We Have to Get the Bullet Out

Having a bullet dug out of a character's flesh or bone is almost as dramatic as the shooting itself. Even better, it requires only simple tools, little expertise, and is intensely painful (thus allowing the bullet recipient to demonstrate his or her heroic pain tolerance). It is easy to see why any series which involves gun play eventually includes a sequence in which a professional or amateur field medic applies a little bullet withdrawal to his or her comrade-in-arms.

Unfortunately, this is a medical fail, as the very last thing you would want to do to help a shooting victim would be to pull the bullet out. Bullets are, once they stop moving, largely harmless, and trauma surgeons frequently leave them in place whilst repairing the damage inflicted by their ingress. Removing a bullet may harm the patient in several ways, but chiefly in that the bullet may be pressed against a damaged blood vessel, and removing it may cause severe bleeding.

Depending on the time period, however, this can be a Justified Trope - historically, a musket ball would have been extracted as part of recovering any part of the wearer's clothing that it had tracked in with it - bits of cloth in wounds were a good source of infection, and because musket balls travel far slower and have less penetrating power, bits of clothing could often be dragged into the wound.

In more futuristic scenarios, the bullet might be laced with harmful substances, made of radioactive material, set to detonate inside the target, or be such an Abnormal Ammo to be more threatening than the blood loss from subsequent removal.

See also Annoying Arrows when this trope is applied to other types of projectiles.

Examples of We Have to Get the Bullet Out include:

Film

In Master and Commander: The Far Side of the World, Stephen Maturin operates on himself to extract a ball round. Justified in that he is after a piece of his shirt that he fears will infect the wound. We even get to see his assistant match the extracted fragment to the hole in the shirt.
Averted in an unusual fashion in Iron Man. Tony Stark ends up with his heart damaged by shrapnel, and instead of having the fragments removed, which would endanger his life, he gets an electromagnetic thingamajig implanted to keep the bits from killing him.
In Bill Cosby's opus Leaonard Part 6, we're treated to an even more heroically pain-resistant hero: Leonard, having been shot, removes the bullets himself, his trusty manservant only standing by with surgical tools and a mirror.
Subverted in The Green Hornet: Britt is shot in the shoulder as Green Hornet, but obviously can't go to the hospital lest he give away his Secret Identity. So he tells Lenore to dig the bullet out with a kitchen knife (while he bites down on a spatula), but even the heat from the sterilized knife causes him to wuss out. They end up having Kato (in costume) drive up and "shoot" Britt at a public event, which lets him safely go to the hospital and makes it less likely that people will think he's the Hornet.
- However, this means that Reid has to spend a day or so with a bullet in his shoulder and not let anyone know about it. Yikes.
At the beginning of The Bourne Identity the fishing boat's medic digs two bullets out of the unconscious Jason Bourne's back.
Inverted in The World Is Not Enough, where leaving the bullet in results in superpowers. The Dragon, Renard, was shot in the head by MI6, the bullet didn't kill him, but it is slowly drifting towards his medulla oblongata which will eventually kill him. Unfortunately for Bond, this somehow causes him to feel no pain and become stronger.

Literature

In The Unexpected Mrs. Pollifax by Dorothy Gilman, the first book in the Mrs. Pollifax series, the titular character (a little old lady spy) and a fellow agent called Farrell are captured by the enemy. Farrell is shot in the shoulder during an attempt to throw himself off a cliff to avoid questioning, and as his condition worsens, much is made of how the bullet must be removed before it kills him. As soon as this is done (not by a doctor, in the rather unsanitary environment of a prison cell), Farrell's health begins to improve.
Subverted in a story told to the Orkney children in The Once and Future King, in which a king has a bullet-like projectile hit him at the base of his skull while fighting in the war. It had to stay in there, because no doctor could remove it without killing him. Unfortunately, he wasn't left much better off, seeing as any serious rise in blood pressure could still kill him from the wound. He ends up dying when he hears that Jesus Christ had been crucified and he took his sword and ran from his home in fury to save his Savior, the anger causing his heart rate to spike enough to kill him.

