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As a hobby I wrote a short story where Character A wanted Character B unconscious for a few hours and to this end A punched B to the chin.

A reader, who claimed she was a doctor, said this was a stupid cliche that triggered her each time she saw this in fiction. She claimed it is not viable to try KO'ing others by punching them. She said that:

  1. Punches are unreliable; their strength cannot be reliably adjusted to get the intended result. Once a sufficiently powerful punch lands, there's no telling whether the punch will (a) have no visible effect (b) render the victim unconscious (c) kill the victim.

  2. Even if by means of pure luck the punch does result in a KO (and not death or an alerted but undamaged opponent) unconsciousness from traumatic concussion lasts very shortly, seconds to minutes, tops, so the time is insufficient to transport the victim anywhere.

Therefore, according to her, the cliche, despite its ubiquity, is pure nonsense and should be avoided by anyone who wishes to write sensibly.

I did some research by reading Wikipedia and Googling and it seems that she was correct at least at point 2.

However, if, as she claims, one cannot attempt to land a knockout punch without a significant risk of the receiver's death, then what about boxing, MMA, and other such sport competitions? If what she said was true, I suppose we would keep seeing fighters killing each other during tournaments and matches, but this just doesn't happen.

Is it correct that a punch with knockout power cannot be reliably expected to KO the receiver, but may always kill the receiver or have little visible effect?

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    Note that not all punches or targets are created equal. An MMA fighter is actively defending themselves and will only very rarely be killed by a punch. If Character A is just sucker-punching unsuspecting Character B, I might expect the odds of lasting injury or death to go up considerably. MMA fighters also have the physical ability and technical skill to take a punch, their low death rate may not reflect what you'd expect if landing head blows on the general population. Jun 5, 2023 at 14:42
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    Even if the punch doesn’t kill outright, a concussion is not fun and can lead to lasting brain damage.
    – Michael
    Jun 5, 2023 at 15:47
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    Regardless of the effect on the target, punching someone on the chin without protective gloves is a good way to break your fist.
    – Mark
    Jun 6, 2023 at 1:24
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    A knockout increases the chance of brain injury because of the almost inevitable unprotected fall, during which the head can strike the ground with sufficient force to cause trauma /death. The chances increase on the street or inside when the fall area is more dangerous than a sprung floor. Jun 6, 2023 at 12:00
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    It's not just head contacts. As evidenced by Damar Hamlin (Who was very lucky to have immediate medical intervention), commotio cordis causes several deaths a year (Blow to the chest at a critical point in the repolarization cycle of the heartbeat).
    – JohnP
    Jun 6, 2023 at 20:40

3 Answers 3

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However, if, as she claims, one cannot attempt to land a knockout punch without a significant risk of the receiver's death, then what about boxing, MMA and other such sport competitions? If what she said was true I suppose we would keep seeing fighters killing each other during tournaments and matches, but this just doesn't happen.

Fighters die in matches. It's infrequent enough not to be banned, but it definitely happens. This happens in sanctioned events with protective gear, referees to help protect fighters, and medical staff on hand.

  1. MMA deaths in fights
  2. CNN estimates an average of ~13 boxing deaths per year: 1890-2011 based on data in the Manuel Velazquez collection described here. This includes a breakdown of deaths by year.

Is it correct that a punch with knockout power cannot be reliably expected to KO the receiver, but may always kill the receiver or have little visible effect?

Yes. The chances of landing a knockout blow against a defending opponent are low, if you just consider how many punches get thrown and how often fighters are knocked out. There is a non-zero chance of death evidenced by the fighters that have died, though as Macaco Branco points out, this may be independent of where blows land.

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    There is also the fact that in a boxing or MMA match, the knocked out person is landing on the canvas, not a road, the corner of a table, etc
    – Kevin
    Jun 5, 2023 at 15:50
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    OTOH, each and every KO is an incidence of traumatic brain injury occurring. I'd think that still ought to be enough to ban the activity, (or at least try to discourage it, by banning hand padding or something) but nobody asked me.
    – T.E.D.
    Jun 6, 2023 at 18:05
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    @T.E.D. - There are bare knuckle fight leagues now (Legal ones that is, there have always been underground ones).
    – JohnP
    Jun 6, 2023 at 20:34
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    @JohnP - I do feel like those are more moral. However I understand the blood involved in fighting without regular concussions turns a lot of people off.
    – T.E.D.
    Jun 6, 2023 at 21:02
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It is technically correct that any knockout punch carries with it the risk of killing the target. Rendering someone unconscious essentially involves disrupting the brain, whether it is by rattling the brain around in the skull, or by disrupting blood flow to the brain. Doing this could cause internal bleeding within the brain, or could send a blood clot through the system. Both of those could kill a person. On the other hand, that is technically true of almost any attack inflicting a decent amount of force. Punching someone in the chest could induce an arrhythmia. Kicking someone in the thigh could create a blood clot that will rush to their heart or brain. Stomping someone's toe could lead to a one in a million situation where the nerve signals for the pain don't quite transmit right and the person's heart stops. Brains are just very dangerous to mess with because they are extremely essential to our existence - despite what watching Congress might make you think - and they don't really heal on their own very well, which means that repetitive trauma will definitely add up.

