause.Go back a little bit.[rewinding]- Ventricular tachycardia.- This means that hisventricles, the part of the heartthat's responsible for forcingthe blood around the body,they're beating more rapidly than normal.This is an indication to deliver a shock,or to cardiovert somebody.So that's what I think is about to happen.- Antihistamines,hydrocortisone, adrenalin?- [Man] As soon as it reads charged.- Lidocaine, that'll work.Bond, don't push the red button yet.Do you hear me?Don't push it yet.- Okay, pause.I don't know how realisticit is for somebodyto distribute a shock to themselves.I mean, maybe that's just a badass thingthat only James Bond can do.People who are in thistype of tachyarhythmia,are unable to, like, hold things.I don't think that it's realisticthat someone would be ableto just push a button anddeliver a shock to their self.- [Man] That willcounteract the digitalis.This is not real.Obviously it's some movie magic,they put some numberson top of some stuff.I would expect the arrhythmiato be a lot higher,150s, 160s, 180s.Most of us get to 135 justfrom a brisk walk or jogging.97 I'm assuming down atthe bottom is his oxygen,usually through a pulsox on a fingertip,which we didn't see him place.- Push the red button now, Bond.[panting][tapping]- It's always the battery.

[laughing][beeping][heart beating]It's a wrap.He passed out.So, I think that that's realistic.A lot of times patientswill have these typesof reactions in this setting.[steady tone][charging whine][electric snapping]So, that's realistic.You are literally rebootingthe heart from scratch,like a cold boot.And so when I talk to patients afterwards,they feel like they died for a second.I mean, technically they were right,because it was entirely jump started.That is a normal reactionfor someone to kind of, like,jolt, and then all ofa sudden come back to.Next, a childhood favorite,"Home Alone 2: Lost in New York."- Okay, kid, give it to me.[whooping][brick smacking]I can't say that I have seena lot of bricks to the head.Any object with considerablemass that strikes you can leadto a concussion like this.Imagine putting like aboiled egg inside of a jarwith a little bit of water.That's essentially what thebrain is like inside the head.And then it strikingagainst walls of the skullis similar to that egg,that soft part of the egg,striking the glass, and itcan lead to nausea, vomiting,confusion, dizziness.He's gonna have that within the next day.Look!See, see?This is called diplopia, right?So, he sees two different objects,and when I have those patientscome in after head injuries,I'll say, "Do you seeone of me, or two of me?"- You wanna throw bricks?Go ahead, throw another one!- Aw, oh my!

[laughs]You get two bricks to the head,you basically are gonna staythere for 24 hours if Ihave anything to do with it.Not because you have an injury,but because you shouldn'tbe doing anything toget hit by two bricks.Like, that's what I'm worried about.And we gonna keep you around.All right, dude.Just stay down.Just stay...[grunting][brick crashing]All right, goodnight.Like, Kevin is incrediblyaccurate in termsof his throwing abilities.And so it looks likedude is getting struckin the same place.I'd be worried that hehas like a small fracturein the front part of hishead, like his frontal bone,or even one of thesinuses being fractured.- [muttering incoherently]- What?- [gibbering]- My man can't even say anything.- [panicked squealing]- [Harry] What?[whopping][brick crashing]He did take a tumble, butdid he actually back out?If he blacked out, thisis a guy that I wanna geton a CAT scan table as soon as possible.One, it can actually bethe person blacks outbecause of the impact.A repeat fall could bebecause less blood flowto that portion of the brain becauseit's leaking into another space.These are all in the scenarioof, like, struck by a brick.I don't know, I've neverbeen hit by a brick,so I'm gonna keep that streak going.- Harry?- That was "The Breakdown" with GQ.Thank you all for watching.Aight, peace.