HEY FANDOM WRITERS I HAVE A THING FOR YOU. See, I’m working on a fic right now where I decided to make use of Cecil saying in canon (twice!) that he can’t feel pain, because a lot of authors seem to ignore that.
And then I started doing research and realized there aren’t really any articles directed at laymen about the inability to feel physical pain. I’m from a medical family and reading Medicalese is sort of second nature to me, but hoshit CAN I EVER SEE WHY PEOPLE WHO CAN’T JUST WRITE HIM AS FEELING PAIN.
So here is a handy-dandy guide of shit I’ve learned about Cecil’s condition, translated into plain English.
WHAT THE HELL IT’S ACTUALLY CALLED: depends on what you’re going for. There are two different disorders that can make you unable to feel pain: congenital analgesia, also called congenital insensitivity to pain or CIP; and the HSAN group of disorders (confusingly, CIP is classified with these, but isn’t the same thing). Most of these are recessive, which makes CIP and HSAN 2 through 5 unlikely candidates for affecting 53% of a town. HSAN I, however, is autosomal dominant. That means if your parent has it, there’s a 50% chance you do, too—and that makes it seem likely that it’s actually HSAN 1, not CIP, that Cecil mentions having. (And HSAN stands for hereditary sensory and autonomic neuropathy, if you were wondering. Also, if you don’t speak doctor, the English version: you get it from your parents, it affects your ability to feel shit, and it’s actually your brain that’s fucked up, not your nerves, although there can be nerve damage, too.)
HE CAN’T FEEL PAIN, WHAT MORE IS THERE TO KNOW? A metric fuckton. For starters, being unable to feel pain means he needs to check his body—his ENTIRE body—at least once a day for injuries, because unless he sees blood there is literally no way for him to know he’s hurt. People with HSAN can develop ulcerated wounds—think “zombie a week after death” here. Those wounds and infections can turn into necrosis (literally, your skin and bone dies) and require amputation. Cecil is actually in pretty constant danger of becoming very ill if he doesn’t watch his ass.
Some people with HSAN also have anhydrosis, which is a nice fancy word for “they don’t sweat worth fuckall.” That might not sound like too much of a problem until you know what sweat is: your body’s way of keeping you from overheating. CECIL LIVES IN A DESERT. Having lived in one myself, I can tell you that a good eight months out of the year you’re sweating as soon as you step outside—literally.
And now for some miscellany:
—some people with HSAN can’t feel anything but pressure. That means sexy time with Carlos—is mostly for Carlos’ benefit. Depending on how severe Cecil’s HSAN is, it’s entirely possible the only pleasure he’d get is psychological. (Most of the information I found on this related to CIP and CIPA—congenital insensitivity to pain with anhydrosis—but some people with HSAN reported it, too.)
—We don’t know a whole lot about itching, but we do know it’s caused by the same nerve responses that cause pain. Cecil can’t feel itches.
—It is genetically impossible for Cecil to both have HSAN and be ticklish.
—We also don’t know what causes headaches, but people with HSAN don’t get them.
—most people with CIPA don’t live past the age of 25. I couldn’t find statistics on HSAN, but it’s likely that Carlos would be stunned by a town full of 40somethings who are apparently thriving with HSAN and related disorders.
—One of the biggest dangers with HSAN is joint damage. Because people with HSAN can’t feel discomfort and shift out of joint-stressing positions as a result, they can easily damage cartilage, tendons, ligaments, and even bone. Given how much of Cecil’s job involves sitting hunched over a sound board (Cecil mentions that he sits in a sound booth and never mentions a sound engineer), it’s entirely possible that he does it from a wheelchair or in a back brace due to hip and spine damage.
—Many parents of HSAN and CIPA children will have primary teeth pulled as they come in. This is because a teething baby who cannot feel pain will literally bite their fingers to the bone or bite through their lips. If Cecil’s teeth were not pulled and he has any form if CIP or HSAN that isn’t type one, the odds are heavily in favor of him having scars on his face and hands from teething.
—It’s unlikely that Cecil has complete anhydrosis (can’t sweat at all) because activities like backpacking through Europe would have killed him years ago. Any Cecil with anhydrosis almost certainly has partial anhydrosis, which is the inability to sweat as much as you need to.
—HSAN I usually starts around the same time as puberty and often begins in the legs and feet. It’s not impossible for Cecil to have had it all his life, but it’s equally possible for him to actually have a comprehension of what pain means.
—Cecil can have ANY KIND OF INJURY AT ALL without knowing it’s there. One case I read involved parents who discovered their three-year-old daughter had CIP after she literally crushed her ankle—and proceeded to happily hobble around on the fractured bones.
—People with HSAN may or may not be able to fully grok temperature. Concepts like “too hot” and “too cold” are purely theoretical; Cecil cannot feel himself either being burned or getting frostbite.
—only one in 25,000 people in the general population have HSAN. Statistically speaking, every single person in the United States who has HSAN must live in Night Vale. (Either that, or the incidence literally doubled when Carlos discovered HSAN in Night Vale.)
—nobody actually knows what causes HSAN, and it’s incurable. The best we can do is shrug and say “it’s some kind of genetic mutation”—which is why I didn’t go into super-specifics here, because if Night Vale is a mostly-closed community, it’s entirely possible they’ve developed a mutation of a mutation and that the forms of HSAN and CIP we know are not the one or ones present in Night Vale.
If you’re planning on writing a Cecil with CIP or HSAN in any depth, you should probably do additional research—but this should get you started, and I hope it helps.