It's the "for a few hours" that is more the issue here. In terms of professional fights, such as MMA, you'll notice that most of the time, when someone is knocked out, they are able to be immediately revived. If left on their own, they would likely snap to it a moment or two later. When someone doesn't wake up shortly after being knocked out, that generally involves much greater trauma having been inflicted on them. Essentially, they are in a coma, which they may or may not wake up out of.

Lastly, as you note, in actual fights, rendering somebody unconscious is unpredictable. Fighters get struck from every conceivable angle with great amounts of force, and still stay on their feet (although, in some cases, fighters do get rendered unconscious, and continue fighting, because the reflexes kick in). It's worth noting that some of the methods of rendering somebody unconscious, such as a strike to the back of the neck, are illegal in MMA chiefly because they are so potentially dangerous.

While it is on an entertainment site, the TV Tropes entry for A Tap on the Head actually gives a pretty decent rundown on why the media depiction is dangerous as well as Instant Sedation expanding on the other common chemical dodges.

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    Worth noting though that there are other ways to make someone unconscious that are safer. Blood-strangles for example. (I have heard different martial arts disagree about what is termed 'strangle' and what is termed 'choke' so let's just say a blood based strangle)
    – Huw Evans
    Jun 4, 2023 at 15:22
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    "which they may or may not wake up out of" Or they may wake up with significant loss of function. Being knocked out is (by definition) brain damage, so all the consequences of a stroke are equally possible from being hit in the head.
    – Graham
    Jun 5, 2023 at 9:50
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    In actuality, there are very few ways of rendering a person unconscious that don't carry at least some risk of killing them. The other one that gets misrepresented in film/TV is chloroform. Contrary to popular belief, an untrained person can't just pour some chemicals on a rag and hold it over someone's mouth to knock them out without risk of killing them. There's a reason anesthesiology is a field in medicine. It takes a lot of training to know how to administer just the right amount of sedatives to keep someone unconscious but without risk of death. Jun 5, 2023 at 14:07
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    @gaazkam: As was noted by mattm, blood strangles are probably your safest bet, although they can kill, as per the recent NYC Jordan Neely case and, well, your target probably will wake up not terribly long after the strangle, so it's a decent window of time to bind their limbs and/or blindfold them to hustle them off. Or you introduce some sort of magic/advanced tech to make it possible (or at least much safer). Or you have it work without incident and then have someone chew the protagonist out for just having gotten really lucky that no major damage was done. Jun 5, 2023 at 17:58
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    Blood strangle followed by a carefully administered anesthetic? blood strange gives enough time for the anesthetic to kick in and sedates the target so that the anesthetic can be injected right into a vein. Perhaps this would be sensible enough?
    – gaazkam
    Jun 5, 2023 at 18:07
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Is it correct that a punch with knockout power cannot be reliably expected to KO the receiver, but may always kill the receiver or have little visible effect?

These are wildly different scenarios; all carry some kind of probability. A punch with knockout power should have a high probaility to KO the receiver (or how would you define "knockout power" otherwise). It may very seldomly directly kill the receiver on its own (maybe if the head gets rotated very violently and the receiver has very little muscle to protect them, basically snapping their spine). It will have a medium probability of killing due to circumstances (hitting their head on a sharp edge when falling over...). And a high probability of being visible due to the "black eye" or whatever discoloration.

All of that said, you are primarily talking about the KO as a story device, and there I'm 100% with your friend - this would be an instant, ludicrous turn-off for me. Knocking someone KO is fine, but I expect quick recovery. You see this all the time in MMA fights; the KO is instant, and the recovery happens within seconds or few minutes 100% of the time. I have probably seen 1000s of fights over the years, and the only times where a fighter had to be carried out was when they broke their leg. Not once due to KO.

Make them go to sleep. Sleeping pills. Knockout drops. Done. Very easy plot device, very believable, very realistic.

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    Actually Chemical ways of making someone unconscious are very hard to get right too. There is a reason anaesthetists are specialist doctors.
    – Huw Evans
    Aug 29, 2023 at 13:13
  • @huw evans: I guess (hope) fewer people know about the finer details of knockout drops than about KO punches. ;) This is about a story, suspension of disbelief and such. If it were a real-world question I would have left the last sentence off, for sure.
    – AnoE
    Aug 29, 2023 at 14:11

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