IF YOU’RE KEEPING up with HBO’s The Last of Us, you’ve seen that Frank’s downfall, shockingly, has nothing to do with zombies. But it may be something just as bad.
By the end of Episode 3, we’ve already met Frank (Murray Bartlett), and have gotten to know him through a number of different time points over a 20-year period. By the time the episode catches back up to 2023, he’s battling some sort of disease, but doesn’t share much about what he’s suffering from.
Coming 10 years after the episode’s previous segment set in 2013, Frank is now in a wheelchair, unable to walk. His partner, Bill (Nick Offerman), is left to tend to him— helping him in to and out of bed, and reminding him to take his assortment of pills. Fans are begging the question: What illness brought him to this state?
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When discussing Frank’s condition on the official The Last of Us podcast, co-creator Craig Mazin says Frank has an unspecified neuromuscular disorder.
“We didn’t necessarily want to specify [the illness] for the audience, it was either MS or early ALS but it was a degenerative neuromuscular disorder,” Mazin says.
Neuromuscular diseases, or NMDs—such as multiple sclerosis (MS) or amyotrophic lateral sclerosis (ASL)—are caused by a dysfunction in the nerves that affect your voluntary control muscles, and the nerves that carry sensory information back to your brain. Neurons, or nerve cells, collect and dispense information to and from the brain. In people who have neuromuscular disorders, these cells break down, leading to muscular issues.
These muscular issues can trickle into a load of other problems, such as muscle weakening, twitching, cramping, pain, balance issues, trouble swallowing and trouble breathing, according to Cedars Sinai.
All NMDs have a prevalence rate between 1 and 10 per 10,000 people. Some NMDs are more common than others, however. Nearly a million people in the United States live with MS, according to the National MS Society. ALS is much less common, with about 30,000 people living with it in the U.S.
In The Last of Us, Frank talks about his condition, saying that there wasn’t a cure for it even before the world collapsed. The same is true today; there is no cure for NMDs like ALS or MS, and no known treatments to regress degeneration.
While MS in itself is not fatal, it causes several issues that could lead to a premature death, such as swallowing or respiratory issues. ALS is a bit different; it is fatal, typically causing respiratory failure within 3 to 5 years of symptoms developing, according to Johns Hopkins Medicine. Studies have found that patients with ALS are at an excess risk of suicide, and there has been an uptick in physician-assisted suicides with patients of this nature in other countries.
In a heartbreaking end to their love story, Frank and Bill ultimately decide to take their lives together, lacing their drinks with enough pills “to kill a horse.”
Cori Ritchey, NASM-CPT is an Associate Health & Fitness Editor at Men’s Health and a certified personal trainer and group fitness instructor. You can find more of her work in HealthCentral, Livestrong, Self, and others.
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