Ghoul

Ghouls are mutated humans or animals affected by the phenomenon of ghoulification. The phenomenon has been observed in humans, gorillas, and American black bears. In the case of humans, ghouls are sometimes referred to as necrotic post-humans in the Capital Wasteland, but this term does not seem to have been adopted outside of it. Despite their zombie-like appearance, the flesh of ghouls is not actually rotten. Intense and prolonged radiation has ravaged their skin, much of their flesh, and in some cases many of their ligaments. Despite their infertility and in some cases mental deterioration, they have greatly extended overall lifespans and are immune to (and sometimes even healed by) background radiation and/or nuclear fallout.

History
The history of ghouls is a mixture of suffering and plight. The bulk of ghouls emerged as a result of the Great War, although there are a cases of some men using controlled exposure of radiation to ghoulify themselves and ride out the upcoming war. There was also an experimental radiation drug being tested somewhere in the Commonwealth. It's known side effects were why Hancock sought out the last remaining dosage.

New California
In California, ghouls were the first group of survivors to begin rebuilding civilization – the inhabitants of Vault 12 beneath Bakersfield founded the Necropolis in the summer of 2083. Less than a year later, in 2084, Set wrestled control of the settlement from the original Overseer and instituted his own reign, characterized by delusions of grandeur. The city would eventually decline, starting with the attack by Unity in 2157, who expected to find an unopened Vault in the ruins of the city. After many ghouls were killed in the assault, Set negotiated peace with the super mutants, after explaining that the ghouls are indeed the vault dwellers. The recovery operation failed, but Unity established a stronghold in the town to ensure Set's cooperation and watch for humans.

It would finally be destroyed and most of its population killed in a retaliatory expedition by the super mutants, sent to the city after the Vault Dweller raided the Vault and recovered the water chip, eliminating the super mutant garrison in the process. This has led to a Great Migration and the eventual founding of a number of ghoul and ghoul-friendly settlements, including Broken Hills in 2185, the NCR state of Dayglow around 2189, Fallout: New Vegas Official Game Guide Collector's Edition p.41: "New California Republic ''The New California Republic was born from the remnants of the survivors of Vault 15 and the small walled community they founded, Shady Sands. Under the leadership of Aradesh, and with the assistance of the Vault Dweller (who saved Tandi, Aradesh's daughter and a future president of the NCR), the community prospered. Trade routes with other settlements allowed cultural exchange, and a movement to form a national entity gradually took root and won popular acceptance. In 2186, the town of Shady Sands changed its name to "New California Republic" and formed a trial council government to draft a constitution. Four more settlements joined the council, and in 2189 the NCR was voted into existence as a sprawling federation of five states: Shady Sands, Los Angeles, Maxson, Hub, and Dayglow.'' ''By post-apocalyptic standards, the NCR is a paragon of economic success and good ethical character: political enfranchisement, rule of law, a reasonable degree of physical security, and a standard of living better than mere subsistence are daily realities for it's 700,000+ citizens. Currently, the NCR in a state of transition, with rapid economic growth and a sea change in political leadership endangering its grand humanitarian ideals. Nowhere is this more evident than in the Mojave, where the occupation of Hoover Dam has improved access to electricity and water, but at the cost of straining its budget and embroiling its armed forces in a morally corrosive imperialist project.'' ''The NCR government's aim is to annex New Vegas as the republic's sixth state. While it already controls Hoover Dam, its treaty with Mr. House and the three families compels it to allot one-fifth of the dam's electrical and water production to local use free of charge. Adding injury to insult, the NCR is locked into protecting New Vegas from invasion by Caesar's legion even as it receives not one cap in tax revenue from the Strip's highly lucrative resort operations. NCR citizens in the Mojave have largely come here for economic reasons, whether as paid citizen soldiers or as prospectors and fortune-seekers."'' (Fallout: New Vegas Official Game Guide faction profiles) and Gecko in 2235. Though problems with equality continue, ghouls are increasingly seen as equal members of society, though their numbers steadily dwindle. Sometime in 2242 marked the end for both Broken Hills and Gecko as they relied on the selling of and using of uranium mined.

