Lord make me chaste--but not yet

So what are ghouls?

Well, a short description from what we see from the wiki/games/canon is that ghouls are those exposed to radiation that don't die of radiation poisoning and instead mutate, with exposure means varying from accidental exposure from the bombs/irradiated areas, to outright deliberate exposures via experimentation, hopes for immortality, or simply listed as.....serum.

The games have shown us that the process of ghouling isn't just novel to humans, nor is it just novel to humanoid shapes (see; Harold).

There isn't a set reason on what exactly predisposes someone to ghouling vs dying of radiation sickness, nor is there parameters on what makes them go feral. This leaves room for the fun, and where I got the hair up my ass to make a long form post.

So lets start with the obvious;

There are two subsets of ghouls,

One is directly radiation induced. These are the ones we are most familiar with.

The other is drug induced. These we have a few examples of, with little to no explanation of....why is there a ghoul drug. At least not a direct reason is given for "Drug that turns you ghoul". I however have some headcanons on how this came about.

In this post I will cover a few topics relating to ghoul qualities and how they vary between the two subtypes. These will be;

I. Modes of Creation: How We Go Ghoul and What This Implies II. Biological Quirks III. Ferals. What Are They, What Causes Them, And Why Aren't They Attacking Each Other IV. The Rotting vs Chem-Heads: Interpersonal Politics Within Non-Feral Ghoul Populations

I. Modes of Creation: How We Go Ghoul and What This Implies

Ghouls Created by Radiation Exposure

So you've just survived the nuclear holocaust. What's next? Well, if the onset of radiation sickness is anything to go by, then not much....

Unless you're one of the lucky few who ghoulify.

But what causes one to ghoulify and another to succumb to the radiation? What exactly in the genes make one turn while another simply dies. The exact question does not seem to have an answer in canon, however we are shown in several cases that Pre-War was not afraid to experiment with radiation.

While in some instances these experimentation involved medications or chemicals (see: next section), there is mention of controlled exposures to radiation being something studied.

This experimentation can be seen through Vault Tec Vaults (Vault 12) and implied in a few pre-war medical buildings/holotapes (Robco Buildings, the accounts of Control Subject Peters) and with outright accounts, such as Eddie Winters and Desmond Lockhart.

In short, while we don't precisely know if Pre-War knew that ghouls from radiation exposure were truly and properly immortal, or even considered them as a "successful" rabbit hole to pursue for immortality, we know that experiments to study the effects of radiation sickness were performed. In some cases, the exposure was to test for serums and medications that would hopefully prevent/reverse radiation sickness (And likely how we got Rad-X/RadAway. See: FO4s Control Patient Peter's Logs).

We do however see that this mode is likely the most common mode for many of the ghouls of the wastelands. Pre-War ghouls that were not part of radiation exposure experiments were often times implied to be those not from areas directly in blast range and rather came into radiation exposure after they crawled out through the falled-out, baby (kill me). However, those directly in the blast that weren't vaporized are often implied to immediately be turned feral (Camp Searchlight, and other similarly directly hit areas), though sections such as Lonesome Road and certain in-game ghouls prove that some do not immediately turn feral.

These ghouls are described as experiencing radiation sickness that never got around to killing them. They experience the GI upset, hemorrhaging, "illness" (fever), confusion, sloughing of necrotic tissues, and so on, before stabilizing into what we call ghouls. It is assumed that they eventually hit the "regenerative" stage of ghoulification after their bodies succumb to these symptoms. This may be evident due to radiation exposed ghouls having the intense healing potentials as ghouls, but never "gaining back" normal, non rotting appearance.

Ghouls Created by Biochemical Means

We know through Hancock that there is an "experimental radiation drug" that can ghoulify people. We see something similar in FO:Prime, with Thaddeus taking a "healing serum" from the Chicken Fucker and how it looks (both in color and method of using) similar to that of the chem that The Ghoul uses/depends on. We are given both The Ghoul and one of his acquaintances (Ass Jerky) as direct examples of being dependent on this chem to prevent going feral.

