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I realize this question may sound broad or vague, so allow me to explain.

I never knew much about combat or dealing with injuries until I started gathering research for a fantasy novel I'm planning to write, which will have a lot of action and fighting. Prior to obtaining my research, I thought that you could get hit in the head and fall unconscious for a few hours. I see it all the time in stories. Somebody sneaks up behind Joe while he's in the woods -- WHAM -- the next scene shows Joe waking up a few hours later tied to a chair in the villain's basement or something.

After doing some very basic reading on concussions, I learned that this situation is not realistic. In fact, when people are knocked out, they're usually knocked out for less than 30 seconds, a few minutes at most. Any more than that and they're dead.

It's not just this specific case. I learned that a lot of other events that are so frequently portrayed in fiction simply would never happen in real life... I never had a problem with it before, but now I am the writer. I am afraid that if I write a scene like the one with Joe above, people might criticize it for being unrealistic, even if I was writing a fantasy. So, in general, where is the line drawn between what's believable and what's too unbelievable (especially if I'm writing a fantasy)? How accurate is too accurate? Should I stray away from writing a flying scene because, realistically, my character would die from increasing in altitude too quickly?

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So make it more realistic. "hahaha" laughed Baddy Baderson, "I knocked you out for 30 seconds and in that time gave you a sedative to keep you unconscious, and then brought you here to my underground lair. You might feel some nausea for a couple of hours, please see your doctor if you have any other side effects." – Jon Story Jan 11 at 14:29
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Not knowing the difference between real life and fantasy has been a problem for a while now. – corsiKa Jan 11 at 20:09
up vote 20 down vote accepted

Be consistent

The most important thing is to keep your story consistent. A story which has the same rules throughout can be accepted even if it is not compatible with the real world. However, even a fantasy story will be rejected by the reader if the rules of what is possible in the fantasy world change without justification.

Even within a given genre, the line is drawn in different places for different stories (even for different stories by the same author). What is essential is that you don't move that line within a single story (or within a series if all the stories within it are set in the same world).


Build consistency

It's also worth bearing in mind that when you first enter a story, the reader has expectations based on the real world, based on the story they read previously, and based on the genre they expect your story to be. An event that would be unrealistic in the real world or unrealistic in a similar story will be hard for them to accept in the first few pages. If you introduce it gradually then it will be much easier to accept later in the story when it has been established as a natural part of how things work in your world.

For the same reason, if you have an event that will be unexpected late in the story, it's important to give reasons for believing that event is possible beforehand. Try to find ways of informing the reader that a particular type of action is possible without giving away what you intend to happen. That way your event can be surprising, without being unbelievable.


Examples

You mention the examples of being knocked out for hours and waking relatively unharmed, and flying to great heights/making rapid ascent without breathing problems.

Some of your readers will see a problem with these, others will not. For the benefit of those who may see a problem, you could make sure the first incidence of the event is not essential to your plot. A few events where someone survives being knocked out in a minor subplot make a later event easier to accept. Similarly, a few flights to places that are clearly at great altitude early on mean that the reader will not be jarred by later being expected to accept something brand new that the plot depends on. This is particularly important if the magical flight will involve carrying someone who lacks that magical ability.


Even realistic can jar

Note that it can also be useful to set things up subtly beforehand even if your event is completely realistic. As Lauren Ipsum points out, because of the longstanding acceptance of being knocked out for hours that you describe, it could be hard for the reader to accept someone being knocked out and then waking with permanent brain damage, or remaining in a coma until death. If you can find a way to make it clear that this is a story where impact to the head is not trivial, then the reader will be prepared for an event that is closer to reality than they would otherwise expect.

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If you're doing essentially the same thing as 90% of your genre (flying people achieve great heights immediately, people with superpowers never have issues with getting fuel for those powers, someone can be knocked unconscious for hours but be okay) because the "realistic" details are not the purpose of your story, then I think you're fine. If anything, your readers may be more surprised if you present the realistic version.

However, it depends what kind of story you're writing. If your entire point is to explore what it would really be like to fly or develop powers etc., then yes, by all means research the effect thoroughly and present the problems in all their gory detail.

