I'm Watching Fallout Without Having Played The Game, And I Needed To Know: How Do People Become Ghouls?

The critically acclaimed Fallout adaptation (which is streamable with a Prime Video subscription) is seemingly striking a chord with a plethora of viewers. It’s been praised for its faithfulness to the video games on which it’s based and for adding fresh elements to it as well. And those who’ve played the games aren’t the only ones tuning in, as uninitiated folks like myself are taking in this post-apocalyptic world for the first time. So I’ve naturally had a number of questions, and one particular query is: how in the world do people in this universe actually turn into ghouls? Well, if you seek answers, you shall find them, and that’s exactly what I did. 

Early on, it’s established within the show that above the underground Vaults that house certain members of society lies a desecrated United States that’s filled with lawlessness. (Said place is akin to the locales you’d see in some of the best western movies.) Ghouls are among some of the most intriguing denizens in this wasteland, with the most notorious among them being Walton Goggins’ noseless sharpshooter, The Ghoul. Based on what’s known about the continuity, it’s immediately clear that radiation plays a role mutating humans into such beings. However, it turns out there's a bit more nuance than I expected.

In my search for answers, I reached out to my colleague Dirk Libbey, one of the gaming experts we have here at CinemaBlend. When we chatted, he did indeed emphasize the role that radiation plays into transforming humans into decaying beings that feed on dead bodies. Though Dirk then explained that certain conditions apply here: 

How one becomes a Ghoul in the Fallout universe is both very simple and surprisingly complicated. The short answer, as you can guess, is ‘radiation’ but ghoulification requires that exposure occur in a particular way. Radiation is still a killer in Fallout so if you get too much radiation, you’ll still die. If, however, you’re exposed to a significant non-lethal dose of radiation, your body will eventually transform into a Ghoul. This usually happens gradually, but can also come from a single massive dose of radiation as long as it doesn’t kill you.

I found this information to be very intriguing, as it would appear that the dose of radioactive emissions that a person experiences matters as well. So, if someone like Lucy MacLean (a Vault dweller) were to be hit with too much radiation at once, she’d surely die. However, a non-lethal blast could set MacLean on the path to mutation. It’s like The Ghoul told Lucy after she asked what he was, “Oh, I’m you, sweety, just give it a little time.” (Of course, in that case, he wasn’t just referring to her anatomy.)

Anyone who needs further illustration of the complexities involving a ghoul transformation shouldn’t fret. That’s because Dirk also provided me with keen examples of how it can come to pass. He astutely made his point by calling back to the franchise’s first and third installments, laying out situations involving a Vault and a character players come across. As Dirk explained: 

In the first Fallout game, you can discover Vault 12, a vault that was specifically designed to have a door that didn’t completely seal. This exposed the entire vault to prolonged radiation, turning everybody into Ghouls eventually. In Fallout 3, if you are an absolute monster and choose to blow up the town of Megaton with the undetonated nuclear bomb at its center, everybody in the town dies, except a woman named Moira Brown, who you can meet again later in the game, and discover she has become a Ghoul.

This is definitely a complex science, but it certainly does add some clarity in regard to the question I initially had. At this point, I’m halfway through the show, so I’m not sure how The Ghoul or his fellow ghoulies factor into the finale. But I’m excited to find out, especially now that I have more context regarding how they came to be and how others can suffer their fate as well!

Fallout, which many are comparing favorably to The Last of Us, has an eight-episode season that can now be streamed in its entirety on Prime Video. Also, be sure to look at the 2024 TV schedule for other offerings if you’ve run through the phenomenal video game adaptation already.

Erik Swann
Senior Content Producer

Erik Swann is a Senior Content Producer at CinemaBlend. He began working with the publication in 2020 when he was hired as Weekend Editor. Today, he continues to write, edit and handle social media responsibilities over the weekend. On weekdays, he also writes TV and movie-related news and helps out with editing and social media as needed. He graduated from the University of Maryland, where he received a degree in Broadcast Journalism. After shifting into multi-platform journalism, he started working as a freelance writer and editor before joining CB. Covers superheroes, sci-fi, comedy, and almost anything else in film and TV. He eats more pizza than the Teenage Mutant Ninja Turtles.