According to the wiki, there are implications of two different types of chems that can cause a person to ghoul, directly quoted with "This does depend on the type of the drug"

While I am not too certain that these drugs differ all that much, I have a headcanon about why the wiki needed to state multiple types of chems that ghoulify an individual.

Firstly that there is mention of experiments for immortality. I believe that this may be an "all roads", a converging of methods to one end, type scenario. One or more of the major corporations was trying to unlock the secrets to immortality, however in this world that usually comes to the end of "ghoulifying" in some manner. I believe this is the drug-type that those like Hancock had found and used.

Secondly, I believe there are other handful of instances where some tried to create failed (or even prototype) Rad-X like medications (or even some kind of advanced form of Stimpakbi) prior to the war as a "Keep this in your prep-kit" first-aid. This would be the direct medication (and in long post-war scenarios "Copy Cat" medication) that those like The Ghoul and ghouls in Fallout: Prime are dependent on. This would easily explain how some people, pre-war (such as Cooper Howard, before his persona switch into The Ghoul) who may seem resistant to the idea of experimental or even promised immortality, would accidentally become a ghoul who is obligatorily stuck taking this medication. This being an assumed Rad-X/Immediate big wound healing-like drug would also allow for easy accidental (or deliberate) manufacturing post-war selling of it. Home brewed variations of a radiation resistant/Stimpak medication can sometimes have opposite effects, and this may be how some people "accidentally" become biochemically created ghouls.

We can however see that there is a market created for biochemical ghouls and their stabilizing medications as both F76 and FO:Prime show that these drugs are manufactured post-war and specifically for ghouls.

The wiki mentions that biochemically created ghouls retain their appearances longer than radiation created ghouls, however ultimately they begin their own process of becoming what we know more traditionally as ghouls.

Now let's move on to how they differ as ghouls;

II. Biological Quirks

Ghouls are defined by a few qualities;

Extended lifespan (functionally immortal), enhanced healing factors, immunity to disease, radiation perks, nourishment requirements, and sterility/reproduction.

We will dive into each of these topics and discuss that while both ghouls may share these qualities, there may be some variance into the extent or modes of how these qualities present.

Extended Lifespan:

We have come to understand and observe that ghouls will live, functionally, forever, unless killed. This point is fairly straight forward, however going feral is an ever present fear amongst both irradiated ghouls and biochemical ghouls. While we will explore ferals later on in this post, we will note that this can be seen as its own form of "death" within certain ghoul communities.

Enhanced Healing Factors:

We are both shown and told that ghouls have incredible healing abilities. While they cannot regrow limbs, it is shown that they can reattach missing body parts so long as one is available to graft.

We will get into nourishment needs in its own section, however I believe that the healing factors also extend here. Ghouls can sustain themselves longer without food or water due to some work of their healing factors, however this creates a strain on the body that makes injury recuperation dampen slightly.

However, while ghouls tend to be able to regenerate from bodily injury with ease, we can see some examples of preexisting conditions not being healed (a directly given example is Hugo Stolz, who remains blind even after ghoulification). This may be explained with the same reason as to why ghoul skin is necrotic and does not seem to heal itself. My personal justification is that anything that happens prior to a ghoul "stabilizing" is almost always permanent.

Another thing to note is how this regeneration may be an imperfect process. This may be best illustrated with how biochemical ghouls have a slower "ghouling" of their appearance. It is mentioned that "accumulating damage will change the ghoul's appearance over time". This implies that sometimes healing from an injury is not done perfectly. This may also explain why some ghouls have different disfigurements or gain degenerative conditions such as arthritis, loss of vision, or hearing.

Immunity To Disease:

We know that ghouls have an amazing ability to regenerate, however it is not gone into detail about how they are "unaffected by most common diseases". I personally believe there is some nuance to this between irradiated ghouls and biochemical ghouls.

