Historical Ways to Kill Off a Character

Guest Post by Sally Bays —

There can be something decidedly satisfying about killing off a literary character. While some authors must account for modern medicine in their creative processes, as historical fiction writers we have a catalogue of deaths at our pen-tips that won’t have readers crying, “Anachronism!”  

In many premodern populations, childhood mortality was high and life expectancy at birth was far lower than it is today. Those who survived childhood could still face substantial risks from infection, childbirth, accidents, poor sanitation, and epidemic disease, although their prospects varied greatly according to socioeconomic status, gender, race, location, and historical period. If a story takes place before the widespread availability of antibiotics in the 1940s, a character with a bacterial infection may have to rely largely on their own immune system and whatever supportive care is available. Before antibiotics and modern rehydration procedures, a respiratory infection or bout of diarrhea could send a character to the grave, though for literary purposes, we can do better

After the plague devastated populations across Europe and parts of Asia and North Africa in the fourteenth century, people continued to face a relatively familiar range of deadly threats: accidents and wound infections, diseases spread through contaminated food and water, respiratory illnesses, and recurring epidemics.

The world is a dangerous place, especially if you don’t know about germs. Louis Pasteur (and other 19th-century scientists) helped establish germ theory, but even then people were skeptical. Not washing a cut could lead to infection, sepsis, gangrene, and death (or grisly limb removals). Until advances in sanitation, obstetric care, blood transfusion, and antibiotics reduced the danger, death during or after childbirth was a significant risk—one way to end a happy relationship that has become a stagnant plot point.  

Telltale signs of infection vary somewhat according to its cause, but generally a character might have a fever, flulike symptoms, swelling or warmth around a wound, and eventually confusion and organ failure. The timeline of deadly infections can be relatively short—a matter of days—or in the case of some infectious diseases, months or years.  

The fecal-oral route of disease transmission is a fancy way of saying a character has consumed food or water contaminated with infected human waste. In places with poor sanitation—crowded cities, military encampments, or wagon trains on the Oregon Trail, for example—dying of dysentery, cholera, or typhoid fever was common. It isn’t usually the disease itself that kills your character, but the dehydration it causes.  

Many OFDs cause epic diarrhea as a propagation method. As the body becomes more dehydrated, organs begin shutting down.  With careful tending and clean water, a patient has some chance of survival, although and resulting immunity varies by disease. According to the National Museum of Civil War Medicine, there were 75,148 documented cases of typhoid fever resulting in 27,058 deaths in the Union Army alone. In most premodern wars, one was far more likely to die of disease than in battle.  

Admittedly, OFDs aren’t the most romantic deaths. For that we look to TB.  

Tuberculosis, or consumption—as one writing in the Victorian times would call it—left the infected pale with rosy cheeks. The disease was romanticized by authors who found it a convenient way of dispatching beloved mothers so their now-orphaned children could have a satisfying character arc.   

In the 1800s, TB was one of the leading causes of death. It is highly contagious, and even with a vaccine and effective treatments, it remains a problem to this day. It was common for the afflicted to move to drier climates searching for a cure; be sent off to sanatoriums for treatment—willing or not; and to refrain from physical contact with loved ones in a bid to save them from the disease. TB is a great narrative tool to keep characters apart for years.  

Faster than TB but still affecting breathing is diphtheria. Before the vaccine, diphtheria could wander into a house and within hours steal all of the children. A fast-acting bacterial infection, it forms a thick membrane in the throat that inhibits breathing. It is an awful way to die, and was once one of the common childhood illnesses.  

But not as common as smallpox.  

Smallpox, thought to be the most prolific killer of all time—which researchers at Johns Hopkins estimate has killed over 400 million people in the last 3,000 years— ultimately has a happy ending in the 1970s; before that, it is fair literary game. 

Smallpox has a two-week incubation period, then fever, pustules, general misery. At best, one recovered with minimal scarring; at worst, painful and prolonged death. Variolation—taking some dried pus and introducing it into a cut on the skin—made for a less severe case with higher survival rates, but it was a controversial procedure outlawed in some places. Epidemics of the disease occurred repeatedly in the American colonies, though more often in urban centers.  

Epidemics are a grand way of killing off many characters at once, as well as introducing survivor’s guilt into a narrative. If smallpox is too cliche, yellow fever or malaria are also excellent choices.  

One of the joys of being a HisFic author is the research. For researching historical diseases, I recommend the World Health Organization, the National Institutes of Health, and this fantastic article for some historically appropriate terminology.  

Killing off characters is a skill authors must hone. A well-written death can open doors into the reader’s heart, and offer other characters in the story a chance to examine their own trajectories. Historical diseases are a fantastic tool to make character deaths all the more impactful.