In the Mojave Wasteland, they can be found in small amounts throughout the region, but no town is completely dedicated to them. There are usually a few ghouls living among humans in various communities performing jobs in order to survive, such as the guard Beatrix Russell and the comedian Hadrian, both of which are in Freeside. The only known community of ghouls in the region is the Bright Brotherhood, a religious faction located in the REPCONN test site, founded and led by an intelligent glowing one named Jason Bright, who wants to leave Earth and go into space to find a "new world," a promised land foretold by Bright himself. There are also several ghoul rangers occupying Ranger station Echo, implying some level of acceptance of ghouls serving in the NCR.

One of the most terrifying developments in ghoul history took place in 2277, at the Divide, where the nuclear warheads triggered by the Courier's delivery of an automated nuclear launch device exploded and triggered rapid ghoulification of the Legion and NCR forces engaged in battle there. Worse yet, the terrifying storms of the Divide flayed them alive, causing them to become dead men walking – marked for death, sustained only by the intense radiation that permeates the Divide. As they never appear outside the Divide, due to the necessity of staying near radiation sources to remain alive, the marked men became a legend in the wasteland, like the Sierra Madre, the Burned Man, or the Big Empty.

East Coast
The densely urbanized East had a great concentration of American population and was strongly affected by the nuclear fallout. People who took shelter in areas affected by it experienced radiation poisoning; those who did not die became ghouls. Within a year, the first ghouls began to appear and with them, the first fledgling settlements, like Underworld in Washington, D.C., which existed as late as 2277. Although in areas like Appalachia, ghouls were quickly sought out and exterminated, no matter what relation they may have had with others before they became Ghouls. Another population of ghouls, transformed Chinese operatives stranded on American soil, chose to sequester themselves from the wasteland. The Chinese Remnant remained stuck in the United States for over two centuries.

In other areas, like the Commonwealth, ghouls cohabited with humans. The most noticeable example was Diamond City. Ghouls were a part of the city's population from its foundation in the 2130s to the 2282 election. Diamond City was gripped by a wave of racism, thanks to a candidate by the name of McDonough. He ran for the city's mayor on the Mankind for McDonough platform and won the election thanks to the votes of the Upper Stands citizens. The anti-ghoul decree of 2282 was enacted in his inaugural speech, leading to a pogrom of ghoulish citizens. Entire families were thrown out of the City by their human neighbors, straight into the surrounding ruins to perish without a cap to their name.The Sole Survivor: "Thanks. You're not so bad yourself." Hancock: "I never get many complaints. It's just real rare these days, find someone who's not just willing to take things the way they're handed to them. Too many good folks not willing to get their hands dirty and too many assholes taking advantage of it. Look at what happened to Diamond City. Before McDonough took over, it was a half-decent place to live. A little stricter than I usually go for, but not terrible. I thought he and I had a pretty happy childhood. But then he decides he's gonna try and get elected with his anti-Ghoul crusade - "Mankind for McDonough." Before ya know it, you got families with kids lining up to drag folks they called "neighbor" out of their homes and throw 'em to the ruins." The Sole Survivor: "How could they do something like that?" Hancock: "There'd always been a pretty big gulf between the folks living in the stands and folks down on the field. McDonough ran on it because he thought enough of those Upper Stands assholes would vote for him. Guess he was right." The Sole Survivor: "It could have gone worse. At least they left with their lives." Hancock: ''"And how long do you think those folks lasted in the ruins? The city condemned those Ghouls to die. Cowards just got someone else to pull the trigger. I remember storming into his office above the stands after the inauguration speech. He was just standing there, staring out the window, watching as the city turned on the Ghouls. He didn't even look at me, just said: "I did it, John. It's finally mine." Should have killed him right there, but I don't think it would have changed anything. Instead I pleaded with him, begged him to call it off. He said he couldn't. He had nothing against the Ghouls. He was just carrying out the will of the people. And he couldn't betray the voters. And then he smiled. That hideous, fucking mile-long smile. He never smiled like that when we were kids. I didn't even recognize him."'' (Hancock's dialogue)

Most of them perished, killed by raiders, Commonwealth wildlife, or Goodneighbor warlords. The minority that survived scattered across the region. In one notable instance, a refugee called Wiseman founded the Slog, the foremost tarberry farm in the Commonwealth.