Irradiated ghouls no longer have an immune system. This was something destroyed and not gotten back (much like how areas of skin will slough off and not regen). However, due to their body's base radiation retention there are very few ailments that can actually infect an irradiated ghoul to being symptomatic. Their bodies are generally inhospitable to outside invading organisms.

Biochemical ghouls on the other hand retain some of their immune system and have a lesser resistance to disease than an irradiated ghoul. However they have a better resistance than an unmutated human to diseases.

Both ghoul types rely on their bolstered resistance to disease and their healing factors to protect against diseases as most medications do not work on them, or at least have a lessened overall efficacy. Again this goes off the logic from the wikia that a ghoul's healing factors provide some dampening effects to chems. Also through this logic, poisons tend to also need to be administered in much higher doses for a ghoul to even feel the effects of it.

While most medications do not tend to effect ghouls or only work at higher dosages, there is a special interaction they have with Rad-X and RadAway.

Radiation; Resistance To And Effects Of:

Ghouls are especially known for their resistance to radiation. This is a quality that is as associated with them as the potential of going feral is. However, I headcanon some key differences between the ghoul types and their interactions with radiation.

Irradiated ghouls stand to gain the most from radiation, for obvious reasons. While traveling through the warm glowing fields of areas still emitting high levels of radiation is a perk in and of itself, they also stand to gain some physical benefits from this as well.

With the example of the Marked Men, it is shown that ghouls can subsist off radiation alone. I also believe this bolsters their base healing factors. Toss a bag of meat pulped ghoul into a nuclear waste spill and he'll join you for dinner in a few hours.

Irradiated ghouls are canonically mentioned to also hold onto their radiation exposure, where some even become glowing ones. I do think that a ghoul must have moments of "recharge" to remain glowing ones, as over time radiation decays off the body. While the short term doesn't seem to be effected by this, for beings who can live hundreds of years, some can see fluctuations of internal radiation retention.

Almost comically, while ghouls have no direct use for RadAway, they can use it to drop this retained radiation. This however is dangerous for Irradiated ghouls...

There is however mentions that radiation exposure can be a risk factor of feralization. We will go into further detail later on, however I will touch on this now.

Concentrated blasts of radiation can be dangerous for both ghoul types, however high radiation exposure over time is more a risk factor for biochemical ghouls going feral than irradiated ghouls. On the other hand, irradiated ghouls using RadAway would put them at a higher risk for going feral. Thankfully this later issue is not something most irradiated ghouls need to consider. Most documented RadAway use in ghouls is for retined radiation regulation for those choosing to stay within human colonies.

Nourishment Requirements:

The wiki seems to be pretty inconsistent with this, so I take this as an invite to shoehorn my headcanons in. The wiki says that ghouls do need to feed and water themselves to stay alive, however we are given a few instances where this is heavily not the case.

Outright, we are given exceptions to the rule with Coffin Willy, Woody, Billy Peabody (fridge kid), and The Ghoul, all of whom had scenarios of being deprived of food and water and survived for extended periods (and more egregiously so is Billy, who was trapped in a fridge starving and thirsty for over 200 years).

This is justified however by them being in "a hibernation like state", however other examples are also the Marked Men, who are said to be sustained off radiation alone. These ghouls are shown to be in an active and alert state. Raul himself mentions baking in the sun for several days, and while unmoving, had to trek three days back to civilization afterwards. We may see other examples of this through dialogue implications where ghouls may be deprived of food and water needs for durations that would kill a regular human.

I believe however that this can be dangerous for ghouls, especially given our next discussion of feralization.

It is worth noting that the wikia says ghouls have lost their sense of taste. While this may be a common phenomenon, we see it may not necessarily hold true due to comments from ghoul companions regarding flavor preferences. (See: Raul's sweet tooth)

Sterility/Reproduction:

While it is broadly understood that ghouls cannot reproduce, the wiki does not dive into much more detail here. I, however, propose that while radiation as a whole is detrimental to the reproductive system, coupled with the regenerative effects of ghouls, there are some...unfortunate outliers within this topic.

