I've seen pictures and videos of things like this before. I assure you, it can be very real and people can survive such things. Saw a picture of a Marine who placed a blasting cap in his mouth and pulled the pin as a joke. It did something similar to his face as well. For those that don't know, a blasting cap is used to ignite the more powerful explosives in the body of a grenade. Alone, it sounds very similar to a cap gun style sound, rather unthreatening really. After what it did to that guy, I have more respect for them myself.
There's a video we watched for our Combat Lifesaver training in the Army where a business exec who basically lost everything leaned over the barrel of a shotgun and pulled the trigger to end his life. The blast went forward of his brain cavity as a result of his leaning forward too far. Remember the T2000 from Terminator 2? Where his head was blasted apart and it was just kinda hanging there? That's how his face looked when they rolled him onto the ER bed. He had no lower jaw and no identifying landmarks for which they could run a trach tube on him. Finally, one of the ER medics found the remaining half of his tongue wiggling around and blowing bubbles and stuck the tube in there to open his airway. It was fairly disturbing to watch really. He ended up getting full facial reconstruction and now he travels speaking about suicide.
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