Fallout’s ghouls are a gruesome lot, but what’s really gruesome is how little recognition the horror behind them gets. I remember my first time meeting one in the exposed rust bucket of a bar looking over the city of Megaton in the third game. “Gah, what the fuck are you?” My thoughts exactly. They look like if you left your thumb in the bath for a couple of hours and it resurfaced with googly eyes and a faint slither of a mouth. At first glance, they’re hideous, but there’s an existential dread and a philosophical quandary that stems from their very existence that has equally as horrifying ramifications.

There’s no doubting that their hideous, zombie-like aesthetic is appreciated. It’s what stands out about them so much so that they’ve become a staple of the series on par with Vault-Tec and the Brotherhood of Steel. But what always unsettled me with the ghouls was the question of whether existing as one would be worth the pain, and I don’t mean physically.

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What you have to factor in with ghouls is they were once human. They’re not another species. We’re not comparing dwarves to elves and saying it’d be horrendous to have pointed ears. What we’re looking at is people like us, from all walks of life who, in the blink of an eye, were washed away by a storm of radiation, left as flaky husks with their skin permanently grafted. They get on with it, though. We’re human. We survive and adapt. What’s horrifying is that they live for hundreds of years and know what it was like to be human. What’s more, many of them know what the world was like before it became such an anarchist hellhole.

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Society is packed into sports arenas, derelict skyscrapers, and ships bobbing hopelessly in harbours, coated in a thick layer of rust. The suburban towns and bustling cities transform from dreams of what was into nightmares of what never will be. It’s an unsettling insight into the philosophical debate of whether you’d actually want to survive a nuclear apocalypse. Should you actually make it out of that initial cataclysm alive, would the weight of rebuilding society be worth it? Would you be able to cope with that mentally? It’s loss on an unprecedented scale. The ghouls endure it as they live to unfathomable ages. Yet while society begins to rebuild, they’re shunned because of who they are. They’re often harassed for their appearance and ostracized, labelled as monsters.

At any moment, a ghoul could go feral, turning into zombies, or at least Fallout’s version of them. Feral ghouls are mindless, ravaging anything that walks into their line of sight. They lose all sense of themselves. Any shred of humanity that they had is now completely gone. The anxiety of that burning away in the back of your mind would crush anyone but, what’s more, it begins to further stigmatize ghouls. They’re already demonized for being monstrous in appearance, but now society has a reason to fear them too. Even if the old world returns one way or another, they’ll never truly be a part of it.

The horror of their existence is far more than their appearance. Ghouls suffer from the terror of knowing what was, the abuse from non-ghouls, the fear of becoming mindless, and the existential dread of dealing with loss on a global scale. Ghouls are the worst outcome for a living being in an apocalypse, and that’s what makes them so terrifying. The horror of their existence is sublime, a bottomless pit of unanswerable philosophy. And yet, in the blink of an eye, that consciousness could submerge, leaving behind a ravaging husk.

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