Elsewhere
Ghouls from other regions most likely originated from opportune or home-made shelters. Such shelters were not adequate to fully protect against all the effects of nuclear fallout. Radiation levels in some areas were such that they were low enough not to kill people but high enough not to leave them unscathed. There are ghouls in the middle of the former country, including a nuclear weapon-worshiping cult in Kansas City. Both Quincy and Springfield also have at least some ghoul occupants. In Texas, many of the former residents of Los Ybanez (known as Los after the Great War) became ghouls, none of which admitted into the Secret Vault. Later, in the same city, the Church of the Lost was created by former vault dwellers that had become ghouls.

Biology


Most ghouls were "created" in the Great War of 2077, with the exception of at least two pre-War ghousl, Edward Winter and Desmond Lockheart. Ghouls are alive during Fallout 76 (2102 - 2103), Fallout (2161), Fallout 2 (2241), Fallout 3 (2277), Fallout: New Vegas (2281) and Fallout 4 (2287). All ghouls live considerably longer than normal humans, though they are sterile. The unnaturally long lifespan of a ghoul is also due to a mutation within the autonomic nervous system of certain individuals following exposure to specific combinations of ionizing radiation with wavelengths below ten picometers. Radiation that has such a short wavelength, is known as gamma radiation and is normally lethal to healthy humans in even moderate doses. The mutation in response to gamma radiation that produces ghouls disrupts the normal process of decay in the neurotransmitters along the spinal cord.

Origins
The precise origins of ghouls are not fully understood. High levels of radiation are a crucial factor, but radiation poisoning typically results in death, rather than ghoulification. Humans who become ghouls must, therefore, possess some additional property that prevents their organs from succumbing to radiation. The reason for this longevity has to do with differences on the cellular level, and the ability of ghoul DNA to regenerate at a rate unmatched by normal human nucleic acids. It is possible that ghouls develop when additional genetic material is incorporated into a human's DNA before irradiation, preventing them from dying.

There are two primary ways in which ghouls can develop from a human. Irradiation and gradual transformation result in ghouls who retain their general human shape, but with a high degree of skin deterioration: Exposed muscle, flaking skin, and damaged connective tissue characterized by the absence of nose and ears. Another is surviving a nuclear blast relatively close to ground zero, suffering burns both thermal and radiation-induced, but surviving. The latter transformation is typically faster and substantially more traumatic for the victim and results in a generally much more horrifying appearance, with exposed bone, asymmetric deformations, and extensive unhealed wounds.

The vast majority of ghouls of both types have developed as a result of exposure during the Great War, but ghoulification is also possible after the War. Camp Searchlight is one such example, with an attack that transformed a majority of the NCR troopers stationed there into ghouls. Camp Searchlight also emphasizes the fact that the nature of the transformation may lead to mental problems. The trauma of transformation can cause a mental breakdown in the victim, causing a rapid degeneration of higher thought processes, causing them to become feral. Moreover, particularly severe irradiation can lead to the creation of luminous necrotic post-humans, or glowing ones with a permanently damaged brain: feral glowing ones are almost invariably hostile to nearly all life forms.

Overview
The transformation can take anywhere from hours, to weeks, to as much as a year, depending on exposure levels. Once it is completed, the ghouls take on the aforementioned appearance, at a rate influenced largely by the manner of their exposure: the more radiation received in a short amount of time causes drastic changes, while symptoms of ghoulification are more gradual with acute exposure. Ghouls generally experience loss of skin and connective tissue in a manner similar to leprosy, resulting in exposed muscle, blood vessels, and in extreme cases even bone and internal organs. As a rule, ghouls generally lose hair along with the skin, though this varies due to the unpredictable nature of the change. Vocal cords and the larynx are also usually affected by the change, resulting in a raspy voice – though again, this varies.

