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What Disease Did Frank Have in ‘The Last of Us’? Here’s How His Death In the Game & Show Differ

Murray Bartlett, The Last of Us.
Murray Bartlett. Courtesy of HBO/Warner Media

Warning: This article contains spoilers for The Last of Us on HBO. If you watched the latest episode of HBO’s post-apocalyptic drama, viewers were left with at least one unanswered question at its bittersweet conclusion, namely what disease did Frank have in The Last of Us that caused him to want to end his life?

The Last of Us is a pitch-perfect adaptation of the 2013 Naughty Dog video game by the same name. It’s set 20 years after a fungal outbreak has decimated much of humanity. While there are moments that are, shot for shot, taken from the game, for other parts, the show drastically expands on and shifts parts of the narrative in a really meaningful way. One of the most significant examples we’ve seen in the first three episodes is Bill and Frank—namely, the nature of their relationship which is only hinted at in the games. In the game, we never meet Frank; alive, at least, which is another departure. So, here’s how his death in the game and HBO show is different.

What disease did Frank have in The Last of Us?

What disease did Frank have in The Last of Us? In the show, the illness that gradually incapacitates Frank isn’t actually named but we suspect, given his symptoms, it’s multiple sclerosis (MS) or another uncurable neurodegenerative disorder. By his story’s conclusion, Frank is bound to a wheelchair and his hands are rigid in a way that fits with this particular autoimmune disease. He also mentions that there’s no cure for his ailment.

The Last of Us
The Last of Us. Courtesy of HBO/Warner Media

On HBO’s Last of Us podcast, which is hosted by Troy Baker (Joel in the games), showrunner Craig Mazin confirmed Frank suffered from a neurodegenerative condition—but doesn’t mention which one specifically. “We didn’t want to necessarily specify it for the audience,” Mazin said. “It was either MS or early ALS but it was a degenerative neuro-muscular disorder. And, you know, this happens. It happens so commonly and yet so rarely.”

He continued: “As people get older on-screen, they tend to be fully healthy until a heart attack staggers them out of nowhere. That does happen, but for a majority of people, there’s a decline and we thought it was really interesting to think, ‘Look, Bill is older—Frank can literally run circles around him—Bill gets shot and then we jump ahead a number of years and it’s Frank that’s been brought low by this disease and there’s nothing they can do about it.” Both MS and ALS eventually impair speech as they eventually affect facial nerves. His quality of life is already suffering and this is ultimately why Frank chooses to end his life. What he doesn’t bank on, though, is Bill deciding it’s his time, too.

Towards the end of the episode, ‘Long Long Time’ we see how Bill and Frank’s story ends. As morning light streams into their sunroom, Frank decides it’ll be his last. He asks Bill to give him “one last good day”. They exchange rings, eat a beautiful meal together and as his final wish, Frank asks Bill to crush his pills into his wine where he will fall asleep in Bill’s arms. Distraught, Bill decides that he no longer wants to be alone and tells Frank he’s split the pills between them. “This isn’t the tragic suicide at the end of the play,” Bill says. “I’m old, I’m satisfied, and you were my purpose.” Frank is initially angry but concedes that, “from an objective point of view, it’s incredibly romantic.” They have their last drink and go upstairs to the bedroom where they’ll spend eternity together.

When Joel and Ellie arrive at Bill and Franks, the dying, dried-up flowers on the porch signal to Joel that something is wrong or has changed. Ellie discovers a note left by Bill addressed “to whomever but probably Joel”. Bill asks that he and Frank’s bodies be left undisturbed in the bedroom but that they left a window open so the house wouldn’t smell.

“I never liked you but, still, it’s like we’re friends. Almost. And I respect you,” Bill writes. “I used to hate the world and I was happy when everyone died, but I was wrong because there was one person worth saving and that’s what I did. I saved him and I protected him. That’s why men like me and you are here. We have a job to do.” This note ties in nicely but contradicts what Bill tells Joel in the game, which is that caring about someone will eventually get you killed. It’s a beautiful divergence from the games and something true fans of the game should be pleased about. “They get to go out on top,” showrunner Neil Druckmann, president of Naughty Dog, told TV Line.

How Frank dies in the game

Neither Bill nor Frank have a happy ending in the game. When you meet Bill, Joel and Ellie are in need of guidance and supplies and as a player, you have to navigate your way through Bill’s traps. Joel and Ellie end up alerting a pack of Infected and Bill comes to the rescue.

The Last of Us
Courtesy of Naughty Dog/Sony.

After the chaos dies down and Joel explains his mission to protect Ellie as they venture across the country, Bill mentions Frank but doesn’t go much into detail about the nature of their relationship. “Once upon a time, I had somebody that I cared about, it was a partner, somebody I had to look after. And in this world that sort of shit is good for one thing, gettin’ ya killed,” he says.

Not long after, the three of them find a decomposing body hanging from a rope. Bill is visibly upset but tries to remain composed. He confirms the body is Frank—“He was my partner, he’s the only idiot that would wear a shirt like that”—and notices the body has been bitten by Infected. Joel theorizes that Frank hung himself after becoming infected, though a nearby suicide note suggests the pair had a falling out—“I want you to know I hated your guts,” Frank wrote. Joel and Ellie drop Bill off after another Infected attack and we never see him again, though he is mentioned a few more times in both The Last of Us Part I and the sequel.

Watch The Last of Us on HBO Max. New episodes air at 9 p.m. on Sundays.

The Last of Us on PlayStation 5

The Last of Us
The Last of Us. Amazon

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