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zenaidamacrouras1 · 1 year

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Writing Modern Steve Roger's Health Issues: A compendium

AKA How do Steve Rogers' MCU canon illnesses hold up in a modern setting?

I am writing something that is SO NICHE and so NERDY I feel absolutely, positively deviant about it. Who knew you could have this much fun while eating a burrito and sitting in the sun on your back porch?

OKAY! This one goes out to all of you writing modern AU's with a modern Steve Rogers. (There are literally dozens of us!). Let's go.

So, I find it somewhat problematic when people write disabled or otherwise medically complicated characters and are wishy-washy about the diagnosis they have. In real life, everyone I know with ongoing medical issues is a fucking expert on their exact shit. A great tumblr reference for disabled characters is Cripple Characters, but I also use reddit threads to read about people’s day to day experiences with different issues in their own words. If nothing else, just decide what your character has and take ten minutes and read through a basic website article about it.

So let's walk through what modern Steve's medical history and diagnoses might be. If you feel like I missed any details or got things wrong, happy to have comments to that end.

We'll start with the list of “ailments,” going with the MCU canon and combining the images from the museum exhibit and screen shots of Steve’s enlistment forms:

Asthma

Scoliosis

Fallen arches

Partial deafness

Scarlet Fever, Rheumatic Fever

Heart arrhythmia

High blood pressure

Palpitation or pounding in heart

Easy fatigability

Stomach ulcers

Pernicious anemia

Nervous trouble of any sort

Sinusitis

Chronic or frequent colds

Caveat: I am not a doctor, but I am a person who enjoys reading medical journal articles about illnesses I do and don’t have. The human body is a fascinating and terrible place to live. Talk to me about your medical complications - I will always find them interesting. I love small talk about Crohn’s disease and/or extremely graphic details about the time you had surgery because one of your wrist bones was the wrong length.

Sucks To Your Assmar: Asthma! How has asthma changed?

Kids who have their asthma well managed at a young age are going to have less scarring and lung damage (this is called airway remodeling). Thus a modern kid will likely have less severe asthma than a kid born in Steve’s time. Further, allergy medicines got way better from the 1990s, so kids with allergy induced asthma would have had fewer attacks. Fewer attacks as kids = less severe asthma as they age.

I would also note that asthma is highly connected to environmental issues. If Steve grew up in a house with cigarette smoke, cockroaches, rats, or mold present, as is fairly easy to imagine, especially without dehumidifiers in a swampy Brooklyn summer, those are environmental factors that would have made his asthma much worse.

They are also all factors that kids today certainly face, depending on how you write your modern Steve’s childhood. While people today certainly can have very severe asthma, it’s also entirely possible that modern Steve’s relationship to his asthma is pretty chill and easy to manage. (My partner has relatively severe asthma with a lot of environmental triggers; modern allergy medicine was a big game changer.)

Let’s talk about scoliosis ~~

There are a lot of variations to how scoliosis impacts people. I have very minor scoliosis and it's barely a thing in my life. I’m not trying to speak for everyone, but for what it’s worth, there are professional athletes with spinal fusion. I used Kyra Condie as my justification for writing climbing coach post-spinal fusion small Steve Rogers in one fic. My younger brother and best friend in high school both had spinal fusions.

In reality the athletic and physical abilities of people with spinal fusion vary pretty much exactly as much as people without spinal fusion, so you have a lot of leeway for how you decide to write a character with scoliosis. I recommend reddit threads to read about people talking about how their bodies felt before and after spinal fusion, or why they decided not to have the surgery, if you want to get a sense of how it might affect your character’s day to day life.

Wait, so how tall is modern small Steve Rogers?

You can see in this article that gains in height post scoliosis corrective surgery/spinal fusion varies, but the mean was 27 mm (1 inch) and the maximum was 66 mm (2.5 inches).

The more severe the curve in the spine, the more height gained with surgery.

We know Steve had scoliosis, we don’t know how severe it was (do we?). But if he was 5’4” without spinal fusion, and with all of his childhood fevers, and possible poor nutrition due to the Great Depression and untreated stomach ulcers, then it’s very reasonable that a modern Steve raised with proper nutrition and his gastrointestinal issues (see below!) properly treated and a spinal fusion could be easily 1-10 inches taller.

I think it’s great if you want to write modern Small Steve as 5’4” - but I tend to write him as 5’7” or so.

I think it is entirely likely that a modern Steve Rogers could end up being 6 feet tall given modern medical intervention and a healthy digestive system and adequate nutrition. As an example of how people with more or less the same genetics having different heights due to environmental factors, I know of one family of four brothers that immigrated from Italy in the 40s. Their height was 100% correlated to their age when they moved to the US/started having access to food: the oldest brother was around 5’4” and the youngest around 6 feet. The oldest was also a chain smoker and worked full time from around age 8, so you know, he was a fucking badass 5'4" Italian guy, if that's not clear.

What about fallen arches?

Fun story, but I have fallen arches/flat feet and had a lot of foot pain as a kid, but I thought it was normal. I wear custom orthotics and/or birkenstocks and do exercises to strengthen my feet muscles and it's fine now as long as I remember to do the things I just mentioned. My dad had to have multiple surgeries on his feet, so I think it helped that they caught it earlier in me.

Should I write modern non-serum Steve as deaf?

Maybe! I think it’s lovely when people write characters with hearing issues. There are great blogs that cover ways to do that well (a good link, another one, and another one and I think this one on hearing aids is particularly good if you are trying to bring in subtle day to day routine differences a character that wears hearing aids may have. Another great option is, again, reddit, especially for questions around how sexual intimacy might vary in small ways that can be nice to bring in. (I am working on a fic with a seeing character whose ex is blind and also read a lot of couples first hand experience with sexual intimacy around that dynamic on reddit).

