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Continuing our series on Fallout‘s realism (or lack thereof), today we’ll be covering radiation and mutations, because who doesn’t love that? For info on the real-world version of things like Vaults and nuclear-powered cars, check out Part One!


Radiation in Fallout is one of the most unrealistic aspects of the series, being that many of its effects just plain don’t work that way in real life. Swanning around in irradiated water won’t turn anyone into a ghoul, you can’t flush away massive doses of radiation with chemicals, and after a couple hundred years not even major nuclear targets will still be heavily irradiated.

In real life, radiation is any energy emitted from a given source. When you microwave a chicken sandwich or a cup of coffee, you’re cooking with radiation. The problems don’t really start until you hit something with so much energy that you knock electrons off its atoms, changing their electrical balance. They become charged, or “ionized.” Ionizing radiation is what makes a Geiger counter click, and it mainly comes in three flavors: alpha, beta and gamma.

The broken bits of atoms created by a nuclear detonation are alpha and beta particles. They get embedded in the dust, ash and debris thrown up by the blast, turning the resulting fallout radioactive. Alpha radiation is pretty weird in that it’s essentially a helium atom minus the electrons. Too big to get past your skin, it can still cause burns due to being energized, and it remains deadly if the dust it inhabits is inhaled or ingested (by, say, settling into food or water).


Beta particles are single electrons, attached to no atom and thus able to penetrate beneath your skin. This type of radiation can cause nuclear transmutation when it strikes an atom, which in turn can change a molecule’s structure. If the molecule in question is DNA, the affected cell can spontaneously mutate. When moving through water, beta particles also create the characteristic blue glow of Cherenkov radiation.

Guess which kind of particle Strontium-90, the active isotope used in Nuka-Cola Quantum, emits?


Might as well cut out the middleman, I suppose …

So what about gamma rays?

They’re the most penetrating kind of ionizing radiation, but they’re also not particles—gamma rays are photons. They’re produced by the fission, fusion, and natural decay of radioactive elements. In Fallout, sources may include piles of nuclear waste, being close to a nuclear detonation, or walking into an exposed reactor core (good luck with that!).

Radiation sickness—the vomiting, hair falling out, bleeding ulcers? It’s caused by billions of your body’s cells having been blasted at the atomic level. The more radiation you absorb, the more cells get shotgunned. In real life, the only way your body gets rid of that radiation is by dumping and replacing the affected cells. Cells which have mutated and keep running often can’t be replaced, however—that’s actually a principle of evolution! The body will just try to work with it, even though in the vast majority of cases the mutation isn’t useful and merely results in unchecked growth of deformations … also known as cancer.

Fallout uses the old “RAD” (Radiation Absorbed Dose) system of measurement to determine how much exposure is unhealthy, and it’s actually historically accurate. At levels of 200, 400, 600, and 800, you get progressively sicker (reflected by reductions in various S.P.E.C.I.A.L. stats), until at 1000 the dosage is fatal absent immediate treatment.

In the original isometric games from Interplay, your stat penalties would be indicated by a message about your symptoms, such as “vomiting does not stop” and “hair is falling out,” which is far more realistic than the mere wobbliness and blurring of vision you get in Bethesda’s first-person games. I’d seriously like to see a “Radiation Immersion” mod that forces you to remove a power-armor helmet or gas mask when puking your guts out, or which changes your character’s hairstyle over time to reflect gradual loss. The inability to keep food down would also make Survival Mode a lot nastier. Give us more reasons to keep that rad-count low!

In real life, any dosage of ionizing radiation will increase your chances of someday developing some form of cancer, and frankly you’d need to be one tough individual to keep fighting with a count of 400 or higher (since this is where Acute Radiation Syndrome usually sets in). So how long does it take to realistically heal from radiation damage? That’s entirely up to your Endurance stat—er, that is, how good your body is at taking care of itself. The record-holder for long-term radiation survival is still Albert Stevens, the victim of an unethical plutonium-injection experiment, who accumulated the equivalent of 6400 rads over the course of twenty years before finally dying of heart disease.

The last thing to bear in mind, before we move on to the weirder stuff, is how medical treatment deals with radiation in Fallout.


“Some brahmin milk, a few magnets, and some happy thoughts ..!” Original image by Jspoelstra, posted to

Believe it or not, stuff similar to Rad-X and Rad-Away exist … they’re just not anything near as effective. At least one of the real-world medications, “Prussian Blue,” is actually mentioned in Fallout 3 as something the medical response team at Germantown Police Headquarters was running short of.

In Fallout, as well as in real life, there are two types of radiation medication: blockers and flushers. Rad-X serves to improve the body’s overall resistance to ionizing radiation, which by current medical standards would be nothing short of miraculous. Since it’s taken as a pill, it has to dissolve in the stomach and thereafter flow to virtually every cell in the body, and assuming that can be done reliably, whatever chemical it’s carrying has to somehow strengthen the force binding electrons to their atoms.

