TIME medicine

How Could Leonardo DiCaprio’s Character Have Survived The Revenant?

Leonardo DiCaprio as Hugh Glass in 'The Revenant.'
Twentieth Century Fox Leonardo DiCaprio as Hugh Glass in 'The Revenant.'

We asked an emergency doctor

The movie The Revenant tells the story of Hugh Glass, a 19th century trapper who was mauled by a bear and left for dead before traveling hundreds of miles in bleak conditions to seek civilization.

Not everything in the movie is wholly based on fact — the novel on which the movie is based introduced a murderous revenge plot — and the movie puts Glass (played by Leonardo DiCaprio) through a grim ordeal of physical challenges and incredibly gruesome injuries.

Could anyone really endure all that? The real Glass survived, of course, but the physical details of his trek have been lost to history and many historians now consider the tale to have been heavily mythologized. “I don’t know if they were that worried about the distinction between fact and fiction back then,”Jon T Coleman, a professor at Indiana’s Notre Dame University told the Telegraph.

So to find out if DiCaprio’s character could really have survived all the filmmakers throw at him I watched the movie with Dr. Dara Kass, an emergency physician at NYU Langone Medical Center and the editor in chief of FemInEM. Her general takeaway? “It’s unbelievable but not impossible,” she says.

Here’s what Dr. Kass thought about the most distinctive—and gory—parts of the film [spoilers for The Revenant follow]:

Exposure to the elements
The journey takes place in the dead of winter and Glass frequently falls into freezing cold water. For Kass, it’s odd he never experiences more severe consequences of being incredibly cold.

“To me that was the most unrealistic part of the movie,” she says. “He never had frost bite. A finger didn’t fall off. We didn’t see his toes but I imagine he shouldn’t have all of them. Being that cold, wet, and recovering—from a hypothermia perspective—is almost unrealistic.”

In fact DiCaprio told interviewers that the threat of hypothermia was very real on the famously primitive conditions onset. “I can name 30 or 40 sequences that were some of the most difficult things I’ve ever had to do,” he said.

The bear attack
Perhaps the most brutal injury in the movie happens toward the beginning. Glass gets attacked by a massive mama bear: He’s torn apart, his neck is slashed, and the bear breaks his leg (and I thought I might faint on Dr. Kass). But apparently it’s not out of the question that he could survive such an attack, as the real Glass did.

“When he was mauled, there were a lot of superficial big long wounds. You have to presume that it didn’t penetrate any of his major organs. Most of the people in this movie, when they got stabbed or shot by arrows, died immediately because they had a penetrating injury,” says Kass. “He had these broad stroke injuries that are gruesome, but first aid could theoretically temporize them.”

In the film, the men traveling with Glass find him quickly after the attack. According to Kass, this is critical, because the greatest risk at that moment is bleeding out. “They bandaged him up and sewed him up,” she says. “After they gave him first aid, they put him on a stretcher and carried him around. They were nursing him back to health. By the time they left him for dead, he probably wasn’t going to die.”

The broken leg
Glass’ leg is broken, which forces him to crawl for a good portion of the film. But before that happens, the men he is traveling with reset it, which Kass says is critical for proper healing. “How do you heal a broken bone? Time and you don’t put weight on it,” she says. “The time frame for bone healing makes sense.”

What’s unrealistic is that Glass doesn’t appear to have any other broken bones throughout the film, says Kass, despite the fact that he survives being swept over rocky waterfalls by rapid currents and even rides a horse off a cliff.

“I will believe [surviving] a bear attack with first aid faster than [I will believe] falling off a cliff and into a tree without even breaking a bone when you already have a broken bone to start,” she says.

Burning his neck
The bear attack leaves Glass with a torn up neck, and when he tries to drink water, it trickles right out a hole in his throat. “Plenty of people walk around with open windpipes, that’s not an injury you can’t survive,” says Kass.

Glass decides to handle the situation by cauterizing the skin on his neck to close up the wound. Apparently, that’s not such a bad idea. “Him burning his skin to heal it and scar it makes sense,” says Kass. “We use heat in surgery a lot. We burn tissue and it heals, we stop bleeding that way. You are creating scar tissue.” The fact that Glass cannot speak after the accident is also accurate for a windpipe injury.

Infections from wounds
Glass gets all sorts of infections from his gaping wounds, but doesn’t die from them. Kass says that technically, you could survive several localized infections, and possibly even survive a systemic infection in the bloodstream. Glass got lucky here though, since some infections are fatal. “If we stopped giving antibiotics and just did wound care, would someone survive? Maybe. But we are never going to do that [today],” says Kass.

Kass says it would be inconceivable for any medic to treat a patient using Glass’ tactics today. That’s largely because our expectations towards treatment have changed radically as medicine has improved. “We have an expectation that nothing should happen to us. [The characters in the film] have an expectation that they are not going to die,” says Kass. “There’s a huge continuum between nothing happening to you and dying. As a society we do not accept the interim. While those infections are not killing him, they are permanently disfiguring him, but he doesn’t care. We care.”

Eating raw meat
Glass chows on a lot of raw and bloody meat and fish throughout the film, and only gags once — all the more remarkable when you consider that DiCaprio actually ate raw bison liver while filming the scene.

“If he ate it regularly, I would assume that he can eat it,” says Kass. “A lot of it has to do with exposure. If you are constantly exposed to these bacteria you have a way to handle them that we don’t have. If you go to another country and eat the food you might get sick. It’s not because the food is bad, it’s because you are not used to it.”

In reality, Kass says, Glass was likely better conditioned to survive the experience than any of us are today. “He probably had resiliencies that we don’t have,” says Kass. “He may have had calloused skin that prevented him from getting frost bite. If you put me with those injuries I would definitely die.”

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