Doctor Reacts to THE LAST OF US // Episode 2 

I dont think Joel was actually on an Atkins diet, more of an excuse to avoid spending time with the neighbours. The whole first episode is littered with Joel and Sarah narrowely avoiding wheat/carbs (no pancake mix for his breakfast and forgetting to pick up a cake for his birthday).

What's also cool is how many times in the first episode bread type items were coincidentally avoided. The fact that they ran out of pancake mix and Joel forgot the cake for example, fantastic hints from the writers.

It seems like an extreme reaction from the mycologist, but in that short exchange, she learned that: -Patient zero is unaccounted for -The initial incident happened 30 hours ago -The subject managed to bite multiple coworkers in a short period and all of them turned within hours -14 workers from the plant are missing I'd say at that point, it's beyond any containment and more about limiting the ability to spread

Just a correction about the game lore. In the game, the spores can't live in direct contact of sunlight. That's why, during the last stage of infection, the infected searches for a humid and dark area to die, bind itself to a wall or something and blow the spores. Also, "killing" the infected don't kill the fungus, so that can explain why they encounter so many sunlight areas with the carcass of the fungus.

That comment about Pedro Pascal and needing to show his face had me rolling on the floor laughing

With the clickers it's confirmed in the game I think that the fungus eats the organs of the infected it doesn't need because the mycelium basically replaced their function which is why they can survive so long. In the case of the one with the fungus on the head it's skull did split open as the fungus eats the part of the brain it's not using to control the body, then grows outwards splitting the skull open as it bursts through the eye sockets and nasal cavities due to the bone being thinner there.

Jakarta also produces a ton of the world's flour, which is why it spread so quickly in the tv show. I think because the infection spreads so quickly inside a person, within 24 hours at the most, they just don't have any anti-fungals that can work that quickly and aggressively. Also, one of the theories is that this particular cordyceps mutation is absurdly resilient, so trying to treat it with traditional anti-fungals is like rubbing Neosporin on necrotic flesh. It survived in flour that would have been cooked at 350F/176C, it survives for years with limited nutrients, and it only takes a small dose to fully infect a human.

Oh fun note: at 13:30 when you are talking about the infected, in the game they are called clickers. They are evolved to be hyper aware with auditory signals, to the point where the "clicking" can be a form of echolocation, albeit a rough version of it. I am super happy how close to the game they are following it as the clickers are hyper aggressive and will try to kill their target like it tries in the show instead of just infecting them.

I’m not even joking if you do the entire series I’m tuning in for all of them

7:00 I don't remember where I read it from, but someone who played the video game explained Ellie's "immunity." There are many kinds of cordyceps; the one featured hijacking people's brains is called UNILATERIS. Ellies immunity is actually the result of one of many cordyceps (not cordyceps Unilateris) already occupying her and preventing UNILATERIS from entering her body.

"The infected WhatsApp group" had me cackling! Your videos on this show so far have been entertaining and I'm glad you're appreciating the concepts this story is presenting!

I think the writers have said that the fungus doesn't spread through spores for the series since it'd be hard to show compared to a game (especially with how it stayed concentrated in certain areas compared to irl where the wind and stuff would likely carry it) and they don't want the stars to have gas masks on for the majority of the time. This version is more of a hive mind sort of thing from what I can gather. Edit: I rewatched the scene where the doctor recommends bombing and you were a bit incredulous about it especially with anti-fungals but I think there's a line said by the general that played into her recommendation. He said that the people that women bit had to be executed a few hours later. If it spreads that quick and causes such aggressiveness to warrant execution I don't think any anti-fungal is gonna be able to be applied in time and there's atleast 15 vectors of spread not accounted for (patient zero and fourteen missing workers) and with such aggressiveness seen in episode 1 I don't think a quarantine is going to be enforceable so the only vector to stop the spread is to destroy it.