Because the whole problem is that one or more of those electrons is getting knocked away, remember? The only known real-world blocker is Potassium Iodide, which simply prevents radioactive Iodine from being absorbed by the thyroid gland. That’s it. It deals with one chemical, in one organ. More reasonable is the concept of Rad-Away, which binds to radioactive material in order to get it flushed out of your system faster.

Still, reality is much harsher: Prussian Blue only binds to cesium and thallium as they enter the intestines, and does so to prevent them being reabsorbed. These are then excreted like any other form of solid waste, getting them out of your system in about a third of the time normally required by the body. The only close match to Rad-Away is a chemical called DPTA (diethylenetriamine pentaacetate), which binds to plutonium, americium and curium … but it can’t reach every part of you where these elements may have lodged. What it does bind to is then ejected through urination.

Then there’s homeopathics (see Moira Brown’s smiling face, above). Magnets and happy thoughts aren’t going to do much for you, but who knows? Maybe brahmin have mutated to the point their milk is chock-full of binding agents. How else to explain going from “positively glowing” to zero rads with whatever Megaton’s resident mad scientist just handed you?


Finally, we get to what might be the most realistic option of the lot: a calibrated decontamination array. I’m no theoretical physicist—heck, I don’t even have a theoretical degree in physics—but if the goal is to de-ionize the parts of you that radiation has ionized, then getting bathed in a tailored energy field of some kind would seem to be what the doctor ordered.

At least it’s better than turning into a Ghoul, am I right?



Honestly, I hope I look this good when I hit my third century. Original image by Zflocco, posted to

And here’s where Fallout radiation parts company entirely from the real thing—Ghouls.

Even the earliest explanations for the existence of Ghouls make clear that all of them are mutative reactions to radiation exposure. In our world, it would be the most incredible quirk of fate for even a single human being to receive enough beneficial mutations to make such a transformation remotely possible. But it’s not just relatively common to the Fallout universe, it can actually be replicated under controlled circumstances (as seen with Eddie Winter here). Even in Fallout 1, the original Ghouls were the result of Vault-Tec deliberately preventing the door to Vault 12 from closing, so as to ensure everyone inside got thoroughly irradiated.

Some few eventually-to-be Ghouls were, much later, also affected by the mega-virus known as F.E.V. (which we’ll get to in a bit), but there appears to be no scientific basis whatsoever for so many Ghouls having virtually identical physical properties. They can’t even pass the traits on to new generations so as to standardize the results … they’re sterile. The Fallout timeline does provide one tiny possibility for this outcome, however: the New Plague.


Some things really never change. Original image by Matson/St. Louis Post-Dispatch, used for commentary without permission.

Also called “Blue Flu,” this mysterious contagion appeared about twenty-five years before the bombs fell, claiming tens of thousands of lives and leading to a nationwide quarantine. Initial symptoms were flu-like, but quickly led to hemorrhaging and death in less than a week. Attempts to cure the New Plague led to the Pan-Immunity Virion Project and the Forced Evolutionary Virus. Other major effects of the Plague were that it sparked interest and support for Project Safehouse, which would build the (in)famous Vaults and also encouraged people to limit their social contacts with folks they couldn’t be sure were still healthy.

It was widely suspected, but never confirmed, that the New Plague was a genetically-engineered bioweapon. It definitely became less and less of a national crisis as time moved on, suggesting that most of the population reacted to exposure by developing a natural immunity of some kind since no cure was ever found. Being as that the Pan-Immunity Virion Project ultimately decided the solution to defeating bioweapons and plagues was to transform human DNA into a quadruple-helix format, it’s entirely possible that the widespread “natural immunity” resulting from the New Plague was itself genetic in nature.

A more resilient form of DNA might well be better-capable of repairing itself after damage, even when caused by ionizing radiation … up to a point. Severely-damaged DNA structures could well result in imperfect fixes, with the mutation interpreting blast-ruined flesh as “the way it’s supposed to be” and creating on-the-fly workarounds. If the New Plague mutation is so flexible as to be capable of incorporating ionized particles into its repairs, it could even explain why Ghouls are so long-lived and heal from further radiation exposure—the energy is being harnessed to fuel new cell growth, or at least to preserve what there already is.

As a genetic trait, such a mutation could even be passed down to descendants (assuming the holder is never actually ghoulified themselves). Thus, when we see people even centuries later becoming subject to ghoulification (for example, in the town of Searchlight), it’s because they inherited the latent ability to survive a long-extinct disease.

Eh. It’s a theory, but to a large degree it seems in line with the official biological explanation. Even Fallout‘s original creators have disagreed over the origin of Ghouls, at one point holding that the Forced Evolutionary Virus had something to do with it before eventually agreeing,many years after publication, that it had not been involved.

Aaaaand that’s our cue to discuss F.E.V. in more depth. Hiya, Doctor Grey!


Original image by Ghouly89, posted to What is wrong with your faaaaaaaace?!


