Holey Men

Eric Lis

Even in real life, characters with a high enough Constitution score can live through, and with, unbelievable injuries.

A man named Alexis St. Martin was one of the most famous cases in medical history. Born in the early days of the 19th century, he, like many people, became famous entirely by accident and against his wishes: while traveling in Michigan shortly after his twentieth birthday, he was accidentally shot in the gut with a musket. The shot struck him just below the left nipple, shredding muscle, braking ribs, and leaving a hole about an inch across in his chest wall. St. Martin was a Canadian, so already a tough bastard, and a professional fur trader and woodsman, which means that his Constitution was probably 18 (or higher); Dr. William Beaumont, a US army surgeon who took care of St. Martin, felt certain he would imminently die, but St. Martin survived and was soon back on his feet. The hole in his chest never closed, however, and instead underwent the dual processes of “epithelialization” and “fistulisation” which resulted in it turning into a tissue-covered hole through which people could see right into his stomach. In fact, for about two weeks, St. Martin had a difficult time eating because food literally fell out of his stomach and onto his lap. Over the course of a few weeks his gut adapted and food would at least stay inside his stomach and move into his intestines, but for the rest of his life, the hole remained open, which didn’t actually stop him from chopping wood or carrying heavy objects. None of this, mind you, is what actually made St. Martin famous. His unwanted fame came from the surgeon, Beaumont, who took the unique opportunity in front of him to conduct experiments on St. Martin over the course of the next ten years. These experiments included dangling food through the hole and watching how the stomach acids affected it. When St. Martin understandably became upset at some of these experiments, Beaumont’s response was to take notes on the appearance of the stomach lining during states of high emotion. Beaumont published his results in a book which immortalized them both. Despite some brief searching, I couldn’t find any records of how they divided the money from it.

Just to put a final touch on this story, St. Martin finally died at the age of 78, having outlived Dr. Beaumont by close to 30 years.

Living in the modern era, where trauma victims generally either make it a hospital or die, it can be hard for us to imagine what sorts of wounds a person can realistically survive and live with. This is a pertinent question in a fantasy setting, where advanced surgical techniques probably don’t exist (although one day I should really get around to writing a column about Aztec trauma surgery, which was apparently extremely advanced). Adventurers notwithstanding, it’s likely that the majority of traumas sustained in a fantasy world never get meaningful magical healing, and there could be people wandering Waterdeep with wounds similar to those of St. Martin. It must be noted that there probably aren’t MANY people who survive wounds like this; St. Martin, of course, was unique enough to go down in history. Still, they’re quite likely out there, and they can make for very colourful NPCs, whether it’s a barkeep with a shocking hole in his belly or a thief who hides stolen objects in the most unlikely place.

More than four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on May 15, 2016. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system