Ok so, I am definitely not a medical expert. But I do really enjoy researching these things, and getting to apply it to my hyperfixation makes it even better. I tried using reliable sources as much as possible. So here y’all go, more of this shit. Sorry if some of y’all aren’t into this kinda post, this is definitely self-indulgence.
Also, if you notice any incorrect information on this, lemme know. This is mainly just my findings so there could be misinformation.
This is a whole ass excuse for me to excitedly ramble about medical stuff
Gotta start off by saying, during this I learned CIPA is a distinct form of Congenital Insensitivity to Pain. However, I assumed Toby also has CIPA so that’s what this post will be based on.
CIPA is not just defined by an inability to feel pain, but also an inability to sweat, which is what the A stands for (anhidrosis). This is what leads to those dangerously high fevers (hyperpyrexia) and seizures brought on by overheating (febrile seizures). Though sometimes these fevers happen without explanation.
I have looked at multiple sources, but some of them conflict a bit when it comes to the ability to feel temperature. Like, they definitely can’t feel when they are burning themselves, for example. However, this might also be because CIPA is a distinct form of congenital insensitivity to pain. Like, the U.S. National Library of Medicine states on their CIP page that they can distinguish hot and cold, but their CIPA page says they can’t feel temperature at all. After looking around for a bit, I think they can somewhat feel temperature, but it is very impaired. A study on NCBI states that it’s characterized by no feeling of discomfort related to temperature and consistent errors in distinguishing between hot and cold moist substances.
Back to Toby. Boy chewed clean through his cheek, which yeah, accidental amputation/self-mutilation is a thing frequently seen in people with CIPA. Usually tongues, lips, fingers. We also know he chews at his fingers, but he has never bitten them off. Come to think of it, this might be why I hc him as a chewer.
I also think it might be important to highlight that Toby’s inability to feel pain is only beneficial in certain ways, and it definitely isn’t a superpower. Like yeah, he won’t feel a slap to the face or most other relatively harmless attempts from his victims to defend themselves. But he won’t exactly notice a knife lodged into his sides either. Not only that, but anything internal will go unnoticed as well. If his appendix bursts he won’t have any idea. Pain is meant as a warning system and he doesn’t have that. Considering how physical and dangerous his job is to begin with I imagine slender can heal him/keep him alive anyways. This is also something I think is the case because people with CIPA heal slowly from bone and skin injuries, which can lead to bone infections and a condition called charcot joints (WARNING BEFORE YOU LOOK THIS UP: pictures of this are gnarly).
His goggles are probably useful because of his CIPA as well, eye injuries are common.
A very large number of people with CIPA have an intellectual disability, which Toby does not have. However, about half show signs of hyperactivity and/or emotional instability, both of which Toby seems to possess, at least in his fandom characterizations. I am not actually sure where the hyperactivity aspect of his personality came from, but it kinda fits him in this way. As for emotional instability,, well,,,, yeah.
Mentioned this before, but Toby likely wouldn’t feel hunger pains, which can make eating feel like a chore and makes it easy to accidentally skip a meal. His sense of taste is unaffected, though.
For sources I used the U.S. National Library of Medicine, two NCBI studies, and some case studies. I tried-
