Warning: This article contains SPOILERS for The Last of Us Part 2.
Lots of people die in The Last of Us 2, so when Abby shoots Tommy in the head around the game's halfway point, players are meant to believe he's dead, too. He later shows up again, very much alive, but the question of how Tommy survived The Last of Us 2's headshot death fake out is complicated.
After hunting down Abby's friends, Ellie, Tommy, Dina, and Jesse hole up in their abandoned theater base. When Abby arrives to get revenge (again), she kills Jesse and holds Tommy at gunpoint. He jumps up to attack her, so Lev shoots him in the leg with an arrow, and Abby shoots him in the back of the head, turning to chase Ellie further into the building.
It's surprising, then, when Tommy appears at Ellie and Dina's house to tell Ellie of Abby's whereabouts, but his survival is technically possible. Here's how Tommy might have survived the traumatic injury - but also why he probably wouldn't have in real life.
Could Tommy Have Survived The Headshot From Abby In The Last Of Us 2?
While Medicine.net points out slow-moving bullets (such as those fired by handguns) are more likely to wobble, causing more damage as they shake while passing through an object, Dr. Keith Black of Lost Angeles' Cedars-Sinai Medical Center told Live Science high-speed bullets do more damage overall. This is due to, as Medicine.net explains, the ripple effects bullets inflict on surrounding flesh while passing through a body, which are more intense the faster a bullet moves. Since there was little time for air resistance to slow down Abby's handgun bullet in the time before it struck Tommy, he would probably have sustained significant damage.
Luckily, according to Live Science's reporting, a bullet passing through only a single half of the brain reduces the risk of death, and Abby clearly shoots Tommy only through the right side of his head. This also means it missed important structures like the brain stem and thalamus, so his body could continue to operate vital functions like breathing and heartbeat.
But there's a major hurdle standing between Tommy and survival: time. According to Live Science, which was reporting on the 2011 shooting of U.S. Representative Gabrielle Giffords, Giffords made it to an operating room withing 40 minutes of being shot in the head, which likely contributed to her survival. Tommy was days - if not weeks - away from proper medical care back in Jackson. The Last of Us 2's Dina showed some medical knowledge earlier in the game, but doubtfully enough to perform emergency brain surgery, especially after she and Ellie were also badly beaten in Abby's attack.
Given all this, the most complete explanation for Tommy's survival is simply that he got lucky. As Medicine.net explained, "it's the luck of the draw as to how much damage the body can absorb and still function. Some victims are lucky and walk away; others don't." Tommy's exact situation pits more than luck against him, so it's a bit far-fetched that he survived, but least Naughty Dog somewhat realistically depicted the effects of his injuries on his body when he comes to Ellie's home.
The Last Of Us Part 2 released for PlayStation 4 on June 19, 2020.