I think that would be a valuable and fascinating story, because while many people know about getting the bends going underwater, or think about air pressure in a plane, nobody really thinks about the effect of that same air pressure if you could fly under your own (magical) power.

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I am afraid that if I write a scene like the one with Joe above, people might criticize it for being unrealistic, even if I was writing a fantasy.

Hang a lampshade on it.

Beefy McProtagonist had seen bards who clearly knew nothing of actual combat perform tales in which a blow to the back of the head would render an adversary unconscious for hours, almost as if it somehow put them to sleep, but any experienced warrior knew better. Such a blow might daze someone, or even knock them out for a minute at most. Any longer, and they'd either be up on their feet again, or at death's door. No, to really put someone out that long, you'd need a wizard and a sleeping spell.

This helps to establish the ground rules by explicitly letting the audience know that you're aware of this convention and it's not going to be used here.

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This is an excellent solution. – Lauren Ipsum Jan 11 at 17:39
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That link is a wonderful rabbit hole! – Joe Jan 13 at 2:43

There are a LOT of things you see all the time in fiction that are totally unrealistic. Not only do characters in stories typically get knocked out and remain unconscious for hours, but they then regain consciousness, shake their heads, and they're fine. In real life a concussion is not something that just goes away by shaking your head.

I develop software for a living, and I regularly gape at the unreality of how computers are depicted in TV and movies. Like when the detective gets a picture from a store security camera and tells the computer guy to zoom in on some tiny object in the distance, then casually says "can you clarify that?", the techie hits a few keys, and additional detail appears in the image out of nowhere: suddenly we can read the license number on a car that was half a mile away or whatever. Etc.

I think a writer should strive for as much accuracy as possible. Sure, this means finding out how real life works. And doing research is way more work than just making stuff up.

That said, you say this is a fantasy story. This adds a dimension. In real life, people can't fly or throw lightning bolts from their fingertips or read minds or whatever. Then the question becomes plausibility. Will the reader accept the rules of magic that you describe?

I read an article by a science fiction writer once in which he dismissed criticisms of unreality in SF, saying that he found it easier to believe that people will someday travel to other stars than to believe that Perry Mason only gets big murder cases with innocent clients.

I think the key is setting the stage. If you tell me that the wizard magically teleports the beautiful princess to his castle, I'll probably accept that as the premise of the story. But I'll assume human nature is the same. If you tell me that after the hero rescues her and they get married, that when he goes off to rescue another beautiful princess that it never occurs to his wife to be jealous or suspicious of what her husband is doing with this other woman, I'll likely find that totally implausible! If you tell me, "In this magical land there is no such thing as lying: the fairies compel everyone to always tell the truth", I'll accept that. But if you never give such an explanation, and characters tell the truth in cases where real people would surely lie to get themselves out of trouble, I won't just say, "Oh, they probably tell the truth because this is a fantasy story". You have to set it up.

In short, I'll accept almost any premise if you tell me up front that this is how the magic in this land works, or this is the amazing new technology that has been invented. But you have to establish up front. You can't just keep throwing incredible things at me with no explanation. And it has to be consistent. You can't tell me in chapter 1 that the hero gets into this problem because he was forced to tell the truth by the magic fairies, and then in chapter 2 have the villain get away with a lie with no explanation of why the magic fairies don't force him to tell the truth also.

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Do you think I could establish that getting knocked out for a few hours (without the influence of magic) is a completely normal thing in my story? Let's just assume that, for whatever reason, getting knocked out for a few hours is needed in my plot. Same goes for things like being able to slice off limbs with a single sword swing (not that easy) and not dying from quickly elevating in altitude -- if I'm consistent, do you think readers will accept that as "the norm" and be okay? – Summer Jan 12 at 4:13
    
@Summer Definitely. If people can believe in a man shooting lasers from his eyes and catching bullets, I think a little thing like that is not a problem. – Benubird Jan 12 at 14:44
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To me, if you say that someone can magically fly, I'd buy that the magic also somehow prevents him from suffocating or having a brain hemorrhage from low air pressure. But the nature of unconsciousness and the power of swords, if you want to make it different from the real world, you have to give some reason. It could be magic, it could be some pseudo-science, but you have to give SOME reason. When I talk about setting the stage, you can't just say "that's how it is". The explanation doesn't have to be rigorous science, but it has to sound vaguely plausible. – Jay Jan 12 at 14:48
    