Considering the fact that Joel is a scary mother, taking on loads of people as a smuggler, he's most likely been in a lot of fights. So the "multiple traumas" you mentioned is pretty accurate to his lifestyle, considering he was easily able to guesstimate the kind of hand injury he got

I saw a game theory video about Ellie’s “immunity”. It’s not that her body is capable of killing the fungus. Instead she’s immune because she’s infected with a second fungus that attacks the first. Which I would say makes more sense. Because if it’s the immune system then it would eventually wipe it all out leaving her as negative, but with a second fungus it’s possible that it’s just keeping it from spreading rather than completely killing it

Its so terrifying to think about the infection , especially the clicker stage. The people infected know what’s happening to them but have no control over their actions and are having a really bad trip on top of that , and to feel a mushroom piercing through your skull and flesh from the brain without being able to do anything about it i find horrific. To me these are the scariest zombies to think about it

There's a theory that the fungus works as a symbiote a la Venom & produces glucose to feed the host, just to keep the body ticking along for the job of spreading the disease. Could kick in after a certain point in the infection when all fat reserves, etc have run out & the fungus panics. Pretty cool idea, I think Roanoke Gaming came up with it.

I don't know of any antifungals that are actually safe for humans to ingest, which is kinda important if the fungus can survive INSIDE a human. All the antifungals I know of are topical ointments for topical infections, and have all sorts of giant warnings to not get them near your mouth.

9:40 Lol I love your snark there cause you are so right xD

Love seeing you break these down! Also it's funny, the special effects when they were cutting into the victims actually squicked me out and I had to look away for a bit! Funny how I can handle that kind of thing in a video game but if the makeup artists do a great enough job with the practical effects I have to duck out 🤣

Too bad you didn't cover the creepy and weird "kiss" as you could call it. But anyway, it's very nice to hear how close this all is to reality, what's real and where the leaps in logic take place! Very interesting!

I loved where he referenced the mandalorian talking about not showing Pedro's face 😁

I think the moment that the professor knew that a bunch of people from the factory were missing, she knew containment/quarantine would be hopeless. We just saw how it was with Covid, especially in a third world country like Indonesia which is also very porous - very similar to my country which is also very porous and also 3rd world. Governments may try lockdown but as soon as even a handful of people get accounted for, it'll just be close to impossible to stop the disease.

What I liked about this episode's cold opening is that the idea of bombing came from the medical professional. Not only that mut the military man, the person who should be used to bombing, is in utter shock and horror at the idea

The "large exploding infected" ellie mentions are also in the game, but only a couple times as bosses.

I don't think Joel is on the Adkins diet. That was just him avoiding eating food her perhaps didn't want to eat. Considering how Mr. Adler was feeding the biscuits to his mother. Sarah didn't like raisins therefore, she didn't eat the cookies. Because he was late getting home from work, Joel forgot the cake. It was all just like they narrowly kept missing out on the flour due to a set of circumstances, not due to the Adkins diet. Remember Joel was relieved they didn't have any pancake mix/flour so they had eggs that Sarah cracked the shells into.

from his experience in Chernobyl, Craig Mazin avoided spored because taking masks on/off was a pain to shoot. in addition to not seeing your stars' faces, you get audio and continuity issues

Joel isn’t actually on Adkins diet. He was going to eat a cake with Sarah that night. He just didn’t want to eat any of the biscuits😂

Your explanation of infection rate also explains the proliferation of limb amputation in the Boston QZ seen in episode 1. You get bit in arm/leg, then there’s a window of opportunity to cut away infected area.

You were pretty spot-on with Clickers (the infected with the plates growing out of their face). Clickers are infected who've survived for several months, which gives the fungus enough time for plates to erupt out of the head and through the face. Due to this, it actually renders the hosts completely blind, forcing them to rely on echolocation, which is why they croak and click, giving them their name. Eyesight is usually the first to go when one's been infected with Cordyceps due to the fungus targeting the brain and eyes, even Runners (the newly infected) have poor eyesight, which only gets worse as the fungus destroys their eyes and face when transitioning to a Stalker, and eventually to a Clicker.