Other notable results of the change are widespread necrosis, rot, and other degenerative conditions like arthritis, cataracts, glaucomas, and more. All are seemingly permanent conditions, whose damaging effect is offset by the regenerative properties of a ghoul organism. The older a ghoul is the more these symptoms crop up and become a nuisance, but younger ghouls might not have all or any of the symptoms, but feralization and dementia can happen immediately. In fact, this necrosis can be exacerbated by a phenomenon whereby rotting flesh around sweat glands exudes macronutrients, which attract detritivorous scavenging insects that further digest and consume the tissue of the ghoul. Some ghouls may also experience loss of appendages, but the radioactive regeneration allows for them to be reattached and retain functionality. Unfortunately, this also means that ghouls tend to smell like a rotting corpse.

People who have purposefully turned themselves into ghouls through pre-War procedures, such as Desmond Lockheart and Eddie Winter, escape some of the side effects of ghoulification, keeping most of their hair and having little vocal chord damage, but still suffer from the necrosis of their bodies like other ghouls. Another purposefully turned ghoul is John Hancock, but he suffers from many of the changes noted above, this could be the uncontrolled environment when ghoulfication took place, but it is unknown.

Ghoulification and its effects are not fully understood. There is a great deal of variation in appearance between ghouls, who can look like semi-skeletal corpses, burn victims, or decomposing cadavers with exposed bone, muscle, and sinew. All of these horrifying changes accompany two major traits that can be considered as beneficial to necrotic post-humans:


 * 1) Exposure to ionizing radiation with wavelengths below 10 picometers triggers a mutation in the spinal cord, halting decay in neurotransmitters and triggering permanent regeneration. Cardiac and respiratory functions continue to function regardless of other damage, extending the lifespan indefinitely unless either system is damaged beyond repair.
 * 2) Regenerative effects of radiation – in fact, the altered ghoul physiology is boosted in the presence of radiation, resulting in an increased rate of regeneration.  In certain cases, such as with the marked men of the Divide, intense radiation can help a ghoul survive even lethal injuries, such as flaying..

The mutated physiology still requires ghouls to provide adequate nourishment for their systems, including providing water and food. The loss of the sense of smell allows ghouls to eat food humans would consider repulsive, which coupled with the resilience of their digestive tract allows them to subsist on any edible foodstuff. As an added benefit, a ghoul is also immune to most common diseases that affect unmutated humans. However, that doesn't mean ghouls are immune to all diseases, and diseases of the mind (not just feralization) can still affect a ghoul. A side-effect of the mutation is that recreational drugs like Jet have a diminished effect on their physiology, requiring double doses or increased potency to work. This is likely because of the regenerative properties of ghoulification. The neurotransmitters that would be firing at an accelerated rate during the use of a drug like jet in a normal human would be quickly dealt with in the ghoul's body. This likely applies to all types of drugs - stimulants and depressants - that are not radiation cures or preventers.

While ghouls require food and water, the regenerative properties of their mutated bodies can sustain them in the absence of either. In most cases, this coincides with the transformation into a feral ghoul (see below). However, there are three known cases where prolonged isolation with no air, food, or water had no deleterious effects on the ghoul: Coffin Willie was buried in a coffin for months and was no worse for the wear, Woody was exhibited as a mummy for weeks while in a state of deep sleep, and perhaps most shockingly, Billy Peabody survived the Great War by locking himself in a refrigerator, and has stayed alive for 210 years.

Ghouls retain their normal cognition and are generally no different than humans in terms of intellect. In fact, many ghouls benefit from their extreme lifespan and are capable of amassing skill and knowledge far beyond the ability of regular humans. By extension, ghouls retain their sexual drive, though, for obvious reasons, sexual partners are usually ghouls, though some humans do have a ghoul fetish. Regardless of their capacity for intercourse, ghouls are sterile and cannot procreate. Any children they may have are either adopted or were mutated into ghouls alongside their parents.