Live-Action TV

Averted in House when a police officer has fragments of a bullet lodged in his skull. The team desperately wants to do an MRI, and House shoots a corpse to prove that an MRI's magnetism makes it impossible. The bullet gets violently ripped out of the corpses skull and breaks the MRI.
- What were the bullets made of? Lead, copper, tungsten, or any other material commonly used for munitions, are all non-ferromagnetic. Those fragments wouldn't have done anything.
  - Except that Foreman specifically states that the particular bullet used was ferromagnetic.
    - Some bullets use steel cores, with copper (or other) jackets. A fair amount of soviet 7.62x39mm surplus ammo, the stuff used in the AK-47, uses this construction, as does a fair bit of ammo designed to be armour peircing.
In the first-season Harper's Island episode "Gasp," a physician directs his friend (and romantic rival) to remove a bullet from his shoulder. "You have to get the bullet out" he (incorrectly) insists.
Subverted in the final episode of Firefly. Simon is shot in the leg, and doesn't have the bullet removed until the end of the episode, and with somewhat sophisticated imaging and removal tools to minimize damage.
- Simon does remove a bullet from Kaylee's stomach wound during the pilot, but as part of a much longer surgical procedure that isn't shown on-screen and (most likely) involved a lot more than just pulling the bullet out.
- In "Safe" Zoe removes a bullet from Book's shoulder (Simon is too busy being kidnapped at the moment), but that isn't the end of it. Zoe is not a trained surgeon, so while she can remove the bullet and bandage and clean the wound, the damage inflicted by the bullet will still eventually kill Book unless he gets professional medical help.
In a season 2 episode of Lost, Sawyer digs a bullet out of his shoulder with his fingers. This one is justified in that a) this causes him more problems than it solves, including a nasty infection, and b) Sawyer isn't a doctor.
- Dealt with a little better in two later episodes, where after the bullet is removed the hole is cleaned and stitched.
Buffy the Vampire Slayer
- In "The I in Team," Spike is shot with a tracer, apparently deeply embedded, and it has to be removed quickly by the team. Justified because a tracer isn't a proper bullet and Spike is a vampire, without the same medical concerns as a human.
- Also justified in the episode "Villains": Willow majicks out the bullet that hit Buffy, but it's OK because she witch-fus all of her wounds closed at the same time (though this is in stark contrast to an earlier episode where magical healing is supposed to be too difficult to even try).
  - There is a difference between trying to cure a middle-aged woman's brain cancer and extracting a bullet from a young healthy woman who already has a superhumanly tough constitution and at least limited regeneration powers.
The Bionic Woman remake justifies this: Jaime's nanomachine-based Healing Factor isn't programmed to handle the situation, and it's actually pushing the bullet deeper inside her.
CSI:
- Averted with an attorney who was shot in the head. Her doctors had left the bullet in place for years due to its dangerous location near the basilar artery of her brain, but later needed to remove it because it had shifted position over time and was sure to become fatal soon. She tells Sarah that she honestly doesn't expect to survive the operation. She lives through the surgery, but the belatedly-extracted bullet provides new clues that exposes her as a murderer.
- Also averted in an episode guest starring Roger Daltrey. A mobster, long thought dead, decides to come back to take revenge on the thugs who tried to kill him after a mob doctor tells him that the bullet they put in him is pressing on an artery and will likely kill him within weeks, but cannot be removed without killing him due to its location. He explains this to Catherine while laying in a hospital bed after having a heart attack while in police custody... and then she shows him the bullet, saying that mob doctors become mob doctors because they're not very good.
The Listener: Zig Zagged in "Desperate Hours," in which Toby and Oz get kidnapped and forced to help a man who was shot. The kidnapper makes Toby perform surgery to remove the bullet, which he believes is the only way to save the man's life, despite the fact that Toby is a paramedic. Toby gets them to call Olivia, an actual surgeon, who advises that the safest way to handle the bullet wound is just to stitch it up and leave the bullet in. Then Toby finds the bullet lodged against an artery; removing it could either be necessary to save him or make things fatally worse. They end up removing the bullet to find little damage in the artery, meaning he's in the clear. He then goes into cardiac arrest and dies anyway.
An episode of New Amsterdam has John help an old colleague who is dying of lead poisoning from a bullet that was never extracted.
Bull Randleman has to have a Dutch farmer do this to him after he is wounded and stuck behind enemy lines. Technically not a bullet (it was shrapnel from an exploding British tank), but the concept remains the same.
In the Supernatural episode "Death's Door", Sam and Dean take the fact that the hospital staff was not rushing to remove the bullet as confirmation that said staff had given up hope of saving the victim Bobby Singer. Also, the Reaper that comes for Bobby tells him that the bullet in his head is killing his brain.
- Played straight in "Born Under A Born Sign" where Jo digs a bullet out of Dean's shoulder so he does not need to seek further medical attention.
In "The Walking Dead" Herschel Greene insists they have to get the bullet out of Carl, who has been accidentally shot.

