I am so over the term, "Like a fish out of water."
I don't know if all of you have had the extensive icthyologous experience that I have, so I'm just gonna tell you: A fish out of water is dead. It's not "like" anything, except maybe something that flops sadly on its side for a few minutes before expiring.
Really, the only way I can see it working as a simile is: "He was shot in the stomach, and, for a brief moment, as his life flashed before his eyes, he was like a fish out of water. Then, when he died, he was like a fish who had been out of water for too long. Only his eyes weren't so buggy." Morbid, but possibly effective.