Just a note: In the game, the infected actually eat. You can sometimes surprise them while eating scraps, leftovers, animals, and all the food they can find. Of course, in a post-apocalyptic world, free food isn't something that you can find everywhere. This is the limiting factor to the infected's lifespans.

Something I noticed in this video and not when watching the episode (this has NOTHING to do with the medicine side of things), is the sound ambiance during the whole first scene. It's so reminiscent of Chernobyl, the looming threat and all, the same kinds of vibes in the music. It's such a great ambiance for a end-of-the-world-like show. So ominous, so powerful.

Fungating Tumours are a thing I could quite happily have gone to the grave without knowing about. So thank you for that.

I saw some video about Ellies condition. It was speculating that Ellie is infected by *another* cordyceps strain that is actually used as an anti-fungal medicine, meaning it kills off the "dangerous" cordyceps but still tests positive since it's a cordyceps. And that's why she's "immune" to the dangerous one. (She's not actually "immune", she's just infected by something else that stops the other one from infecting her.) It's an interesting theory. (Game theory! That's where I saw it! Just remembered now :P )

I'm really hoping you keep this up for the rest of the series. Very cool to get a doctor's perspective on all these things!

Another great vid as always doc! I really hope you keep up with the series. I just watched this with a friend and was just saying that the observations and information you present in these vids give me a greater and deeper understanding of what the writers likely intended with all their subtle details that I had missed.

Love your review of the series! I actually find it highly interesting how they were able to translate video game elements into "real life" practical effects. The clickers (zombies with mushrooms on their heads) look SO TERRIFYING. When you play the game a couple of times you get used to it, but I do remember Pedro and Bella saying that all the infected they have in the show are makeup and practical effects... the attention to detail of this show is just sooooo goooood!

I've been avoiding all The Last of us videos because it's infecting RU-vid like a disease but the second I saw you upload on the topic my blood froze. Never clicked so fast. This channel is perfection.

These videos are so fantastic, thank you! Looking forward to your thoughts on future episodes!

I've always had a theory about Ellie's immunity, and you sorta touched on why. There is undeniably a fungus within her body (which isn't just a case in the show. This was a fact in the game as well). By all accounts, she is infected, but is asymptomatic. The fungus spread to her brain, and likely to the rest of the body as well, but it's my theory that it mutated in an unfortunate way (either in the infected who bit Ellie, or within Ellie before the incubation period was over), which makes it incapable of taking control of its host. It also doesn't progress to a point where it starts sprouting from her head, so even the spread and growth seems to become dormant. One thing is certain: It's still alive. It at no point dies off and then gets discarded by her immune system--honestly I think a fungal organism that widespread just dying off inside you would probably cause a lot more problems than the immune system could handle, but I'll leave that up to the medical doctor ;) The conclusion of this theory is that Ellie is not inherently special. She is not immune like the game or show claims. The fungus within her is just "broken" for lack of a better word. From the game, we know spores have a pretty rough, immediately noticeable effect on uninfected. They cough and sputter, but Ellie can breathe them in all day and night, and not show a single form of irritation. I believe the fungus within an infected's body also eradicates other invading fungi, likely to ensure that several individual organisms aren't vying for control within a single host. I think the hive mind aspect depicted in the show makes this less likely to be the case, as the individual organisms appear to cooperate quite intricately, but we have yet to see the immediate effects spores have on an uninfected person and Ellie in the show, so who knows. All just my opinion, of course, so grain of salt and all that. If my theory is correct, then all it would take for a "vaccine" to be developed is to get a sample of the fungus in Ellie and purposefully infect others with it (with a bit of genetic engineering required to be absolutely sure, I suspect). This has a major implication for the ending of the game (and I assume the show), but I'm not gonna spoil it here.

