Other replies have covered the “tiny bullets” angle, but you also asked about how the damage is done.
There’s two kinds of health effect. The first one is what happens straight away when you get a high dose – this is radiation burns, organ damage, etc. It’s basically those tiny bullets shredding bits of your body so they don’t work any more. If the damage isn’t lethal, it should heal in time.
The second one is called the “stochastic effects”, which means random – because it increases your chance of getting cancer over the long term. Tiny changes in your DNA that might (or might not) cause something to go wrong.
One other thing of note is that some chemicals your body needs in specific small bits of your body – eg, iodine to your thyroid gland.
If you happen to get the radioactive versions of those chemicals in your body, your body can’t tell the difference so effectively creates a concentrated radioactive source inside you.
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