The Forced Evolutionary Virus is exactly what it says on the tin: a virus that forces human DNA to mutate. Think of it as a really nasty version of the “super-serum” which gave our world Captain America … no wait, that’s another world entirely. My bad.

More technically, it’s a shifting-absorptive mega-virus, protected against radiation by a protein sheath reinforced with ionized hydrogen, which carries genetic information programmed for the species being infected. It works by copying the host cell’s DNA, placing them into exons that are then reintroduced into the host’s cells alongside the programmed material. It also uses a recursive genetic code, allowing it to repeat its genetic copying and insertion process infinitely. Similarly to Ghouls, humans transmogrified by F.E.V. into Super Mutants are sterile, a result of the virus interpreting “half-cells” common to reproduction as genetic damage.

That’s really quite an accomplishment, considering the first breakthroughs in Pan-Immunity research took place on March 21, 2075, just thirty-one months before the world would end. By October of 2077, the creators of F.E.V. were still conducting tragic and horrific experiments on prisoners at their military base in Mariposa, California, when everything went pear-shaped. The base’s military contingent discovered what was going on, mutinied, killed the scientists, sealed the base, and left Mariposa behind them, eventually forming the Brotherhood of Steel as America burned around them.


Meanwhile, West-Tek’s original P.V.P./F.E.V. research facility had been directly hit with a nuclear warhead. Despite being buried several levels below ground, the remaining bio-tanks were breached, releasing the virus into the atmosphere. This early version had only been used in animal testing. Its mutative effects on the surviving fauna of the Fallout universe, in conjunction with heavy radiation resulting from the Great War’s nuclear exchange, is clear.

Additionally, the Mariposa base was eventually breached by roving wildlife, which then mutated in accordance with this second, more advanced strain and began attacking nearby human settlements.

Numerous species merely grew larger and more aggressive, something commonly ascribed to mere “radiation gigantism,” but which are also traits specific to F.E.V. infection. This seems borne out by more radical mutations one would not expect from simple irradiation, such as the spontaneous appearance of intelligent talking animals. Other animals have been uplifted to sapience using F.E.V., though there are also cases where similar uplifts were apparently accomplished without need of the virus … and that, for arachnids and plants!

The sterility issue may also be specific to human genetics, as a bugged “good ending” to handling the issue of intelligent deathclaws(!) in Fallout 2 made clear they would not only survive, but also expand their numbers. The issue remains hotly contested in the Fallout community, with even the game’s creators differing in their views.


This is one guy you never want to run into on a dark oil rig. Original image by Ghouly89, posted to

Nonetheless, the trickiest use of Forced Evolutionary Virus by far has been on the species it was originally intended for: humans. Its ionized sheath, originally meant to confer radiation immunity to the virus host, interacts badly with any radioactive particles said host may already include. The best description for what happens next is “gone haywire.”

The more irradiated or mutated a subject is at the start of their transformation, the bigger and dumber they tend to get as it proceeds. “Pure-strain” humans, with little to no radiation and zero mutations present, tend to produce superior Super Mutants, exceeding their former selves in all respects—except that part about being able to procreate. After stumbling across the F.E.V. vats at Mariposa, in which one of their Secret Service agents became infected, the Enclave was able to finally achieve the program’s original super-soldier goal, though they were never able to replicate the initial accident that doused him. Yet even a “pure-strain” type, if they have been journeying for any substantial amount of time through the wasteland, will tend to pick up ambient radiation as well as possible genetic quirks, producing unpredictable results when infected.

Which brings us to the abomination three images north of here. That’s “The Master“, formerly known as Richard Grey (and before that, as Doctor Richard Moreau). He got knocked into a vat at Mariposa, but instead of a short soak he was stuck there for a solid month before being able to drag himself out. Initially believing himself unchanged, Grey began first to mutate, and then to absorb both flesh and minds of the mutated animals roaming the facility. He soon discovered that dipping multiple animals into the vats would fuse them together into a single organism. After that, he developed the ability to interface directly with computer equipment by growing neurolinks into them.

In short, Forced Evolutionary Virus is the “magic dust” that makes just about everything related to genetic manipulation or mutation possible in Fallout. When a human being can be reduced to a psychic goop capable of merging with any biomass or machinery it can get its tentacles on, all bets are off and anything goes.

Well, I hate to say this because I promised otherwise, but the supertech-talk and economic stuff will have to wait for Part 3 of this series. As it is, this is running pretty long and I’m sure you have other stuff you want to get done today … like hunting down that damn Nukalurk Queen and mounting her corpse outside your newest settlement as a warning to anyone even thinking of screwing with your people!

Just a suggestion.

Do you have some interesting arguments to make about Fallout’s realism (or lack of same)? Let’s hear ’em in the comments below!

More About This Game

Scott Malcomson

Staff Writer

Old enough to have watched the first moon landing live on TV, I've been gaming since the days of ApVenture and the Zork series. My last console was an Atari 2600, and my first PC was an Apple IIc (in glorious monochrome!). If you want to understand the kind of person I am, it might help a bit to play Ultima IV.