Jesus, those fungating tumors sound horrifying. I think I'm too scared to google that

Yes, I was hoping you would do more! I'm really loving how you break this series down

Regarding the section "how long can you live without food", remember that at a certain point the human host is effectively already dead and it's the fungus itself that's living by devouring the host. How long humans can survive without food isn't really relevant to how long an infected could survive since the fungus can keep living even when the human is dead, the relevant factors would be how well the fungus can preserve the hosts tissues so they don't decompose and how much of the host the fungus has to consume over a period of time to keep going (how long can the fungus stretch it's "rations").

She recommended bombing because of how quickly it spreads and the TERRIBLE response time they had 30 hours since the first attack and the person killed wasn’t even patient Zero and that 14 other workers were missing/infected it was way too late

So glad you did more of this. Honestly, even though some of the science in this is a bit exaggerated, it really is impressive how much of it is grounded in reality.

I’m currently in nursing school and this is my favorite story series. WIN WIN

Just a quick fact, some fungi do utilize capillary movement, and some species do produce spore with flagella that are utilized for movement and propulsion. So, fungi are not universally immobile.

This is a lot of fun and great insight. I don't really know what else you cover but this is good enough for a subscribe!

Enjoying you talk about it. Please keep posting em until the season is over.

On the last of us podcast the creators also said that “carefull listeners will be rewarded with little bits & breadcumbs of knowledge”, & that breadcrumbs part pointes towards bread amd flour:)

You would think that a fungus couldn't possibly spread from a bite on your foot to your brain in 24 hours (Or from your face/neck into your brain in a few minutes) but there are some fungi capable of growing at rates up to 0.2 inches a minute when the resources for its growth are available. If this Ophidiocordyceps was consuming tissues as it expanded (or once it accesses the blood it can rapidly colonize in or around the brain) its possible that the fungi is flooding your blood stream with psychoactive chemicals to cause the initial symptoms (the twitching, agitation, psychosis, coughing and biting) as it colonizes the mouth to permit further transmission quickly. The mouth growths may actually erupt once the infection has progressed past that point which is why its only really present on people who have shown symptoms previous to losing their minds.

The showrunners actually addressed the lack of spores in the show... real world spores obviously get everywhere, and would theoretically be really hard to avoid. So the showrunners felt that the concept of spores staying extremely isolated/locational to a specific building/room/area like in the games would stretch the suspension of disbelief a little too far. And, like you noted, they didn't want their stars spending extended periods hidden behind gas masks, haha.

The underground network reminds me of why they say not to pick off a moldy spot on bread and eat the rest. Because it has already spread but you just can’t see all of it.

Thanks for the diagnosis Doc lol. I really enjoy your take on this I hope to see more content in the future.

7:57 THANK YOU FOR ANSWERING THIS BECAUSE I WAS CONSTANTLY ASKING WHAT " HAIRLINE " WAS HE TALKING ABOUT !?!

One thing about the fungus, is that it is weirdly symbiotic, feeding the body nutrients in order to gain some form of mobility. To have _some_ kind of vector with which to spread. Technically, _you_ die, but your _body_ survives, so long as nutrients can be fed into it, like through an IV. Plus, whenever the infected are resting, they're connected to the fungus. Some, having to wrench themselves free.

In the game and also the series, the prologue parts take place in 2003, so there's a chance that there were no, or not as effective antifungals that time

Me just waiting for the cell at work code black anime reaction i can't wait! 😁

For the spores, it's certainly been removed so as to not have the actors wear gas masks all the time, but it's also because in a video game it's way easier to suspend your belief that spores stay concentrated in one room/around one body rather than be carried away by the wind. In a live action TV series, the existence of spores would make everyone question how there's even any humans alive because it'd be way harder to actually lead a life if spores were implemented and worked as they would in the real world. Instead of the spores, they've made the fungi more aware and able to control a horde through a hivemind.

Love your reactions to the show ❤ please do moreee

I don’t think I’d be able to watch this show but I am really interested in the science behind it so I appreciate and enjoy your commentary on it!