Video Games

Played straight in Apollo Justice: Ace Attorney, where a gangster was shot in the chest, miraculously survived and had an operation to remove the bullet, or else he'd die in six months. Justified by the bullet's location, extremely close to the aorta.
- But averted with Von Karma in the first game. The villain has had a bullet lodged in their shoulder for 15 years, and its presence is key to solving the case.
Played absolutely straight in Resident Evil 2. Leon Takes The Bullet for Ada. Ada then says that she has to remove the bullet. She does so, even though they are in a sewer (thus increasing the risk of infection), she has no apparent implements to do so, there's a zombie virus loose and Leon's presumably covered in zombie fluids (increasing the chance, that should he die, he'll become a zombie), and she bandages his wounds on the outside of his uniform.
In Metal Gear Solid 3: Snake Eater, Snake is able to dig out bullets, arrows and various other projectiles from his body with his knife. Doing this ingame will cause the wounds to heal faster, but leaving them over time will cause the wounds to naturally heal around them, leaving the projectile in the for remainder of the game.

Web Comics

In Cuanta Vida, Scout is shot in the arm. He doesn't want to go to the Medic, so Pyro removes it for him. Possibly justified as Pyro (probably) isn't a doctor, and might not know any better.
In Last Res0rt, Scout Arael in her civilian wear removes a sniper's bullet from Jigsaw's chest—of course, it may be justified not only because we don't know if it's some kind of futuristic bullet, but also in that Jigsaw is a vampire—so it's possible she was "staked" by the bullet, requiring its removal.
Possibly justified in Freak Angels, as apparently the bullet remaining in the wound screws up their Healing Factor somehow or other, and in any case the two individuals we see getting shot are neither in the presence of The Medic or especially well-equipped with brains.

Web Original

We're Alive features this when Saul is shot and the bullet is removed without proper tools, antiseptics, or morphine. Plus the only one actually trained to perform the operation is Saul himself.
The Salvation War has a scene where the angel Michel is demanding a bullet be taken out of him. Justified since angels have healing powers that have already healed over the bullet wound and that said bullet was a round that was literally burning inside of him.

Western Animation

In The Simpsons episode "Simple Simpson", after Homer (as the Pie Man) gets shot in the arm, Lisa later finds him in the kitchen digging the bullet out of his arm with a butcher knife, while naming the things the knife is touching (including "vein", "nerve" and "bone").
Something of an aversion in The Venture Bros. When Phantom Limb rescues Brock Samson, he gives the following comment:

Phantom Limb: No, don't get up. You've been shot. Sadly, it wasn't fatal. I've removed the bullet and three others, a blowgun dart, two sharks teeth, the tip of a bayonet, a twisted paper clip and a meager handful of buckshot. You may want to learn to duck.