Complications
However, turning into a ghoul can bring about severe complications. The degeneration into a feral state (referred to as ferocious post-necrotic dystrophy) is not fully understood. It is known that it is a result of a degeneration of the brain (which is not affected by the regenerative mutation of the spinal cord) and emerges following the atrophy of higher brain functions, accompanied by an increased level of aggression and appetite. When the loss of capacity for thought is complete, a ghoul is considered feral. The factors that may cause a ghoul to enter this state are unclear, but anti-social or isolated ghouls are more susceptible to it.

Exposure to intense radiation may also be a factor – feral ghouls have no body heat and emit lethal levels of radiation, indicating that feral ghouls are for all intents and purposes dead, their functions sustained only by their high irradiation. This allows them to survive for centuries, relying only on the energy provided by radiation – at the expense of a horrifying, emaciated appearance. Understandably, the process is irreversible. These feral ghouls strongly resemble zombies like those depicted in old horror films, and this misconception succeeds in alienating non-feral ghouls even more from humans. Feral ghouls are chief among the reasons for discrimination against all intelligent ghouls as it is viewed that they could go feral at any moment.

The transformation of a ghoul into a luminous necrotic post-human (Glowing One), which occurs when the organism of a ghoul ceases filtering radioactive particles from the blood, resulting in bioaccumulation and the gradual appearance of bioluminescence as a result. Luminescent ghouls are usually heavily irradiated, due to the accumulation of radiation in their bodies and some can even violently discharge the accumulated radiation in what is termed a "radiation blast" by wastelanders. Luminous ghouls are usually feral, due to the damage to their nervous system and the time it takes to accumulate the radiation, though ghouls uncommonly develop luminescence before degenerating into a beast-like state, like the glowing ones of Necropolis, the Gecko reactor, Jason Bright, Oswald Oppenheimer, and Hank.

However, the topic is poorly researched and complex, with many exceptions. As stated above, intense radiation may turn ghouls into glowing ones without making them go feral, while isolation need not cause the same for exceptional individuals. The aforementioned Oswald Oppenheimer managed to survive over two centuries while isolated in Kiddie Kingdom, surrounded by his former co-workers who suffered degeneration into a feral state. Oswald's single-minded dedication to protecting his fellows until Rachel Watkins returned with a way to reverse the process is likely to have played a factor. The same is true for Dean Domino, who haunted the Sierra Madre for over 200 years, seeking to achieve victory over Frederick Sinclair.

Non-human ghouls
Ghoulification is not unique to humans and is a possible mutation for various families of animals. Animal ghouls seem to share all the disadvantages and advantages of becoming a ghoul as a human does, this includes rapid hair loss, the deterioration of the epidermis, severe cataracts and glaucoma of the eyes, elongated life-spans, as well as transforming into glowing ones through extended exposure to radiation. The one difference between human and animal ghouls is the seeming ability to reproduce. Examples of affected species can be found throughout post-war America from New California to the East Coast. Known pre-War animals include Ruzka, a circus bear that was performing around the Point Lookout area, and The Beast of Beckley, a legendary wolf known to roam Appalachia from 2077 to 2102, even had pups. Roaming Alpha Mongrels can also be found to be wearing dog collars from their previous domesticated lives. A final example dwells in the creature known as the "Ghoulrilla," an aptly titled ghoulified gorilla.

Discrimination
The attitude towards ghouls in the wasteland varies from acceptance, through apathy, to outright hostility. This is predicated on a variety of factors – for example, in New California of the mid-22nd century, ghouls were almost legendary creatures, as their population had isolated itself within Necropolis, leading to the rise of rumors about terrifying zombies living within its borders. The fact that patrols that entered the city rarely returned alive (as was the case with two patrols Killian Darkwater sent into it) did not help. Of course, some daring souls (like Keri Lee of Crimson Caravan) managed to make inroads and secure lucrative trade relationships with the ghouls of the city (or skags, as the Hubbers referred to them).