Woot Sunday! Means new episode tonight and a new video!! Can’t wait!!😁

Love these videos on Last Of Us - keep up the great work! Just a thought, when you're cross-referring to real life examples (such as your explanation regarding some cancers that grow through our skin) it would be super helpful if you show pictures or videos to help reference what you're describing. Otherwise, love your work! 👍🏻

if you notice, during the opening credits the cordyceps is the shape of entire United States ( as if to show it covered everything.) then shows it morphing into an infected human, then into Joel and Ellie. Awesome visuals.

Back in the late 1800’s there was a bizarre outbreak of murders and suicides in Black River falls and Menomonie WI. It’s now thought that there was an ergot infection going around.

I've been waiting for this, thanks!

I just love how he had the same look on his face that I had during the incision shot. You know if the doctor is visibly grossed out, there's some nasty sh*t going down on screen 😅😅😅

I am so hyped for today's episode 🔥🔥🔥

Do u have any full reactions to this show available, I'm loving your explanations of injuries and take on this world then the normal emotions coming up from this show

The whole no medicine part, It's 2003 in the beginning of the outbreak. 20 years makes a difference.

A pet theory I have is that they're using the fungal network to explain some of the more specialized infected, like the clickers. The idea behind their design is that the hardened fungal growth around their face exists specifically to shield the brain from damage, but in the game, they never established how the fungus would know to do that. I think they might explain it in the show by saying that the network itself has some level of intelligence, like a hivemind, and that it's at least smart enough to guide the fungus to grow in such advantageous ways.

Such a good video!! 🥰 I legit think that HBO should partner with you, hearing your doctor's perspective really enhances everything. :) Also, I'm thinking the scientist going "bomb them" was just a bit of a fanservice moment 😅 I mean, I think we were all thinking it after the last episode lol

I think the show so far as done a good job at retaining the most interesting aspects of how real world fungi works, and knowing where to sacrifice realism to the benefit of the story.

This episode really convinced me. It's going to be a great show.

Great video thanks! I can’t believe you didn’t mention the Anna Torv infected kiss at the end though! What a way to spread the disease. The grossest thing ever! 😬

Speaking about the Clickers, the infected with their heads covered in fungus, the fungus does not grow around their face, if you look up concepts of their skulls, what happens is that the fungus becomes so massive that it breaks through the bone and exposes itself on the open

9:41 Mandalorian shows up with the windows error sound effect 😂

8:42 - I think they do this to close up one minor plothole in the games: the environmental damage is often too severe for 'just' infected rampaging, so fantheory had it that there may have been other concurrent natural disasters at the time; earthquakes and floods and the like. Here, the entire world went full-on Racoon City to explain whole buildings toppled in just 20 years of neglect.

I like your reactions! :D I wish you'd show a bit more though, from the show itself! :D Keep it up!

Hey great video! I'm no biologist or mycologist , but I did get my degree in astrophysics. The last video you said that it's not possible or rather highly unlikely that a cordyceps could jump from say an ant (or whatever other species) to a human because they evolved that way with that particular host. That's fair enough, totally agree. BUT that's the thing about science right? You want to make sense or explain the phenomena with the information we have over a subject of documented patterns from similar systems. But that's the thing right? A major point about why this is so scary is that it's new. Something completely different that hasn't been seen before. The frontier is when you find something out that *almost* can be described but in some prominent way that doesn't conform to established theories. That's why science exists. The idea that we see stars orbiting what is essentially nothing, makes no sense, then you find out about neutron stars or black holes. On the leading edge we have dark matter holding galaxies together. We have Dark energy accelerating the universal expansion. We have no clue what those are, except that they have properties that we can describe, but other properties that we just simply do not understand at this point, but it happens. I'd hesitate to completely dismiss something like this human cordycep outright. The machination of life, is far far far more complex than physics, and we don't even have that figured out yet. It's not a worry for anyone because it can't happen... until it does. Need I remind people that Anatoly Dyatlov was adamant that it was impossible that Chernobyl could explode. He knew in every fiber of his being it was physically impossible. Ya know... until it did.