In Justice League Doom, Superman is shot with a kryptonite bullet which created an interesting problem: It must be removed because it's killing him on the inside, but he's still as tough on the outside, making traditional surgical tools ineffective.

Real Life

This features in the cases of several United States presidents:
- Most researchers agree that when James Garfield was shot, probing for the bullet (with dirty instruments, and not even coming close to finding it) did more to kill him than the bullet itself. The assassin tried to use this in his defense at trial, but was convicted and hanged anyway.

Charles Guiteau: The doctors killed Garfield, I just shot him.

- William McKinley's doctors elected to remove only one of two bullets, fearing they would do more harm than good. They had the right idea, but he inevitably died of gangrene anyway, because the shot had punctured his intestines and antibiotics had not yet been discovered.
- Theodore Roosevelt got shot and--remembering what happened to Garfield—decided not to have the bullet removed, and survived. (In his case, the bullet was too afraid of Roosevelt to kill him.)
- Some researchers claim this is what killed Abraham Lincoln, though it's not very likely. They speculate that the teeny bullet merely rendered the President unconscious, and his doctors killed him when they dug into his brain to find it. However, given the state of medicine at the time, the bullet hole in his head would have been inevitably fatal no matter what. Even with modern medicine he might never have regained functionality.
- Ronald Reagan ended up being a rather unusual case where politics ended up playing a part. After he was shot through the armpit, doctors decided to probe for the bullet since they did not have the equipment to find out what it had damaged. After fifteen minutes of not finding it, the doctor doing the probing wanted to stop, since Reagan was a very old man and it was unlikely his body could handle too much. They decided to continue, partly out of fear that the media would claim incompetent doctors had left a bullet inside the President.
  - This later turned out to be a good decision, because the shot was an explosive one that had failed to detonate yet. That's one of the few situations when we really do Have To Get The Bullet Out.
- Andrew Jackson had at least one bullet in him for 19 years.
- And just for the sake of completeness, we'll mention that John F. Kennedy was the only assassinated president whose wound was certainly unrecoverable regardless of available medical treatment. He was dead before a doctor ever got near him.
When Wild Bill Hickok was murdered, the bullet passed through his head and lodged in the wrist of another man at the table. The man left the bullet there the rest of his life, and apparently reveled in the fact that had the bullet that killed Wild Bill in his arm. The bullet may have ultimately killed him through lead poisoning.
Steve Irwin reportedly pulled out the stingray barb that had punctured his heart. Some speculate that he may have survived to get medical help if it had been left in place.
An aversion that spectacularly shows how false this trope is: An elderly man in Britain went to the doctor complaining of dizziness, and as part of the tests, they took an X-ray of the man's head. The doctor was somewhat surprised to see a bullet lodged at the base of the skull, and asked the man if he was aware that he carried a bullet in his neck. "No", the man replied, "I had no idea. It must have been there since WWII, because I haven't been shot at since!" The doctor replied that in that case, it would probably be best to leave the bullet alone.
- It's actually more common than you think for nurses and doctors to discover bullets from old wounds still inside a person, often without the patient ever realizing it.
It's not rare, when there's no pressing need to get the bullet out, for the decision to be to take a wait-and-see approach since, if it is going to cause any additional harm, it will take a lot of time to do so. If it is necessary to remove it, it's safer to do so after the immediate trauma has already healed and the surgeon can just cut straight to the point.
- A surprising number of people carry bits of foreign material in their bodies. One person has carried a bit of pencil graphite embedded in his forearm, visible under the skin, since the age of 8 (he's now 54). Nobody wanted to dig in and remove it, so there it stayed.
There is also a geographical version of this trope: live ordnance from World War I still littering the fields of France. Farmers have just about gotten used to plowing up bullets and shells by now. More tragically, former war zones in several third-world countries are full of land mines, and no one has the money or authority to remove them. Occasionally an unlucky villager will step on one and get blown up.
- It's not just war zones, former artillery training areas usually leave some projectiles behind. Fortunately, since they are training grounds the rounds are usually non-explosive.