In regards to spermatogenesis, sperm count is at a constant low. Assuming there is anything produced, it is almost always malformed in someway.

In regards to ovum, almost all remaining eggs within the ovaries are considered mutated and non-viable. While menstruation is not unheard of in ghouls, it is more likely to occur in biochemical ghouls. However, all cycles are highly abnormal with next to no regularity. Ghouls will eventually hit a 'menopause', however this is not conventional in timeline as with humans.

While viability of either gamete is near non-existent, this doesn't not confirm absence of fertilization. Most common cases of fertilization is that between human egg cells and ghoul sperm cells. While this often ends with miscarriage in the blastocyst stage, implantation has happened in even rarer cases. Intervention is usually needed as this often is ectopic or produces continual hemorrhage. In even rarer cases, these can produce teratoma type "pregnancies".

Very rarely does a ghoul egg cell get fertilized. It is almost undocumented and it is believed this is due to every instance of fertilization is miscarried before or soon after implantation.

Within the realm of sexual disease, there is few directly infectious agents to worry about between ghouls. However, for ghouls with human partners it is encouraged to use barrier-type protection or other means to limit radiation exposure. Necrotic tissue is also a concern, especially when exposed to mucosa membranes. Exposure of irradiated semen to these membranes is also another large concern for human partners. Condoms are highly encouraged, with rad-checks and use of RadAway being another measure to facilitate healthy measures for these relations.

III. Ferals. What Are They, What Causes Them, And Why Aren't They Attacking Each Other

So let's talk ferals. Aside from the rotting flesh smell and appearance, the threat of going feral is among one of the biggest factors that non mutants use for ostracizing ghouls, and one of the biggest threats that ghouls face.

While we understand what causes feralization and know risk factors, what precisely makes one turn feral while another doesn't is about as well understood as what makes some go ghoul in the first place.

Feralization is described as a degenerative process of the mind and, in late stages, the body.

In this section we will cover a few things;

1.) Risk factors and how they fluctuate between ghoul sub-types. 2.) Behaviors of ferals 3.) Inter-community treatment of ferals

Risk Factors: What Are They And How They Differ Between Ghoul Subtypes:

We are of the understanding that ghouls can turn feral when experiencing certain physical or mental stressors. These stressors are reported as follows;

Social Isolation Poor Mental State/Intense Emotional Stressors Exposure to Intense Radiation Genetic Factors

While the above are wiki provided risk factors, I have included some of my own accepted risk factors below;

Intense Physical Stressors Extended Periods of Fasting/Dehydration Sudden Decrease in Retained Radiation Substance Withdrawal

First we will address the risk factors that effect both sub-types and discuss how these can pose higher or lower threats based upon the specific biology of said ghouls.

Social isolation, poor mental state/intense emotional stressors, genetic factors, substance withdrawal, intense physical stressors, and extended periods of dehydration/starvation are all things that can trigger feralization in ghouls, however the threshold for such will vary among the individuals.

For irradiated ghouls, exposure to intense radiation is unlikely to be a trigger for feralization unless it is a direct, concentrated blast of radiation. However if there is a sudden decrease in their retained radiation, such as if RadAway is used in high enough doses, then feralization is a much higher concern.

Irradiated ghouls have somewhat of an advantage against starvation/dehydration, as being in areas with a higher ambient radiation can mitigate the ill effects of not eating/drinking.

Biochemical ghouls, however, struggle more with going longer periods of time without sustenance. They are also more vulnerable to continued exposure to high doses of radiation. While it is unfair to include their serum under substance withdrawal, it is also their main means to prevent feralization. However both ghoul types are vulnerable to withdrawal causing them to turn.

Behaviors of Ferals:

It is well known that feral ghouls are a dangerous type, however it is also well known that they do not seem to attack each other nor other ghouls.