Vault City is a textbook example of racial prejudice at work. Since the atomic reactor in Gecko did not operate properly, waste from the power plant started leaking into the local groundwater around 2239 and it eventually led to serious poisoning of the whole reservoir. Harold learned that a hydroelectric magnetosphere regulator was needed for the repair job, but no such part could be found in Gecko, so attempts were made to contact Vault City but the messengers were shot on sight by the Vault City Guard, marking the beginning of an official policy to shoot all ghouls on sight. The situation became worse, when Vault City residents started to believe that the ghouls had deliberately poisoned the groundwater, accusing them of terrorism against Vault City and demanding that they should be punished. The First Citizen of Vault City, Joanne Lynette, even tried to hire someone who was willing to help stopping the Gecko problem by any means necessary.

In regions away from New California, ghouls likewise experience a variety of attitudes. For example, in the Mojave Wasteland, ghouls are generally seen as equals and share both the misery of poverty and the prominence of the stage on equal terms with humans. Of course, not everyone is as egalitarian as the people of Freeside and New Vegas. The New Vegas Strip doesn't permit the entrance of ghouls or other mutants unless under the supervision of a human visitor, or with permission from a higher-up. The Bright Brotherhood is a cult centered around Jason Bright, formed in response to suffering its members experienced at the hands of humans. In some areas, ghoul lynchings also happen, while in others ghouls are considered a possible threat and are fired upon – like in Washington, D.C., where Lyons' Brotherhood of Steel members will routinely open fire on ghouls sighted in the city.

A lot of anti-ghoul sentiment is caused by inexperience and ignorance. For example, some believe ghouls to be carriers of disease, without ever having examined one, while others believe that all ghouls are inevitably bound to become feral and pose a threat to people around them, a sentiment with a lot of truth to it. This was the basis for the Anti-ghoul decree of 2282 in Diamond City, that saw their ejection from the city based on prejudice.

Sometimes, the situation is not helped by the ghouls themselves. Of particular note was the cause of Roy Phillips, a disgruntled ghoul from the Capital Wasteland, obsessed about seizing Tenpenny Tower for himself. His increasingly threatening behavior, when refused entry by Chief Gustavo, led to suspicions that he might attack the Tower directly, only confirming the security chief's belief that all ghouls are walking ticking bombs.

That said, misconceptions and prejudice are not unique to humans. Apart from the hateful Roy Phillips, even the seemingly tolerant inhabitants of the Underworld have shown a racist side when some of them threatened Doctor Barrows over his research into ghoulification and its causes, claiming that "ghouls are ghouls and humans are humans." Fortunately, not all ghouls are like that and many long for their pre-mutation life and seek ways to reverse the changes, no matter how unlikely the means.

Legal protection
Some polities take steps to protect ghouls and other mutants, like the New California Republic, which extended legal protection to them in 2205 (though enforcement of these laws is notoriously spotty) and allowed a significant number of ghouls of both genders to serve in the ranks of the New California Republic Rangers, with the bulk of them being accorded veteran status due to their resilience and experience in combat.

Necrotic post-human (ghoul)
Commonly referred to as ghouls, these men and women are no different from regular humans when it comes to intellect or personality. They are as stupid and as intelligent as regular humans – and share their capacity for compassion and cruelty as well. Intelligent ghouls have suffered little to no mental degradation from their condition and retain their full faculties from before their transformation. These ghouls possess the ability to talk, and they normally wear clothing, as well as carrying and using weapons. Some may have hair on their head, but not a lot. Ghouls often refer to humans as "smoothskins." These ghouls also find terms such as "shuffler" and "zombie" to be offensive. Hostile intelligent ghouls, violent even without provocation, do exist, the most noteworthy being the Chinese remnants, Chinese spies, soldiers, and special forces units trapped in the United States following the Great War. Remnant forces are wholly unaware (or perhaps in denial) of the worldwide nuclear destruction that has occurred and believe that they are still in a state of war, continuing to follow old objectives sent to them pre-War by the People's Liberation Army. Remnant forces have retained much of their intelligence and training, and attack all those they encounter without hesitation.