7:14 there is a pretty nice analysis of this Ellie immunity on Game Theory channel. And their hypothesis is - prior to getting bitten by cordiceps-zombie, Ellie got another fungal infection. The thing is - a lot of fungi will try to avoid competition with different fungi species by producing anti-fungal agents that don't work again them but wipe out their competitors. So Ellie having another infection by a non mind-altering fungi makes her immune while still testing positive. And the implications here are - 1 it is technically possible to study her blood to isolate this cordiceps-killing agent and thus develop a cure. And two - probably she is not unique in having this kind of immunity... But most likely others who have it either never had a bite to need it. And those who got bitten probably were executed by others to not risk it. ... And this is why in the case of actual zombie abocalypse you don't just shoot people because they got bitten. You isolate and monitor them and only shoot when they show symptoms.

thanks man for explaining how this could never happen but still make me creeped out by the show because of all the details but still really good explanations

Sped up wildlife footage was the inspiration for how the cordyceps moves.

There are timeskips in between scenes in the show, so it could be believable during the scene with the mycologist that there was no such antifungal treatment available to help- both because it may not have existed yet or because their country is a second-world/third-world country.

not sure if it was in previous videos comments or elsewhere, but I read they moved year when Last of Us situation to 2003 because it was listed as one of the warmest years which would give fungus reason to evolve and Jakarta was especially warm, with ideal substrate for initial growth

According to Matt Patt, Ellie isn't immue but infected with a different fungus that doesn't turn her into a zombie but does keep the other fungus out of her body.

Dr Ed you’re on a roll!!😅

"Typhoid Mary" is a great name for a metal song!

Those split head open infected are nicknamed Clickers since their vocal cords are so degraded that they can only make contorted and clicking sounds which act as a sort of echo location

Doc, you are doing this incredible show the justice it deserves :D The nasty dudes at the end did echolocation through clicks though!

I just watched an interview with a mycologist talking about this show. I think you should check it out. It's on the New Rockstars channel. Hearing your take on this show from your perspective as a doctor and now the mycologist has made me enjoy this show even more. I can not wait for your take on 3rd episode

Only Ellie was eating bread, since she is inmune, Joel and company eat beef jerky, flour is avoided to this day

in The Last of Us (Game) Spores can infect people, very often Infected reaching the end of their life span and being unable to go on with the state of their bodies, rush to cold, humid, dark places, lean up against a wall and die there while the Fungus produces spores, in the TVShow that idea was cut because the actors using Gas masks alll the time wouldt be convenient, so it was replaced with the network of Fungus on the ground that can alert hordes as far as Kilometers away from the place.

On the hairline fracture, I was given a diagnosis of a hairline fracture when I fell approximately one story onto my side hitting the ankle on the ground, going by your definition what I had was a closed non-displaced fracture. I'm not sure if doctors use the term interchangeably with closed non-displaced fracture, but it was definitely expressed to me as a hairline fracture.

I saw some people talking about why the fungus only grew the most around the head, I thought it was because the cordyceps wants to get to the highest point for its spores in real life so maybe it's the same in TLOU universe.

So in the game at least that fully infected is called a "Clicker" and can't see due to the intense fungal buildup on their head. They use a form of echolocation though, thus the clicking sound.

Don’t know if it’s been verbally explained in the show yet (has been visually), as time progresses with the infected individuals, they lose their eyesight. The two in the room couldnt see in the dark but react to sound (think they also react to contact of light but not sure) Also I think the growth of the fungus around the skull acts like an extra protective measure for the infected brain.

Fungi do move some species pulsate and you can see it. Specifically slime molds

I only just realized after watching this video that the third episode is up now. Monday here in New Zealand, and its online at 3PM. It's 15:54 now.

I love that a doctor makes the same face that I do during the gross parts.😂

What about as your next series reacting to the new ITVX drama ‘Maternal’? There’s a lot of interesting medical scenes as well as the emotional lives of doctors being explored. There’s also a frequent appearance from a former ‘Inbetweeners’ actor. Keep up the good work and I hope you and your NHS colleagues are doing well 💙