If feralization is a degradation of higher cognitive function, how is it then that most feral ghouls know when they are in like company? This is not so well understood, however it has been observed that appearance does seem to have some sway in this but is not a sure fire way to pass through a horde of feral ghouls. One theory I have is that ferals are drawn to radiation and by extension can feel it off other ghoulified beings. This keeps them in a calmer, more contented state. Surprisingly, super mutants seem to also bypass the ire of feral ghouls. The precise reason for this is less understood, however FEV may have some play here. It is known that ferals have heightened senses, perhaps even FEV created mutants have a specific smell that does not trigger a hunt response in feral populations.

In regards to their dangerous behaviors, ferals seem to be driven by hyper aggression and hunger. I will take liberties and a page from the lobotomite handbook, as well as reference how some extensive cognitive degeneration causes hyper sexuality/aggression in some.

However, the less observed side to ferals is one more human. While they never truly seem to know what they are doing, some ghoul colonies that tend their feral population note domestic-like behaviors such as; attempting to clean, cook, perform yard work, tend dolls, or perform duties and adhere to schedules relating to those they had prior to turning feral. Some have even reported that certain ferals "remember" the action of smoking and will perform this action in rudimentary fashion.

Inter-Community Treatment of Ferals:

So now that we know more about feral ghouls, how do they fit into the world? While most of us know them as residing in city ruins, content to stay hidden away from the harshness of the burning sun and light, some have found home amongst ghoul societies.

While non-feral ghouls within mixed colonies may hold less compassionate views of their feral brethren, certain ghoul societies dedicate care and inclusion of ferals into their society. Their exclusion may even be seen as betrayal, and they are as valued and protected as much as any non-feral member.

IV. The Rotting vs Chem-Heads: Interpersonal Politics Within Non-Feral Ghoul Populations

While most people view ghouls as ghouls, and acceptance of them can vary from being seen as equals, to indifference, to outright hostility, the nuance between irradiated ghouls and biochemical ghouls is almost entirely understood exclusively within ghoul populations (or with those that study them).

Unsurprisingly, this has caused some conflicts. While feralization is something that is an assumed inevitable end for all ghouls, the more immediate threat of turning plagues biochemical ghouls near constantly. This has given some irradiated ghouls a complex that biochemical ghouls are the poster child for why most non-mutant societies fear unprompted feralization.

On the other end, biochemical ghouls will often criticize their irradiated brethren for their appearance and smell being a determining factor for why most people do not welcome ghouls into certain spaces.

There is also the discussion of who has suffered more, with irradiated ghouls often citing their endurance of radiation sickness and often continued effects while biochemical ghouls often quote their substance dependency as a constant struggle.

V. In Conclusion:

So surely with all that we have learned so far we understand that there is much more complexity to ghouls than initially thought. I hope you enjoyed my compilation of headcanons and stuff I got off the wiki/from gameplay as much as I enjoyed writing it.

Head:

Torso/Body:

Legs:

My thoughts;

So starting with the head we have a interesting point of what appears to be them texturing brain exposure. Take this as you will, but I have no idea how someone would manage to be able to walk around with that. Though, considering his imprisonment with Tabitha and that he had gotten heavily assaulted by supermutants at least once, there may have been some skull fracturing from that. Given the genre of game, your mileage of suspension of disbelief may vary.

He also seems to be missing his left pinna (outer ear) entirely (evident as missing skin textures on that side) and has a small, flattened amount remaining on the right side.

Lots of facial muscle exposure, especially on the mandible. Facial hair loss due to bother radiation sickness and loss of skin? Perhaps.

His spine is exposed in several places, this seems to be a trend in areas where there is a lot of thin skin layers over bone (as we can see on his left knee, though this may be exposure of the tendons/muscle of the knee area, see image below).

Very large areas of the torso and abdomen where skin has sloughed off. We can see exposed capillaries/veins along these areas. Especially in regards to his face, I wonder if some nerves are potentially exposed.

Same can be said of his extremities. Nothing major to write home about here save for that left leg. I believe it is mostly tendon exposure there vs outright bone as it doesn't dip low enough to expose shin, and the shape of the white exposure reads as the tendons of the knee. You can compare below.