Luminous necrotic post-human (glowing one)


A highly irradiated ghoul that has absorbed enough radiation to develop bioluminescence, glowing a ghastly green color that's especially visible in the dark. They are colloquially known by most as "glowing ones," and are often considered outsiders even by other ghouls. Glowing Ones are predominantly feral, due to isolation and the time it takes to acquire that much radiation. Although uncommonly they may transition into this state before losing their faculties. See this section for more details.

From Fallout 3 onwards, Glowing Ones are particularly difficult in combat due to their resilience and the ability to suddenly discharge radiation from their body in a room sized "blast" that harms non-ghoul targets and heals ghouls.

People have seen on more than one occasion a feral glowing one fighting or being chased by "normal" feral ghouls. Although very rare, it is possible for a glowing one to retain their intelligence and cognitive functions, such as Jason Bright, Oswald the Outrageous, and several unnamed ghouls in Necropolis and most of the technicians at the Gecko power plant.

Ferocious necrotic post-human (feral ghoul)


These are ghouls who have irreversibly transitioned to a feral state, sustained only by radiation they absorb. Ferals are invariably hostile to living creatures (with the exception of other ghouls) and tend to cluster together in packs. Feral ghouls are among the more unfortunate mutants whose minds have deteriorated from prolonged radiation poisoning, becoming instinct-driven savages, attacking anyone and anything relentlessly, save for other ghouls. They are roughly divided into groups according to the danger they pose:


 * Regular feral ghouls wear torn, shredded civilian clothes and are very easy to dispatch.
 * Feral ghoul roamers and stalkers are often wearing rags or no clothes at all. They are considerably tougher than a normal feral ghoul and considerably more dangerous with their attacks.
 * Feral ghoul reavers are the most deteriorated form of a feral ghoul, wearing bits of metal armor and metal flight suits. Radiation has melted and fused entire segments of their body, making them incredibly tough to dispatch. In Fallout 3, even worse is the fact that reavers have no self-preservation instinct and will readily rip out its radioactive guts and throw them at their targets.
 * Withereds, gangrenous, rotting, and charred feral ghouls are the rarest of feral ghoul subtypes and the most dangerous given their resilience to being dispatched and considerably deadly attacks.

Marked men


A unique subtype of the ferocious necrotic post-human, marked men are indigenous to The Divide area. Wounded by the subterranean nuclear detonations of 2277 and flayed alive by the resulting storms of the Divide, marked men are sustained only by the high background radiation that permeates the area, which keeps the regeneration going despite otherwise fatal damage to their bodies. As a result, the marked men cannot leave the Divide, and have developed a unique culture due to retaining a semblance of cognition. Despite still being cognitive enough to carry weapons and utilize advanced tactics such as constructing outposts and utilizing guard towers, they are still immediately hostile to any and all outsiders that venture near.

Endless walker


Ghouls exposed to the harsh conditions of the American Southwest for too long will become what is known as an endless walker. Years of the desert sun has cooked their brain, destroying the cerebrum and turning any normal ghouls that undergo the process feral. They are cursed to endlessly walk, forever searching for something to quiet their insatiable appetite. Their skin has hardened into a natural leather, making them more resilient.

Born ghoul


Through cruel experimentation on humans by Dr. Sebastian at the Reservation, born ghouls were created. They are ghouls who have not mutated from humans, but who were actually born into ghoul-dom. There are only three known born ghouls.

Appearances
Ghouls appear in every Fallout game to date.

Behind the scenes

 * A ghoul is described as "Bloodman" in an old Fallout concept art piece.
 * In folklore, a ghoul is a monster or spirit that is associated with graveyards and consuming human flesh.

Controversy over origins
There is some disagreement, even among the makers of Fallout games, about the origins of ghouls. While Tim Cain said explicitly that ghouls are only a result of radiation, consistent with an understanding of the science of radiation as it stood during the 1950s, Chris Taylor said that a mix of both radiation and FEV was involved. While Chris Avellone initially supported the latter view in his Fallout Bible, he was later convinced to support the radiation-only version.