But how likely is it that modern Steve would be deaf?

I think that it’s reasonably likely that Steve’s hearing issues were a result of Scarlet Fever, which is a bacterial infection that can result in rheumatic fever, an inflammatory condition that develops in more severe cases of scarlet fever.

Scarlet fever caused deafness - in fact, both Helen Keller and Thomas Edison had hearing loss due to scarlet fever infections. Further, sustained fevers of over 104 degrees can also cause hearing loss, so there is a reasonable chance that some other fever caused Steve’s hearing issues.

Today, the kind of hearing loss caused by fevers and infections can usually be surgically repaired or never occur because we have better antibiotics and better medicines to treat fevers. However, I have a friend who has partial hearing loss and lots of other life long nervous system and fatigue issues due to complications from childhood chicken pox in the 80s (this vaccine came around in 1995).

I don’t know if it’s canon or fanfiction, but I often see Steve as having one bad ear. For what it’s worth, hearing loss in one ear is much less common than hearing loss in both ears.

However, potential causes of hearing loss in one ear are infections that result in a high fever and some kind of head trauma, both of which are easy to imagine would have affected a Steve born in 1918, and while possible in a modern Steve, also easier to avoid.

Heart Stuff: Heart arrhythmia, High blood pressure, Palpitation of pounding in heart, Easy fatigability

The aforementioned fevers that can cause hearing loss can also cause heart issues. I think it’s reasonably likely that Steve’s heart issues were from his fevers as a young kid, but I often write him with a congenital heart defect, because why not?

These days, most of the time, such issues are detected at or before birth and fixed when the person is a baby, but there are plenty of heart issues that can require multiple heart surgeries at various points. Regardless, a modern Steve would most likely either have had access to corrective surgery or medication to manage these heart conditions. Which is not to say that he wouldn’t suffer mental and physical trauma from this medical complication.

There are plenty of professional athletes you can find who have all of the above heart issues. And plenty of people with heart issues who have no interest in being professional athletes, so like, follow your bliss.

Digestive System Stuff: Easy fatigability, Stomach ulcers, Pernicious anemia

I have easy fatigability under heart stuff too, because lots of shit can make you tired.

My personal head canon is that Steve Rogers has celiac disease and/or lactose intolerance, it would cause all of the above. Both can also lead to poor growth - in fact falling off growth charts is one of the most common symptoms of celiac disease in children.

While people have been aware of celiac disease since there were people, gluten wasn’t identified as the clear cause till the 50s.

I typically write modern Steve with some kind of food allergy, and I think that addresses quite a few of his canon medical complications.

Because so many causes of this category of symptoms are relatively easily solved with modern medical intervention/avoiding the problem, I would point folks towards Crohn’s disease if you are looking to write a modern character with medical issue that is more likely to be an ongoing source of similar medical complications today.

(Also, kids with Crohn’s are likely to have reduced height. I have a friend who has Crohn's whose 3 siblings are well over 6 feet and he is around 5'8" (so 4-6 inches aka 11+ cm shorter due to his severe childhood illness).)

Nervous trouble of any sort

Kids with medical complications and food allergies are much more likely to have anxiety. I’m so proud of all the kids making it through the day with anxiety. Luff you anxiety kids, I see you working twice as hard to be present as the non-anxious kids. Tough as hell. Give yourself a high five. I’m so damn proud of you.

Sinusitis and Frequent colds

I mean, god bless modern decongestants and allergy meds. Celiac disease and lactose intolerance can both cause sinus issues, so here is another one of Steve's ailments that can be "cured" through that diagnosis.

Other stuff

When you look at the above, you can see a lot of scenarios where modern era Steve, like many children/adults today, had multiple surgeries and serious and scary health complications as a child, but as an adult would appear as a relatively healthy able bodied person, with the possibility of even becoming a top athlete if he was so inclined. It’s also likely that some issues like chronic fatigue etc, might linger into adulthood as relatively invisible illnesses that nonetheless affect his everyday.

In some ways his character arc given the advances of modern medicine could mimic his arc due to the serum.

Being medically complicated as a kid sucks. Even if you have surgeries to treat and/or learn how to live with things like Crohn’s and celiac and reduce flare ups, lingering mental health trauma can have an impact.

Lastly and most importantly, I have a personal headcanon that young Steve Rogers of any era spent a lot of time sick in bed and staring into a mirror learning how to raise one eyebrow and perform other eyebrow gymnastics so he could more effectively sass his nurses.

IN CONCLUSION:

I think it's actually reasonable for an author to say, "My modern Steve never had any fevers, and got his severe lactose intolerance diagnosed as a baby, and had good nutrition, had medications/clean environment that prevented his asthma."

So this Steve is 6 feet tall and healthy as long as he doesn't eat dairy and takes his daily zyrtec (cetirizine - it's an allergy med). The only medical issue he has from canon left is scoliosis, flat feet, and an astigmatism.

You can also choose to write a Steve with more complex medical issues, and there are lots of things that can be good and interesting and value about that. I think the main thing is to pick a diagnosis and write it realistically, hopefully this helps some with that!

#stucky fanfiction #smol steve #writing disability #steve roger #pre serum steve rogers #modern steve rogers #honestly whats wrong with me #I don't even know but I feel like I'm dealing with my mental illnesses well enough and I had fun writing this #meta #headcanon #stony fanfiction

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