#but I've seen so many people being very sad about Caracalla's health that like. you can also now have this

[inseparabiles]

My (least) favourite part about writing fic for this ridiculous fandom is trying to play Google PhD for Caracalla's fantasy-convenience syphilis.

You don't get to just have symptoms from every godforsaken stage of the disease at once willy-nilly like you're collecting them in jars for display. Pick one or AT MOST two stages at once and sit with it. Christ.

Let's see what we've got here. Welcome to my unlicensed clinic for fictional people and friends only, but do take this neutral disclaimer that I dropped out of school at 12 so I'm totally a professional and this analysis is medically sound as all hell.

Ready? I'm not.

Primary stage: 2-12 weeks after infection - congratulations, nothing here. I have not checked his privates but the only symptom of the initial stage is the chancre, which lasts for up to six weeks before healing on its own and nothing else exists in this stage so. Clear based on presence of other symptoms.

Secondary: 1-6 months after primary stage. - rash, check - fever, can't measure without touch or thermo but a safe check anyway - sores, yes but in a weird location (how are you getting these on your cheeks exterior, tell me). - muscle aches, check. Have you seen how this boy walks? How he holds his hands? - weight loss, don't know. He's petite, doesn't really look malnourished. - headaches, hard probably. - hair loss, none. Fluffy as fuck. - swollen lymph nodes, again I have no touch contact. Probably though. - sore throat, no complaints and has no issue shouting.

Latent: that stage after secondary, where you kind of just don't have symptoms most of the time, but the virus is getting everywhere. Spine, brain, heart, nerves, organs, everything. Flares are possible but mild. Lasts up to 20 fucking years - our boy is like... 25 at most. Hopeful? Not so fast. Based on all evidence and speculation, I wouldn't give Caracalla's immune system much credit as to its ability to hold the infection at bay and the "up to" numbers are best case scenarios. The lowest range for how long the latent stage can last is three years, but quicker progression is usually seen in AIDS patients, and AIDS didn't exist in 200 AD, so we're ignoring that. Despite this, given the era and its customs and culture, it's perfectly possible that Caracalla's caught his infection in his early to mid-teens, which...

... no symptoms to check against, so, moving on,

Tertiary: Most people with untreated syphilis never hit the tertiary stage, because the infection takes so long to get to this point. Up to 30 years. Yet somehow, Caracalla manages to have tertiary stage neurological symptoms from advanced neurosyphilis while not having the physical symptoms or, sans despair-inducing circumstances, the age to show for it. And while having the definitive second/latent stage symptom of skin rashes, which you do not have in the tertiary stage at all. And you don't get to speedrun this stage either: you can live with this thing for twenty years without dying of it. You don't just hit tertiary one day and die next week. Again, how are you managing all of these cherry-picked symptoms and HOW are you fast-tracking them and yourself to hell SO fast. This is going to be such a long list but here we go: General: - brain damage / dementia / cognitive problems, absolutely. - heart disease, nope. - movement disorders and muscle problems, aside from the forementioned pain, no (clear) evidence. - nerve damage, no evidence. - seizures, none. - vision problems / blindness, none. Neurosyphilis: (can and will develop at any stage, however, symptom progression seems tied to general progression, you don't get to have tertiary stage symptoms with secondary stage disease, etc. Except if you're Caracalla and the gods hate you I guess.) Meningeal: - headache, hard probably - nausea and vomiting, no evidence - neck stiffness, I mean sure but he also sits like a sack of potatoes, differential diagnosis of your fucking posture sucks so much - light sensitivity, honestly Geta suffers more of this than Caracalla does (I think this is Joe's fault and I relate) - vision or hearing issues, still nope - cranial nerve dysfunction, no evidence

Menigovascular: - vertigo, no evidence - stroke, thank gods no - muscle weakness or atrophy, still petite but looks fine, twin comparison checks out

General paresis, early: - mood disturbances / irritability, very much - personality changes, yes (based on Geta's statement) - changes in sleeping habits, unknown - forgetfulness, dear god and how.

General paresis, late: - mood swings, and how - memory loss, yes. - impaired judgement, sorry is laughing at this inappropriate - confusion, yes - delusions, yes - seizures, still no.

GP / psychiatric: - depression, no - delirium, hard maybe - mania, no evidence - psychosis, well on the way there

Tabes dorsalis: - ataxia (issues with coordination), reasonable or strong evidence sans differential (drugs. he's on so many drugs) - nerve pain, probably - bladder control issues, most likely not - outside of differential (script case -> fear) - abnormal sensations, we just won't know - vision changes, still no evidence - pupil abnormalities, none - loss of coordination/reflexes, some sans differential (DRUGS) - neuropathic arthropathy (bone/joint fragmentation), none - problems walking, some

So with all of that out of the way, this boy's manifesting: - none of the initial stage as far as we can tell, so he's had syphilis for longer than six weeks. Great, this really narrows it down, lads. - nearly all of the secondary stage symptoms, including rash, which is not present in other stages, indicating that he's either secondary or latent stage per presentation (1-20 years after infection). - one definitive symptom of tertiary stage syphilis, being his absurd amount of neurological / neuropsychiatric symptoms. Even then it's almost impossible for him to be at this stage under any circumstances, but here we are. TERTIARY STAGE DOES NOT HAVE RASHES OR OUTWARD SYMPTOMS. TERTIARY STAGE IS INTERNAL ONLY. (screams into a megaphone in the general direction of Hollywood) - three symptoms of early general paresis - every single symptom sans seizures from late general paresis (again you can't have this with your other symptoms by ANY standard that I have been able to dig up. Like based on medical law this is literally illegal go straight to fantasy disease jail.) - let's say one whole symptom of neuropsychiatric made out of two halves, with psychiatric disorders manifesting in late stage disease - 2½ symptoms of tabes dorsalis which is whatever, as none of this is technically outside the legal zone of what he's allowed to be experiencing.

WHAT THE FUCK KIND OF DISEASE PROGRESSION BLIND BAG ARE YOU DRAWING FROM. No wonder everyone's so worried about you. You're either going to die an absolutely excruciating and horrifying death in a week or in 50 years and nobody can tell which is it going to be.

The only thing we can say for somewhat certain is that regardless of where his disease progression is headed, his mental state is not going to go back to fine ever again thanks to the plentiful evidence of physical and permanent brain damage from his infection, even if he was pre-latent and experienced a decent degree of improvement in the asymptomatic period - but honestly, as a person of questionable mental and physical state myself, I relate to and accept this. Disability is not a death sentence.

The rest of this though? What the hell. What are we supposed to do with this. Who do I sue.