Second thought: I don't know how hard it is to cut someone's arm off with a single blow from a sword. There's surprisingly little opportunity to do this in my day-to-day life. If you said that Fwacbar was a great and mighty warrior, and he was carrying a strong and sharp sword, and then you say he cut someone's arm off with a single blow, I'd accept that as plausible. Whether it really is I don't know. Need to get an expert on Medieval combat here. The only sword I've ever used is a fencing foil with a rubber tip. – Jay Jan 13 at 14:48

I like to use Sanderson's First Law for this:

An author's ability to resolve conflict with magic is DIRECTLY PROPORTIONAL to the reader's ability to understand it.

The key to that sentence is "resolve conflict." You can get away with using "magic" to create conflict far better than you can get away with resolving it that way.

You don't even have to call it magic. The rules work for things that are not stated to be magic as well. There's always the magic of storytelling. Its what makes little girls in capes happen to have grandmothers who live all alone in the woods.

In other words, you will get away with the setup you mentioned where the protagonist gets knocked unconscious for hours far better than you would get away with the protagonist knocking the villain out and having the villain be unconscious for hours, unless the reader has some way of understanding why the villain went out for so long (maybe he had narcolepsy).

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I think that it's important to keep in mind that you are writing fiction, therefore you are taking your readers into a fantasy world that you have built around your characters. I would try to keep it as realistic as possible, but most of the time this fantasy world is far from being realistic. The fine line between reality and fantasy should be determined by the needs of your characters.

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Terry Pratchett had a clever excuse for readers if something happened that went against the laws of physics. He'd simply say that the rules were different because the world was shaped like a disc instead of a sphere. But he only used that for the laws of physics. He didn't try to explain away every possible plot hole that way.

I think as long as you are consistent, there shouldn't be much problem. But if in every single chapter the readers are thinking, "Wait, how is this even possible?" The answer better be a little more in depth than, "Because magic! Anything can happen with magic!" You'll get away with that once or twice, but any more than that, then you're going to have serious difficulty holding things together.

I remember working on a MUD with a friend several years back. (basically an online game.). I told my friend that there were some serious flaws in the combat system. For instance, in the game, it was possible to stand in front of a monster who was fully aware of your presence, and backstab them with a hammer. He said that this was no problem at all, because the game was fantasy, and therefore anything was possible. I told him that may apply to wizards casting fireballs, but you can't backstab someone who knows you're there. If you're going to stab them in the back, you shouldn't be facing them because most people have their backs behind them. And you can't use a hammer to do all this, because you can't do any stabbing at all with a hammer.He disagreed, and then threw several hissy fits when several beta testers complained about the mechanics of backstab.

Anyway, you don't have to get every single detail on point. In fact, I read somewhere that in fantasy magic, if you get too detailed and try to make it too scientific, there will be readers who will pick your books apart because you didn't follow your own rules exactly. Apparently, Robert Jordan's biggest fans are the worst about it.

So long as most of the story is honest and has decent explanations that are mostly consistent, your readers will be willing to suspend disbelief over a few minor inaccuracies.

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I realize that there are already several great answers to your question, and I'm not trying to override any of them, I would just like to share an idea that came to mind when reading your question.

My idea goes back to the usage of two worlds in fantasy stories; the mundane world, and the fantasy world. The level at which you seperate these two worlds is up to you, but the idea of using two worlds is one that distinguishes fantasy from most other genres. The protagonist starts in the mundane world, with a weakness/need that applies to that world, in the story, he is placed in a fantasy world,one which challenges, and eventually overcomes his internal weakness. In the end of the story, he is placed back in the mundane world, where the solution of his weakness is shown.

My idea, is that, when in the mundane world, the level of realistically is higher, making it more mundane. And when in the fantasy world, you could inconspicuously lower the amount of realisticality, which might result in the fantasy world seeming more fantastical, if you don't wish to make it be like Wizards, dragons, ogres, etc.

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